First Health will include a notice of the change in premiums with the June invoices mailed June 1, 2002 for those active premium group families.  Premiums paid in June for July coverage will not change.  Premiums collected in July for August coverage will be in the new amounts.

The IM-4(PRM),(pdf) MC+ Premium Amounts Based On Family Size and Income, is being revised and an initial supply will be sent once produced.  It will be necessary to make copies of the attached IM-4(PRM) for MC+ approvals for July in the premium group.

Effective July 1, 2002 First Health will no longer be responsible for premium collections.  The Premium Collections Unit with Division of Medical Services will be responsible for collections.  The toll-free number has not changed.  Continue to refer inquiries concerning premium payments to 1-877-888-2811.

Hearing requests will be handled by DFS using normal hearing procedures.  Evidence presented at an appeal of a premium amount should include a copy of the invoice from First Health, copy of the budget used to arrive at a monthly gross income and the IM-4 (PRM) reflecting premium amounts based on income. 

• Review this memorandum with appropriate staff.

• Copy the attached IM-4(PRM) for use until the new supply is received.

• Destroy the IM-4(PRM) with 06/01 date upon receipt of the revised form.

• File the revised IM-4(PRM) in the Forms Manual.

• File the revised manual sections in the Family Healthcare Manual