Section 405IAC10-10-6. POWER account balance; termination and disenrollment

   (a) If a member loses plan eligibility due to nonpayment of POWER account contributions as specified in section 12 of this rule, the member shall be paid only a portion of the balance remaining in the member's POWER account as calculated in subsection (b).

  (b) If a member loses plan eligibility for reasons set forth in subsection (a), the member refund shall be calculated as follows:

(1) Divide the total contributions made on the member's behalf in accordance with section 4(b) of this rule during the current benefit period by the total amount paid into the POWER account from all sources.

(2) Multiply the ratio calculated in subdivision (1) by the total amount remaining in the individual's POWER account.

(3) Subtract member debt, if any, as calculated under section 7 of this rule.

(4) Multiply the amount calculated in subdivision (3) by seventy-five hundredths (.75) to determine the amount to be returned to the individual.

  (c) If a member loses plan eligibility for reasons other than those set forth in subsection (a), the member shall be paid a portion of the balance remaining in the member's POWER account, calculated as follows:

(1) Divide the total contributions made on the member's behalf in accordance with section 4(b) of this rule during the current benefit period by the total amount paid into the POWER account from all sources.

(2) Multiply the amount calculated in subdivision (1) by the total amount remaining in the member's POWER account to determine the amount to be returned to the individual.

(3) Subtract member debt, if any, as calculated under section 7 of this rule.

  (d) The insurer shall return the amount calculated in subsection (b) or (c) to the member within sixty (60) days of the last date that the individual was a member in the plan. The former member shall be liable for the POWER account portion of any claims for covered services with dates of service occurring during the prior benefit period but after the POWER account balance has been paid to the former member. The former member shall not be liable for claims originally denied but overturned on appeal if the appealed claim is paid more than sixty (60) days following the member's last date of participation in the plan.

  (e) After payment to the member of the amount calculated in subsection (b) or (c), the state shall retain any remaining POWER account balance.

  (f) In the event that a member:

(1) cannot be located; or

(2) otherwise does not claim the amount calculated in subsection (b) or (c);

such amount shall be treated as unclaimed property and shall be subject to the Unclaimed Property Act, IC 32-34-1. (Office of the Secretary of Family and Social Services; 405 IAC 10-10-6; filed May 18, 2015, 12:34 p.m.: 20150617-IR-405140339FRA)