SUBJECT:
MC+ PREMIUM INCREASES
FORMS MANUAL REVISION #4: IM-4(PRM)
MANUAL REVISION #20: SECTIONS 0920.020.10.05 AND 0920.020.15
DISCUSSION:
Effective July 1, 2005, the premiums for MC+ for Children with income above 225% of the federal poverty level will change. The new premiums will range from a minimum of $65 to a maximum of $257. The maximum premium is based on the Missouri Consolidated Health Care Plan member's average rate of $257 for the children's portion of the premium. Affordable healthcare coverage will be $342 per month effective July 1, 2005.
The Premium Collections Unit included an advance notice of the change in premiums with the invoices mailed June 1, 2005, for the active premium group families. Premiums paid in June for July coverage will not change. Premiums collected in July for August coverage will reflect the new premiums. Questions concerning premiums should be referred to the Premium Collections Unit at 1-877-888-2811.
It is necessary to make copies of the attached IM-4(PRM) to include with MC+ premium group approval letters beginning July 1, 2005. A hard copy version is not being produced at this time. The initial premium for families approved in June will be based on the 2004 premium schedule.
Hearing requests for the yearly adjustment will be handled by the Family Support Division using normal hearing procedures. Evidence presented at an appeal of a premium amount should include a copy of the invoice from the Premium Collections Unit, copy of the budget used to arrive at the monthly gross income and the IM-4(PRM) reflecting the premium amounts based on income.
NOTE: This memorandum only addresses the annual adjustment of the CHIP premiums; it does not address the changes that resulted from legislative/budget changes. A separate memo will be sent at a later date regarding the additional changes in the CHIP program.
NECESSARY ACTION:
- 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 the 06/04 date on July 1, 2005.
- File a copy of the revised IM-4(PRM) in the Forms Manual.