| TO: | ALL COUNTY OFFICES |
| FROM: | JANEL R. LUCK, DIRECTOR |
| SUBJECT: | MC+ PREMIUM CHANGE |
DISCUSSION:
Premiums are required for families with income above 150% of the Federal Poverty Level (FPL). Each year, the Division of Medical Services (DMS) establishes the new premium amounts, by rule, for these families. Effective July 1, 2007, these premiums will change; the new premiums range from a minimum of $12 to a maximum of $294 and are based on gross income. The new premiums effective July 1, 2007, are as follows:
Families with gross income above 150% up to and including 185% of the FPL are responsible for a monthly premium equal to 4% of monthly income between 150% and 185% of the FPL for the family size.
Families with gross income above 185% up to and including 225% of the FPL are responsible for a monthly premium equal to 4% of monthly income between 150% and 185% of the FPL for the family size plus 8% of monthly income between 185% and 225% of the FPL for the family size.
Families with gross income above 225% up to and including 300% of the FPL are responsible for a monthly premium equal to the statewide weighted average premium required for the child(ren) by the Missouri Consolidated Health Care Plan, not to exceed 5% of the families gross income. The new statewide weighted average premium for children, required by the Missouri Consolidated Health Care Plan, is $294.
The DMS Premium Collections Unit included an advance notice of the upcoming change to premiums with invoices mailed May 2007 through June 2007 to all eligible premium group families. A copy of the MC+ premium change notice 
is attached for information purposes only. Premiums paid in June for July coverage will not change. Premiums invoiced 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, 2007 for MC+ cases in Legacy. FAMIS will send the revised IM-4(PRM) with MC+ premium group approval letters for those cases that have been converted. A hard copy version is not being produced. The initial premium for families approved in June will be based on the 2006 premium schedule.
Hearing requests for the premium change will be handled by the Family Support Division using normal hearing procedures. Evidence presented at the hearing must include a copy of the invoice from the Premium Collections Unit, a copy of the budget used to arrive at the monthly gross income, and the IM-4(PRM) reflecting the premium amounts based on income.
NECESSARY ACTION:
-
Copy the attached IM-4(PRM)
for use until the revised copy is posted online. -
Destroy the IM-4(PRM) with the 07/06 date on July 1, 2007.
- Review this memorandum with appropriate staff.