Hedlund Agency Insurance Updates

Medicaid and CHIP

Fri, 26 Mar 2010 16:20:59 -0700

If you are eligible for health coverage from your employer, but are unable to afford the premiums, some States have premium assistance programs that can help pay for coverage. These States use funds from their Medicaid or CHIP programs to help people who are eligible for employer-sponsored health coverage, but need assistance in paying their health premiums.

If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, you can contact your State Medicaid or CHIP office to find out if premium assistance is available.

If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, you can ask the State if it has a program that might help you pay the premiums for an employer-sponsored plan.

Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP, your employer�s health plan is required to permit you and your dependents to enroll in the plan � as long as you and your dependents are eligible, but not already enrolled in the employer�s plan. This is called a �special enrollment� opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance.

If you live in one of the following States, you may be eligible for assistance paying your employer health plan premiums. The following list of States is current as of February 16, 2010. You should contact your State for further information on eligibility � ALABAMA � Medicaid CALIFORNIA � Medicaid

Website: http://www.medicaid.alabama.gov

Phone: 1-800-362-1504

Website: http://www.dhcs.ca.gov/services/Pages/
TPLRD_CAU_cont.aspx

Phone: 1-866-298-8443

ALASKA � Medicaid COLORADO � Medicaid and CHIP

Website: http://health.hss.state.ak.us/dpa/programs/medicaid/

Phone (Outside of Anchorage): 1-888-318-8890

Phone (Anchorage): 907-269-6529

Medicaid Website: http://www.colorado.gov/

Medicaid Phone: 1-800-866-3513

CHIP Website: http:// www.CHPplus.org

CHIP Phone: 303-866-3243

ARIZONA � CHIP

Website: http://www.azahcccs.gov/applicants/default.aspx

Phone: 602-417-5422

ARKANSAS � CHIP FLORIDA � Medicaid

Website: http://www.arkidsfirst.com/

Phone: 1-888-474-8275

Website: http://www.fdhc.state.fl.us/Medicaid/index.shtml

Phone: 1-866-762-2237

GEORGIA � Medicaid MONTANA � Medicaid

Website: http://dch.georgia.gov/

Click on Programs, then Medicaid

Phone: 1-800-869-1150

Website: http://medicaidprovider.hhs.mt.gov/clientpages/
clientindex.shtml

Telephone: 1-800-694-3084
IDAHO � Medicaid and CHIP NEBRASKA � Medicaid

Medicaid Website: www.accesstohealthinsurance.idaho.gov

Medicaid Phone: 208-334-5747

CHIP Website: www.medicaid.idaho.gov

CHIP Phone: 1-800-926-2588

Website: http://www.dhhs.ne.gov/med/medindex.htm

Phone: 1-877-255-3092

INDIANA � Medicaid NEVADA � Medicaid and CHIP

Website: http://www.in.gov/fssa/2408.htm

Phone: 1-877-438-4479

Medicaid Website: http://dwss.nv.gov/

Medicaid Phone: 1-800-992-0900

CHIP Website: http://www.nevadacheckup.nv.org/

CHIP Phone: 1-877-543-7669

IOWA � Medicaid

Website: www.dhs.state.ia.us/hipp/

Phone: 1-888-346-9562

KANSAS � Medicaid NEW HAMPSHIRE � Medicaid

Website: https://www.khpa.ks.gov

Phone: 785-296-3981

Website: http://www.dhhs.state.nh.us/DHHS/
MEDICAIDPROGRAM/default.htm

Phone: 1-800-852-3345 x 5254

KENTUCKY � Medicaid NEW JERSEY � Medicaid and CHIP

Website: http://chfs.ky.gov/dms/default.htm

Phone: 1-800-635-2570

Medicaid Website: http://www.state.nj.us/humanservices/
dmahs/clients/medicaid/

Medicaid Phone: 1-800-356-1561

CHIP Website: http://www.njfamilycare.org/index.html

CHIP Phone: 1-800-701-0710

LOUISIANA � Medicaid

Website: www.dhh.louisiana.gov/offices/?ID=92

Phone: 1-888-342-0555

MAINE � Medicaid NEW MEXICO � Medicaid and CHIP

Website: http://www.maine.gov/dhhs/oms/

Phone: 1-800-321-5557

Medicaid Website: http://www.hsd.state.nm.us/mad/index.html

Medicaid Phone: 1-888-997-2583

CHIP Website:

http://www.hsd.state.nm.us/mad/index.html

Click on Insure New Mexico

CHIP Phone: 1-888-997-2583

MASSACHUSETTS � Medicaid and CHIP

Medicaid & CHIP Website: http://www.mass.gov/MassHealth

Medicaid & CHIP Phone: 1-800-462-1120

MINNESOTA � Medicaid NEW YORK � Medicaid

Website: http://www.dhs.state.mn.us/

Click on Health Care, then Medical Assistance

Phone: 800-657-3739

Website: http://www.nyhealth.gov/health_care/
medicaid/

Phone: 1-800-541-2831

MISSOURI � Medicaid NORTH CAROLINA � Medicaid

Website: http://www.dss.mo.gov/mhd/index.htm

Phone: 573-751-6944

Website: http://www.nc.gov

Phone: 919-855-4100

NORTH DAKOTA � Medicaid UTAH � Medicaid

Website: http://www.nd.gov/dhs/services/medicalserv/medicaid/

Phone: 1-800-755-2604

Website: http://health.utah.gov/medicaid/

Phone: 1-866-435-7414

OKLAHOMA � Medicaid VERMONT� Medicaid

Website: http://www.insureoklahoma.org

Phone: 1-888-365-3742

Website: http://ovha.vermont.gov/

Telephone: 1-800-250-8427

OREGON � Medicaid and CHIP VIRGINIA � Medicaid and CHIP

Medicaid Website: http://www.oregon.gov/DHS/healthplan/index.shtml

Medicaid Phone: 1-800-359-9517

CHIP Website: http://www.oregon.gov/DHS/healthplan/app_benefits/

ohp4u.shtml

CHIP Phone: 1-800-359-9517

Medicaid Website: http://www.famis.org/

Medicaid Phone: 1-800-432-5924

CHIP Website: http://www.famis.org/

CHIP Phone: 1-866-873-2647

PENNSYLVANIA � Medicaid WASHINGTON � Medicaid

Website: http://www.dpw.state.pa.us/partnersproviders/medicalassistance/doingbusiness/003670053.htm

