MEMORANDUM
2004 Memorandums
IM-56      06/09/2004
SUBJECT:
MC+ PREMIUM INCREASES
FORMS MANUAL REVISION #9:  IM-4(PRM)
MANUAL REVISION #12: SECTIONS 0920.020.10.05 AND 0920.020.15
DISCUSSION:
Effective July 1, 2004 the premiums for MC+ for Children with income above 225% of the federal poverty level will change.  The new premiums will range from a minimum of $62 to a maximum of $252.  The maximum premium is based on the Missouri Consolidated Health Care Plan member’s average rate of $252 for the children’s portion of the premium.  Affordable healthcare coverage will be $335 per month effective July 1, 2004.

The Premium Collections Unit included an advance notice of the change in premiums with the invoices mailed June 1, 2004 for those active premium group families.  Premiums paid in June for July coverage will not change.  Premiums collected in July for August coverage will be in the new amounts.  Questions concerning premiums should be referred to the Premium Collections Unit at 1-877-888-2811.

The IM-4(PRM), MC+ Premium Amounts Based on Family Size and Income, is being revised and an initial supply will be sent once produced.  It will be necessary to make copies of the attached IM-4(PRM) for MC+ approvals for July in the premium group.

Hearing requests will be handled by FSD using normal hearing procedures.  Evidence presented at an appeal of a premium amount should include a copy of the invoice from the Premium Collections Unit, copy of the budget used to arrive at the monthly gross income and the IM-4(PRM) reflecting premium amounts based on income.

 
NECESSARY ACTION:
  • Review this memorandum with appropriate staff.
  • Copy the attached IM-4 (PRM) pdf file for use until the new supply is received.
  • Destroy the IM-4(PRM) with the 06/03 date upon receipt of the revised form.
  • File a copy of the revised IM-4(PRM) in the Forms Manual.
CW