1. 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

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
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. Total 2007 Household Income
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
Total Number
in Household
Total 2007 Household Income 1
$22,462 2
$30,118 3
$37,774

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
Develop program timeframe
Establish eligibility guidelines
Material development: cover letter, application, Instructions, reminder notice, denial letter, & checks
Printer cost quotes for mailed materials & checks
Establish bank account and verify check format
1) Planning Process
(4 weeks)
Identify eligible enrollees
Eliminate ineligible enrollees
Mailing of applications in batches (3 batches to 23,000+ households)
Application and instructions available or downloading on web site
2)Application Mailing

9. Administrative Process
Develop enrollee Q & A’s for each phase of the program (available on web site)
Address application inquiries, processing questions and check and denial inquiries
Staff available from date application is mailed through duration of the program
3) Helpline staff/customer service
Reminder Notice – increases participation
Update address changes
Reminder Notice mailed 3 weeks following application mailing
4) “Reminder” Notice Mailing

10. Administrative Process
Establish clear deadline date using postmarked date
No applications accepted after deadline
Allow U.S. Mailed applications only
Allow 3-4 weeks for application completion and mailing
5)Application Deadline
Process applications per qualifying criteria
Identify those who qualify/those who do not
Extranet access by helpline/customer service staff to track status
Begins when first applications are received & completed 3 weeks following deadline
6)Application Processing

11. Administrative Process
Identify enrollees who qualify
Deposit funds/mail checks
Allow enrollees days to cash checks
Letters/calls regarding non cashed checks
Stop payment issued after a defined timeline
Reissuance of checks only due to theft
7) Issuing checks
Identification of the those that did not qualify
Letters mailed with reason for denial
Identify that “all decisions are final” – there is no appeal process
Extranet updated with denial reason
8) Denial Notices

12. Summary of Results 2005 2006 2007 # Applications Mailed 26,885 24,000
24,709
Program Application Timeframe
July-August
February-March
May-June
Income Tax Year
2004
Income Cut Off
180% FPL
200% FPL
# Applications Rec’d
1,860
2,688
2,406
# Of Enrollees Who Qualified
1,558
1,392 newly qualified
1,315 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
Average Check Amt. Per Member
$171.40
$857.69
$716.08
# Denied
302 (16.2%)
440 (25%)
566 (19%)

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