MEMORANDUM

DISCUSSION:

Effective April 1, 2015, the affordability standard for Children's Health Insurance Program (CHIP) premium families is changed with the increase to the Federal Poverty Level (FPL) income guidelines. The affordability standard is based upon a percentage of income for a family of three at 150%, 185%, or 225% of the FPL, depending upon the family's gross income.

Effective April 1, 2015, families with income between 150% and 300% of the FPL with access to health insurance must meet the following affordability guidelines:

• 151% - 185% of the FPL (CHIP 73) = $75/month
• 186% - 225% of the FPL (CHIP 74) = $123/month
• 226% - 300% of the FPL (CHIP 75) = $188/month

NOTE:  Consider all state agencies where health insurance is available to their employees as affordable regardless of the cost of the health insurance.

Applications and Interim Changes

On the weekend of March 14, 2015, the MO HealthNet programs with income eligibility based on federal poverty level are adjusted in FAMIS. FAMIS adjusts active cases, based on the new affordability standard. For cases with no outstanding verification or other outstanding issues at the time of the adjustment, the system authorizes the action(s). Notices are sent on all actions except actions that resulted in no change (NOCH in FAMIS).

For FAMIS determinations created on or after March 16, 2015, FAMIS will use the new affordability standard effective for April 2015. For determinations effective March 2015 and earlier, FAMIS will apply the previous affordability standard.

NECESSARY ACTION:

• Apply the new affordability standards for April 2015 and later.
• Review this memorandum with appropriate staff.

AC/mks