Health Insurance Premium Payment (HIPP). The HIPP Program helps people get insurance or keep insurance they already have by paying for the premiums. Website: http:// Phone. Insurance Premium Payment Programs. Office of AIDS Health Insurance Premium Payment (OA-HIPP) Program. OA-HIPP is a subsidy program that pays monthly health insurance premiums for eligible clients. HEALTH INSURANCE PREMIUM PAYMENT HIPP for Kids (HFK) PROGRAM. Cost Sharing of Co-pays. HMS's TPL program includes cost avoidance. MEDICAID FACT SHEET #24 HEALTH INSURANCE PREMIUM PAYMENT PROGRAM (HIPP) FORM NUMBER - 032-03-842/2 PURPOSE OF FORM - The local agency workers may distribute this form to provide customers with basic policy information. Profiles in Coverage: Pennsylvania's HIPP Program. SCI talks with Joanne Slesser, the former director of Pennsylvania’s Health Insurance Premium Payment (HIPP) program. Questions and text prepared by: Isabel Friedenzohn, SCI associate. Pennsylvania’s Health Insurance Premium Payment (HIPP) program has emerged as an efficient and financially successful employer buy- in program. HIPP, established as Section 1. Medicaid statute, is one method of implementing employer buy- ins. Other states have typically developed employer buy- ins through SCHIP or through Section 1. Health Insurance Flexibility and Accountability (HIFA) waivers. Implemented in 1. Pennsylvania’s program is one of 1. HIPP programs currently in operation. As of April 1, 2. Joanne Slesser, the former director of the program, has worked for the state of Pennsylvania for 1. HIPP program’s design and implementation. Her first assignment on HIPP was to review the proposed Omnibus Budget Reconciliation Act of 1. OBRA . We asked Slesser about how Pennsylvania’s HIPP program works, its successes and challenges, and the lessons she learned along the way. Slesser attributes the success of the program to its automated process for enrolling and tracking participants and effective outreach. The program’s 5. 3 staff in five regional offices have established solid relationships with employers throughout the state. The most difficult obstacle to implementing the program was getting referrals and establishing the cost- effectiveness analysis, Slesser says. But with everything now in place, the program has achieved savings goals: Savings for Fiscal Year 2. Overview. 1. SCI: What kind of political and financial commitment did you need to make in order for the program to succeed? SLESSER: Once HIPP was implemented as a result of OBRA ’9. The staffing request was based on program size projections that were made using reports showing the number of employed persons currently receiving Medical Assistance and estimating the percentage of those employers who offered medical benefits. Costs were justified by showing return- on- investment projections. The state’s financial commitment to provide the staff necessary to run the program was essential to its success. When compared to the savings generated by the HIPP program, the return on investment for staff is about 3. This reflects net savings after consideration of premium amounts, deductibles, and co- pay amounts, which could be billed to Medical Assistance. Operating expenses are compiled at the end of each fiscal year, and deducted from the reported savings at that time. SCI: Of your 2. 1,0. Why is there such a high proportion of young people in the program? SLESSER: There are several reasons. First, a large number of children are eligible for Supplemental Security Income whose parents are not Medicaid- eligible. Second, many Medicaid- eligible parents with access to employer- sponsored insurance opt only to enroll their children, because their employer covers 1. Employer Insurance Verification (rev. Re-evaluation Employer Insurance Verification (rev. Homeless Intervention Programs Updated April 2012 Accomack-Northampton Regional Housing Authority 23372 Front Street Accomack. Portsmouth, Norfolk, Chesapeake, and Virginia Beach Click to return to map. Harvest Information Program (HIP) New – HIP Permit to Replace HIP Number. All hunters requiring a Virginia hunting license including lifetime license holders who plan to hunt doves, waterfowl, rails, woodcock, snipe, coots. Virginia Hipp Program CaliforniaFinally, many enrolled parents have multiple children. SCI: Given the general lack of success of HIPP programs in other states, what distinguishes Pennsylvania’s program? SLESSER: The automated system that we developed exclusively for HIPP distinguishes it from other programs. We created a software application that stores case records and generates payments. The application has interface capability with the mainframe eligibility files for the Department of Public Welfare. With the system and database, we can: Process and maintain a large number of cases with minimal cost and effort. Provide quality control and eliminate data- entry errors, especially with regard to the automated cost- analysis functions and the real- time transfer of data. View reports and compare case statistics, such as the number of enrollments, average savings, average costs, policy benefits, employer data, etc., from an individual case level to a program- wide level. With this capability, management can identify needed program or procedure adjustments to respond to changes in the market or staffing needs. Respond to all inquiries quickly and easily by accessing the case and looking at the narrative, which is a detailed history of the case and any action taken on it from the time of enrollment until the case is ended. This represents a huge time savings; often an inquiry can be resolved immediately during the initial