2008 NASCHIP Conference October 16, 2008 Minnesota’s Low Income Subsidy Program

1. 2008 NASCHIP ConferenceOctober 16, 2008 Minnesota’s Low Income Subsidy Program Presented by: Peggy Zimmerman-Belbeck, MCHA Kris Messner, Medica Jeanne Ripley, Halleland Health Consulting

2. Today’s Objectives • Provide an overview of MN’s Low Income Subsidy Program • Eligibility & qualifying criteria • Administrative issues and processes • Program results • Lessons learned • Questions and discussion

3. Overview • 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

4. Eligibility Criteria • 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

5. Qualifying Criteria • 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

6. Administrative Issues/Guidelines • 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

7. Administrative Process • 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

8. Administrative Process

9. Administrative Process

10. Administrative Process

11. Administrative Process

12. Summary of Results

13. Lessons Learned • 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)

14. Questions and Discussion