MEMORANDUM

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, 2014, these premiums will change; the new premiums range from a minimum of $14 to a maximum based on family size and gross income, not to exceed 5% of the family's gross income. A premium chart with an effective date of July 1, 2014 is attached.

The MHD Premium Collections Unit is including an advance notice of the upcoming change to premiums with invoices mailed June 2014 to all eligible premium group families. 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.

Both the Family Assistance Management Information System (FAMIS) and the Missouri Eligibility Determination and Enrollment System (MEDES) will send copies of the attached IM-4(PRM) with MO HealthNet CHIP premium group approval letters beginning July 1, 2014 for MO HealthNet for Kids premium households.  A hard copy version will not be produced. The initial premium for families approved in June will be based on the April 2014 premium schedule.

NOTE: Manual IM-80 Adverse Action Notices were mailed on June 20, 2014 to all MEDES CHIP households requiring premium adjustments.

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:

• Review this memorandum with appropriate staff.

ATTACHMENTS:

• IM-4 (PRM)
• IM-80

AC/df