phone call. Generate a large number of HIPP payments to the correct payee. This helps establish and maintain good relationships with employers. SCI: How does the automated referral process work? SLESSER: When a case is being considered for HIPP enrollment, the system allows us to enter and import all the information needed to assess cost- effectiveness. This includes demographic information for all members of a household, and the premium amount and deductible for an employer’s insurance policy. The system has a matrix that returns cost- effectiveness information showing yearly and monthly cost- effective amounts. Monthly, all cases scheduled for payment are pulled from the HIPP system and loaded onto a file, which interfaces with the eligibility files of the Department of Public Welfare. Once the eligibility edits are passed, a second file is generated and submitted to the Pennsylvania Department of Treasury for payment. Checks are generated monthly following established time frames, to ensure that checks are received prior to the first of the month. Checks can be made payable to employers, insurance carriers, or directly to employees. Cases that do not pass the eligibility edits are returned to the HIPP worker for appropriate action. The HIPP worker receives one of three status codes: Status code #1 identifies cases where there are fewer Medical Assistance- eligible members in the household than reported on the HIPP case. These cases generate a HIPP payment, but are returned to the operations specialist to re- evaluate cost- effectiveness. The worker will then either close the case as no longer cost- effective, or continue the case with an adjusted savings amount. Status Code #2 identifies cases where all members have lost their eligibility for Medical Assistance for less than 3. These cases generate a payment but the operations specialist sends a HIPP notice to the client advising them that HIPP will no longer pay their employer group health insurance premium if they remain ineligible for Medical Assistance. The case is tracked until the next cycle to see if it remains closed. Status Code #3 identifies cases where all members have lost their eligibility for Medical Assistance for longer than 3. These cases do not generate a HIPP payment. The operations specialist ends the case on the HIPP system and performs a savings adjustment to deduct the previous month’s savings amount. Administration. 5. SCI: How does the HIPP program coordinate with those eligible for Medical Assistance? SLESSER: Pennsylvania’s application form for those applying for Medical Assistance has been modified to include three relevant questions, which are the backbone of the automated referral process: 1) Is anyone in the household employed by an employer who offers health insurance? Did you or anyone in your family lose a job within the past 3. Is there someone in your family who is pregnant or seriously ill? These questions are used to trigger the automated referral process. Once an individual is found eligible for Medical Assistance, his or her responses are entered by clerical staff in each County Assistance Office onto the Department’s mainframe eligibility file. On a weekly basis, a batch process pulls these responses and generates a HIPP referral letter to clients who answered “yes” to one or more of the three questions. The letter indicates that enrollment in the HIPP program is mandatory for Medical Assistance enrollees that meet eligibility criteria for the program. They must enroll in their employer’s health insurance, which will serve as their primary insurance; however, they will continue to maintain their eligibility for Medicaid. Responses are required within 1. HIPP screens the referrals, and contacts employers for additional information when it appears a referral response could result in a HIPP enrollment. About 9. 5 percent of all HIPP referrals are received using this automated referral process. SCI: How does the system prove cost- effectiveness? SLESSER: Our computerized matrix contains information on the benefits programs of employers in the state to simplify the cost- effectiveness analysis. Program staff calculate the average Medicaid cost per client from insurance data in the matrix; the information can be organized by employees’ age, insurance category, and geographic location. They then compare the estimate to HIPP program costs, including premiums, deductibles, co- payments, and administrative fees. For fee- for- service Medicaid, staff calculate expenses yearly and compare them with the HIPP program’s paid claims history database. For managed care Medicaid, cost- effectiveness is determined by comparing the average cost of Medicaid’s health plan with that of the employer. SCI: How does the HIPP program monitor enrollees? SLESSER: Program staff do periodic re- evaluations of cases to verify such items as employment status, insurance carrier information, household composition, premium amounts, and levels of coverage. SCI: How has the program dealt with recent changes in benefit packages and cost- sharing arrangements as employers try to manage rapidly rising premiums? SLESSER: Our automated system gives us the ability to enter benefit information unique to each employer package, including benefit limitations such as co- pay and deductible amounts. All these variables, and any changes that may occur, are taken into account when the system calculates cost- effectiveness. We have experienced an increase in premiums and changes in benefits packages and have had to disenroll cases that are no longer cost- effective due to these changes.
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