DISCUSSION:

Premiums are required for families with income above 150% of the Federal Poverty Level (FPL). Each year, the MO HealthNet Division (MHD) establishes the new premium amounts, by rule, for these families. Effective July 1, 2008, these premiums will change; the new premiums range from a minimum of $12 to a maximum based on family size and gross income, not to exceed 5% of the family's gross income. Senate Bill 577 (2007) removed the use of the statewide weighted average of the Missouri Consolidated Health Care Plan in determining the maximum premium range.

The new premiums effective July 1, 2008, are as follows:

• Families with gross income above 150% up to and including 185% of the FPL (CHIP 73) 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 (CHIP 74) 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 (CHIP 75) 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 plus
  • 14% of monthly income between 225% and 300% of the FPL for the family size, but
  • the total monthly premium is not to exceed 5% of the family's gross income.

The MHD Premium Collections Unit is including an advance notice of the upcoming change to premiums with invoices mailed May 2008 through June 2008 to all eligible premium group families. A copy of the MO HealthNet 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.

NOTE: The MO HealthNet Premium Change Notice and IM-4(PRM) are for the projected time period of July 1, 2008 through March 31, 2009, as MHD is anticipating a change to the effective start date for the annual premium adjustment.

FAMIS will send copies of the attached IM-4(PRM) with MO HealthNet SCHIP premium group approval letters beginning July 1, 2008 for MO HealthNet for Kids premium eligibility units (EU's). A hard copy version is not being produced. The initial premium for families approved in June will be based on the 2007 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 07/07 date on July 1, 2008.

• Review this memorandum with appropriate staff.

LH

ATTACHMENTS:

• IM-4(PRM)

• MO HealthNet Premium Change Notice