Phone: 1-800-644-7730

Website: http://ihrsa/sites/DCS/COB/default.aspx

Phone: 1-800-562-6136

RHODE ISLAND � Medicaid WEST VIRGINIA � Medicaid

Website: www.dhs.ri.gov

Phone: 401-462-5300

Website: http://www.wvrecovery.com/hipp.htm

Phone: 304-342-1604

SOUTH CAROLINA � Medicaid WISCONSIN � Medicaid

Website: http://www.scdhhs.gov

Phone: 1-888-549-0820

Website: http://dhs.wisconsin.gov/medicaid/publications/p-10095.htm

Phone: 1-800-362-3002

TEXAS � Medicaid WYOMING � Medicaid

Website: https://www.gethipptexas.com/

Phone: 1-800-440-0493

Website: http://www.health.wyo.gov/healthcarefin/index.html

Telephone: 307-777-7531

To see if any more States have added a premium assistance program since February 16, 2010, or for more information on special enrollment rights, you can contact either:

U.S. Department of Labor U.S. Department of Health and Human Services

Employee Benefits Security Administration Centers for Medicare & Medicaid Services

www.dol.gov/ebsa www.cms.hhs.gov

1-866-444-EBSA (3272) 1-877-267-2323, Ext. 61565

OMB Control Number 1210-0137 (expires 07/31/2010)

Cobra Updates

Thu, 2 Apr 2009 20:00:00 -0700

The American Recovery and Reinvestment Act of 2009 (ARRA) provides for a 65% reduction in COBRA premiums for certain assistance eligible individuals for up to 9 months. An assistance eligible individual is a COBRA "qualified beneficiary" who meets all of the following requirements:

Is eligible for COBRA continuation coverage at any time during the period beginning September 1, 2008 and ending December 31, 2009;

Elects COBRA coverage⟨when first offered or during the additional election period)

Has a qualifying event for COBRA coverage that is the employee�s involuntary termination during the period beginning September 1, 2008 and ending December 31, 2009.

An example of involuntary termination would include layoffs or terminations, but not terminations do to gross misconduct.

An example of a voluntary termination would include an employee terminating his employment.

Those who are eligible for other group health coverage (such as a spouse's plan) or Medicare are not eligible for the premium reduction. Other limitations may also apply, such as income. There is no premium reduction for periods of coverage that began prior to February 17, 2009.

Under the stimulus bill 65 percent of COBRA premiums are subsidized for people laid off between September 1, 2008, and December 31, 2009. The subsidy is limited to nine months and available only to those without another source of group health insurance. Individuals who lost jobs after September 1, 2008, but who didn't sign up for COBRA at the time will get a second chance to do so. Employers must provide their former workers with a notice by mid-April. Individuals who receive these notices will then have 60 days to sign up for the subsidy.

Model notices are available at http://www.dol.gov/ebsa/. Employers must have the new notices out to employees by mid April.

PREMIUMS ARRA treats assistance eligible individuals who pay 35 percent of their COBRA premium as having paid the full amount. The premium reduction (65 percent of the full premium) is reimbursable to the employer, insurer or health plan as a credit against certain employment taxes. If the credit amount is greater than the taxes due, the Secretary of the Treasury will directly reimburse the employer, insurer or plan for the excess.

Federal Cobra Laws apply to all employer groups with 20 or more employees. Wisconsin Continuation Law applies to all fully insured Wisconsin Employers with two or more employees.

We do know now that the ARRA, American Recovery and Reinvestment Act of 2009,does apply to Wisconsin Continuation plans. The commissioner of insurance web site does not have any new information on this so far. But we will continue to watch for forms and their interpretations.

This is what we do know so far. The look back period to September 1, of 2008, does not apply to the mini Cobra or Wisconsin Continuation plans. It seems to only apply to members having an involuntary layoff after February 1, whom are in their 30 day election period. In this example, the member is laid off on February 1, 2009; they have a 30 day right to consider their continuation option. If they elect continuation for the month of February, they will be eligible for the subsidy beginning March 1, 2009. Note: They must elect and pay for the month of February to get coverage subsidy for March 1, 2009.

ARRA gives assistance eligible people a new 60 day right to consider Cobra. This rule does not seem to apply to Wisconsin continuation, which allows for a 30 day right to consider their option of continuing coverage.

Cobra / ARRA Update

Some additional examples have been provided to help determine Assistance Eligible Individuals (AEI).

An Employee passes away: Dependents not AEI

Employee is reduced to less than 30 hours per week: May lose eligibility for coverage and be entitled to COBRA and also the AEI. So if an employee is reduced to 25 hours a week, they may lose eligibility for the insurance and qualify for COBRA and the the subsidy. Representatives from IRS have stated that if a person is reduced to 1 hour a week, they clearly cannot afford the premium and would be considered eligible as an AEI.