IM-112 HEALTH INSURANCE PREMIUM PAYMENT (HIPP) APPLICATIONS UPDATED IN FORMS MANUAL

Department of Social Services
Family Support Division
PO Box 2320
Jefferson City, Missouri

TO:  ALL FAMILY SUPPORT OFFICES

FROM:  KIM EVANS, DIRECTOR

SUBJECT:  HEALTH INSURANCE PREMIUM PAYMENT (HIPP) APPLICATIONS UPDATED IN FORMS MANUAL

FORM REVISION #18

HIPP-1

HIPP-1 (Spanish)

HIPP-A

HIPP-A (Spanish)

DISCUSSION:

The purpose of this memo is to notify staff that the following HIPP applications have been updated in the Forms Manual:

The updated forms are dated August 2019.  Any HIPP forms with previous dates should be destroyed.

 

NECESSARY ACTION:

  • Review this memorandum with appropriate staff.
  • Destroy all HIPP forms prior to the 8/2019 date.

 

KE/df