The purpose of this memorandum is to introduce CHIP premium adjustment effective July 1, 2017. Premiums are required for families with income above 150% of the Federal Poverty Level (FPL). Each year, as required by state statute, the MO HealthNet Division (MHD) establishes the new premium amounts. 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, 2017 is attached.
The MHD Premium Collections Unit is including an advance notice of the upcoming change to premiums with invoices mailed July 2017 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.
Hearings requested as a result of the premium change will be conducted by the MO HealthNet Division (MHD) using normal hearing procedures. Refer participants to the MHD Participant Services number: (800) 392-2161.
Hearings requested as a result of a change in income or household composition that affect the premium will be conducted by the Family Support Division. If a hearing is requested on any of these cases, please complete the Application for State Hearing (IM-87) form. Send this completed form and any exhibits to the Hearing Unit following the guidelines in the FSD Administrative Hearing Document Indexing Instructions.
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.
NOTE: The Adverse Action and Action Notices for these CHIP cases can be found in the Missouri Eligibility Determination and Enrollment System (MEDES).
- Review this memorandum with appropriate staff.