2008 naschip conference october 16, 2008 minnesota’s low income subsidy program
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2008 NASCHIP Conference October 16, 2008 Minnesota’s Low Income Subsidy Program. Presented by: Peggy Zimmerman-Belbeck, MCHA Kris Messner, Medica Jeanne Ripley, Halleland Health Consulting. Today’s Objectives. Provide an overview of MN’s Low Income Subsidy Program - PowerPoint PPT PresentationTRANSCRIPT
Presented by:Peggy Zimmerman-Belbeck, MCHAKris Messner, MedicaJeanne Ripley, Halleland Health Consulting
Provide an overview of MN’s Low Income Subsidy Program
Eligibility & qualifying criteria Administrative issues and processes Program results Lessons learned Questions and discussion
Low Income Subsidy Program funding from the Federal Grant opportunity–Consumer Bonus Grant
Oversight by Board of Directors Subcommittee
Subcommittee recommendations to the Board Program conducted 4 consecutive years
2005-2008 One time application process per year Based on household income and not tied to
premium paid
Must be an MCHA enrollee ◦ Enrollee’s whose premium is paid by 3rd party are
ineligible Completion of entire application- including
signature, etc. Provide information and documentation of
annual household income for ALL individuals in the household and
Provide information on household size Application must be postmarked by
deadline
MCHA enrollees qualify for the Low Income Subsidy if their total annual household income is at or below a defined percentage of the FPL for their household size (all house-hold members, not just MCHA enrollees)
2008 program based on 220% of FPL Total Number in Household
Total 2007 Household
Income
1 $22,462
2 $30,118
3 $37,774
HIPAA issues/protection of enrollee information Business associate agreements in place Program “buy in” of regulators Administrative expenses - from “operational”
grant funds so all bonus grant funds are distributed to enrollees
Initial program tied to premium - now divide total bonus grant funds by the number of qualifying enrollees
No appeal process – all decisions final No contacting enrollees for additional
information- decision based on application and documentation submitted
Utilize a project management approach Goal – conduct the program within a 6 month period
of time “Enrollee friendly” approach – yet maintain strict
criteria to assure a “fair” process Coordination and communication Key participants:
◦ MCHA – Oversight of the program
◦ Halleland Health Consulting (HHC) – Responsible for managing the application and screening process
◦ Medica (Writing Carrier) – Responsible for all administrative functions and outside vendors (printer and check vendor, and banking functions)
◦ Wipfli- MCHA’s Accounting firm
2005 2006 2007# Applications Mailed
26,885 24,000 24,709
Program Application Timeframe
July-August February-March May-June
Income Tax Year 2004 2004 2006
Income Cut Off 180% FPL 180% FPL 200% FPL
# Applications Rec’d
1,860 2,688 2,406
# Of Enrollees Who Qualified
1,558 1,392 newly qualified1,315 prequalified-2005
2, 07 total
2,442
$ Distributed $267,039.81 $2,700,000 $2,000,000
Distribution Method
Based on monthly premium
paid
Total funds divided by # of qualifying enrollees
Total funds divided by # of qualifying
enrollees
Average Check Amt. Per Member
$171.40 $857.69 $716.08
# Denied 302 (16.2%) 440 (25%) 566 (19%)
Every year the process is refined & enhanced
Every year application format and instructions are enhanced
Every year the percent of FPL needs to be reviewed
Target enrollees who have difficulty paying premiums
Evaluate program for “unintended consequences” (Medicare population)
Questions and Discussion