Haw. Code R. § 17-1709.3-22

Current through November, 2024

Section 17-1709.3-22 - Recoupment

(a) An eligible employer shall face a penalty if the eligible employer:

(1) Released a qualified employee before the end of the reimbursement period;

(2) Released a qualified employee before the end of the maintenance period; or

(3) Intentionally provided false information about the qualified employee or eligible employer, or both.

(b) The penalty shall be recoupment of an amount equal to:

(1) For subsection (a)(1), the total amount of the premium subsidy paid to the eligible employer for the affected qualified employee.

(2) For subsection (a)(2), the amount of premium subsidy paid for the number of months equivalent to the number of full or partial months remaining in the maintenance period.

(3) For subsection (a)(3), the amount determined by applying paragraphs (1) or (2), or both.

(c) An eligible employer shall not be subject to a penalty of recoupment according to subsection (a)(1) or (a)(2) in the following situations:

(1) The qualified employee voluntarily terminates employment;

(2) The qualified employee is released for cause. Causal situations include, but are not limited to, the following:

(A) Unexcused absence or recurring unexcused tardiness;

(B) Altercation at work;

(C) False statements by the qualified employee to the eligible employer (including false information provided by the qualified employee for the application to enroll the employee in Hawaii premium plus);

(D) Qualified employee's gross neglect of duty;

(E) Qualified employee's willful disobedience of eligible employer's directives or qualified employee's insubordination;

(F) Intentional conversion of eligible employer's property by the qualified employee;

(G) Qualified employee's unauthorized use of intoxicants on the job;

(H) Qualified employee's willful and substantial abuse of the eligible employer's equipment or property;

(I) Lack of work as a result of the state of the economy; or

(J) Other situations approved by the department; or

(3) The program is terminated as described in section 17-1709.3-21.

(d) An eligible employer shall be subject to recoupment in the amount pro rated for the period during which a premium subsidy was paid but the qualified employee was not receiving health insurance through the eligible employer.

(e) If an eligible employer fails to meet the reporting requirements as described in section 17-1709.3-18, the eligible employer may be subject to a penalty of recoupment of an amount up to the amount of premium subsidy paid for the number of months equivalent to the number of months for which the reporting requirement was not met.

(f) The eligible employer must provide all requested information and documentation within the specified timeframe or may be subject to a penalty of recoupment of an amount up to the amount of premium subsidy paid for the number of months equivalent to the number of months for which the information or documentation request was not met.

(g) If an eligible employer is terminated from participation in Hawaii premium plus as described in section 17-1709.3-12, the eligible employer shall be subject to recoupment as described in subsection (b) for each qualified employee as if that qualified employee was released.

Haw. Code R. § 17-1709.3-22

[Eff 09/17/10] (Auth: HRS §§ 346-14, 346-26) (Imp: HRS §§ 346-14, 346-26)