Blue Cross Agreement Regulation

(Consolidated up to 26/2020) ALBERTA REGULATION 77/2006 Alberta Health Care Insurance Act BLUE CROSS AGREEMENT REGULATION Table of Contents 1 Definitions Part 1 Applicants for Enrolment 2 Enrolment as non‑group member 2.1 Former Part 2 members 3 New residents 4 Person who ceases to be a dependant 5 Transfer from group member 6 Transfer from other group insurance plan 7 Cancellation by resident 8 Cancellation by Minister Part 2 Enrolment by Minister 9 Application of Part 1 10 Enrolment of seniors 10.1 Cancellation of dependant membership Definitions 1 In this Regulation, (a) “Act” means the Alberta Health Care Insurance Act ; (b) “Alberta Blue Cross Plan” means the Alberta Blue Cross Plan operated by the ABC Benefits Corporation under the ABC Benefits Corporation Act and the regulations under that Act; (c) “date of receipt” means the date the applicant’s application under section 2 was received by the Minister; (d) “date of residency” means the date the applicant became a resident of Alberta; (e) “dependant”, except in section 4, means dependant as defined in the Alberta Health Care Insurance Regulation ; (f) “senior” means a person who is 65 years of age or older. AR 77/2006 s1;26/2020 Part 1 Applicants for Enrolment Enrolment as non‑group member 2 (1) A resident of Alberta who is not in arrears in the payment of premiums under the Health Insurance Premiums Act may apply to the Minister in the form established by the Minister to be enrolled, with the resident’s dependants, as a non‑group member of the Alberta Blue Cross Plan. (2) The effective date of membership of an applicant under subsection (1) is the first day of the 4th month following the date of receipt, unless section 3, 4, 5 or 6 applies. (3) The effective date of membership of an applicant’s dependants is the same as the effective date of membership of the applicant. Former Part 2 members 2.1 (1) If a resident has a dependant whose membership as a non-group member of the Alberta Blue Cross Plan has been cancelled pursuant to section 10.1, the resident may apply to the Minister to enrol the dependant as a non-group member under this Part. (2) If a resident has applied to the Minister under subsection (1) to enrol a dependant as a non-group member, the effective date of membership of an applicant’s dependant is (a) March 1, 2020, if the application is made no later than August 31, 2020, or (b) the first day of the 4th month following the date of receipt, if the application is made after August 31, 2020. AR 26/2020 s3 New residents 3 The effective date of membership of an applicant under section 2 is the first day of the 3rd month following the date of receipt if the applicant moved to Alberta (a) from another jurisdiction in Canada and the date of receipt falls before the first day of the 4th month following the date of residency, or (b) from a jurisdiction outside Canada and the date of receipt is not later than 3 months following the date of residency. Person who ceases to be a dependant 4 The effective date of membership of an applicant under section 2 is the date on which the applicant’s registration under the Health Insurance Premiums Act is effective if all of the following apply: (a) the applicant ceased to be a dependant under the Health Insurance Premiums Act and applied for registration under that Act; (b) the applicant requested an application form referred to in section 2 within one month after the date shown in the Minister’s records as the date that the applicant ceased to be a dependant under the Health Insurance Premiums Act ; (c) the date of receipt is not more than one month after the date the application form was given or mailed to the applicant; (d) the applicant’s eligibility for receipt of benefits under the Alberta Health Care Insurance Plan has not ceased since the date the applicant ceased to be a dependant under the Health Insurance Premiums Act . Transfer from group member 5 (1) Subject to subsection (2), the effective date of membership of an applicant under section 2 who wishes to transfer from enrolment as a group member of the Alberta Blue Cross Plan to enrolment as a non‑group member of the Alberta Blue Cross Plan is (a) the date on which the termination of the applicant’s enrolment as a group member is effective, or (b) if the applicant is notified of the termination of the applicant’s enrolment as a group member after the date on which the termination is effective, (i) the date on which the termination of the applicant’s enrolment as a group member was effective, or (ii) the first day of the 4th month following the date of receipt, whichever the applicant chooses. (2) Subsection (1) applies only if the date of receipt is not more than 30 days after the applicant is notified of the termination of the applicant’s enrolment as a group member. Transfer from other group insurance plan 6 (1) Subject to subsection (2), the effective date of membership of an applicant under section 2 who wishes to transfer from enrolment under a group insurance plan that in the Minister’s opinion is similar to the Alberta Blue Cross Plan to enrolment as a non‑group member of the Alberta Blue Cross Plan is the date on which the termination of the applicant’s coverage under the group insurance plan is effective. (2) Subsection (1) applies only if the date of receipt is not more than 30 days after the date on which the termination of the applicant’s coverage under the group insurance plan is effective. Cancellation by resident 7 A resident enrolled as a non‑group member of the Alberta Blue Cross Plan may notify the Minister to cancel the resident’s membership and the cancellation of the membership is effective on the last day of the month in which the Minister receives the notification. Cancellation by Minister 8 If a resident enrolled as a non‑group member of the Alberta Blue Cross Plan is in arrears in the payment of premiums under the Health Insurance Premiums Act or the regulations under that Act for a period longer than 3 months, the Minister shall cancel the resident’s membership as a non‑group member of the Alberta Blue Cross Plan. Part 2 Enrolment by Minister Application of Part 1 9 Part 1 does not apply to a resident enrolled as a non-group member of the Alberta Blue Cross Plan in accordance with this Part. Enrolment of seniors 10 (1) If a resident is a senior, the Minister shall enrol the resident as a non‑group member of the Alberta Blue Cross Plan. (2) The effective date of membership of a person enrolled under subsection (1) is (a) the date on which the registration for basic health services under the Health Insurance Premiums Act becomes effective, where the resident is a senior at the time of registration, (b) the first day of the first month following the 65th birthday of the resident, where that birthday occurs after the date on which the registration for basic health services becomes effective, or (c) the date of the 65th birthday of the resident, where that birthday falls on the first day of the month and occurs after the date on which the registration for basic health services becomes effective. (3) Entitlement to enrolment under subsection (1) ceases at the end of the 2nd month following the month in which the death of the resident occurs. AR 77/2006 s10;26/2020 Cancellation of dependant membership 10.1 If a person who is not a senior was enrolled as a non-group member of the Alberta Blue Cross Plan under this Part prior to March 1, 2020, as a dependant of a resident who is a senior, the Minister shall cancel the non-group membership of the person who is not a senior and the cancellation shall be effective March 1, 2020. AR 26/2020 s5 11 Repealed AR 194/2019 s3. Part 3 Repealed AR 4/2016 s2.