MEMORANDUM

DISCUSSION:

Memorandum IM#73 dated 9/25/2009 introduced Section 2110 of the Social Security Act which states "Children of state employees who are eligible to purchase state health insurance on their behalf are not eligible for MO HealthNet for Kids (MHK) Children's Health Insurance Program (CHIP) premium level of care."  The term "children of state employees" refers to all state agencies including state agencies that do not participate in the Missouri Consolidated Health Care Plan (MCHCP), but provide another health insurance source to their employees.

Example:  The Missouri Department of Transportation (MODOT) is a state agency that does not participant in MCHCP, however, provides health insurance to their employees.

An applicant with two children applies for MO HealthNet (MHN) and works part-time for MODOT. The applicant's income places the household at a CHIP73 level of care. The expense of purchasing the MODOT health insurance is $300.00 per month and therefore, the applicant chose not to purchase the insurance. The applicant's household is uninsured and has been for one year. The affordability issue is not a factor in this scenario because the applicant is a state employee who can purchase health insurance through their state employer.  The household is not eligible for CHIP premium level of care.

State employees who have access to state health insurance are not eligible for CHIP premium level of care.  Consider health insurance available to state employees even after open enrollment closes if the state employee had the option to purchase the state health insurance.

If a hearing is requested, contact Program and Policy (P&P) by e-mailing Cole.MHNPolicy@dss.mo.gov for direction.

NECESSARY ACTION:

• Review this memorandum with appropriate staff.
• Consider all state agencies where health insurance is available to their employees as affordable regardless of the cost of the health insurance.
• Contact P&P if a hearing is requested.

LH