M E M O R A N D U M

IM-181  12/12/00  REVISE MC+ PREM APPROV LTR FMR 43


SUBJECT:
REVISED MC+ PREMIUM APPROVAL LETTER
FORMS MANUAL REVISION #43:
IM-32PRM FORM AND INSTRUCTIONS
 
DISCUSSION:
The IM-32PRM, premium approval letter for MC+ children with income from 226% up to 300% of the Federal Poverty Level has been revised.  The following changes have been made to the letter:
  • A statement, including legal references, has been added explaining that income exceeds the maximum to receive coverage without paying a premium. 
  • A space has been added for the worker to fill in the current monthly premium payment
  • An IMPORTANT NOTICE section now addresses appeal rights of the claimant.
 
NECESSARY ACTION:
  • Review this memorandum with all appropriate staff.
  • Begin using the new IM-32PRM upon receipt
  • Destroy all old paper copies of the IM-32PRM.
  • File the IM-32PRM and instructions in the Form Manual.
  • Order additional supplies of IM-32PRM from the warehouse as needed.
  • Do not use the electronic IM-32PRM until the new revised form has been downloaded onto computer.
MJS
Distribution #2
[ Memorandum Table of Contents ]