An Overview of the Working Timeline, Objectives and Frequently Asked Questions

1. An Overview of the Working Timeline, Objectives and Frequently Asked Questions

2. Learning Objectives • Examine the HIP 2.0 working timeline • Compare current HIP program to HIP 2.0 • Discuss aspects of HIP 2.0 programs • Answer frequently asked questions

3. HIP Background

4. Current HIP Program • Covers low-income, non-disabled Hoosier adults ages 19-64 under 100% FPL • $11,670 annually for an individual • $23,850 annually for a family of four • POWER Account (like an HSA) of $1,100 for all members • State has a budget (provided through cigarette tax) for 40,000-45,000 enrollees • In July 2014, FSSA announced that HIP reached enrollment capacity and would no longer accept applications • The application has been removed from the Indiana Benefits portal and the FSSA website, and assisters are advised to avoid submitting new applications

5. HIP 2.0 Timeline July 17thIndiana notified by CMS of unmet requirement for tribal consultation June 22ndInitial public comment Period ended Mid-November FSSA will send notices to previous applicants; the DFR portal will have streamlined application September 21stFederalpublic comment period ends Dec Oct Nov Jan Aug Sept May June July January 1st FSSA hopes HIP 2.0 coverage will become effective May 15thGovernor Pence announced proposed expansion of the HIP program July 2ndIndiana submitted the HIP 2.0 Waiver Application to CMS August 22ndCMS approved the Waiver Application; 30-day federal public comment period began November 15thOpen Enrollment begins!

6. HIP 2.0 Proposal • Coverage for low-income, non-disabled Hoosier adults ages 19-64 under 138% FPL $16,105 annually for an individual in 2014 $32,913 annually for a family of four in 2014

7. HIP 2.0 Programs

8. HIP Basic

9. HIP Basic Copayments for HIP Basic members

10. HIP Plus

11. HIP Plus POWER Account Contributions

12. HIP (Employer Benefit) Link Premium assistance for people with access to “unaffordable” insurance through an employer Eligible individuals can choose the employer-sponsored plan that works best for them Members can either enroll in HIP Plus or receive contribution from the State into their POWER account • Enrollment in HIP Link is optional • Begins in 2016

13. Gateway to Work Program Consumer Responsibility Connects members to Enables members job training and job search to move up and out of HIP programs

14. When can Consumers Apply? • FSSA hopes to launch the new online application in mid-November with coverage effective January 2015 • Streamlined with the Indiana Application for Health Coverage on the DFR Benefits Portal • Assesses eligibility for all IHCPs

15. How Will Transitioning Work? • Two groups, low-income parents and caretakers at 19% FPL and low- income 19- and 20-year-olds at 19% FPL will transition into HIP Basic • Current health plans and FSSA will send notices to consumers who will be transitioning • Premium Tax Credits will no longer be available on the federal Marketplace for Hoosier consumers up to 138% FPL

16. Pregnancy and HIP 2.0 • Women who are in HIP 2.0 and become pregnant can stay in HIP 2.0 or can opt to go to the Medicaid pregnancy category. • Women that are pregnant prior to or atapplicationtime will transfer to the Medicaid pregnancy category (HIP 2.0 will not be an option during pregnancy for this group) • If pregnant at redetermination, pregnant women will transition to Medicaid pregnancy category (per CMS guidance).  • Women that deliver while enrolled in Medicaid pregnancycategory will be able to move into HIP 2.0 (there is a potential for gap in coverage if a POWER account contribution must be made and the payment is not made soon after delivery).

17. Positive Outcomes of HIP 2.0 • HIP 2.0 will cover approximately 350,000-559,000uninsured, nondisabled Hoosiers • Visionand dentalfor HIP Plus members • No enrollment caps • Maternity coverage with no cost-sharing • Remove annual and lifetime limits • Lock-out date for non-compliance will decrease from 12 months to six months • As an alternative to disenrollment, HIP Plus members will be moved to HIP Basic

18. Incentivizing Features of HIP 2.0 HIP Plus • Members making 12 consecutive contributions will: • Receive a free pass to Indiana State Parks • Be eligible forroll-over POWER account balances • The state will double this amount if the member received all recommended preventivecare services during the plan year HIP Basic • Members receiving recommended preventive care have the opportunity to reduce their POWER account contributions in future years for HIP Plus up to 50%

19. Who’s Paying? • The program will be funded by: • Federal money • Agreement with Indiana hospitals • HIP 2.0 will be fully funded at no additional cost to Hoosier taxpayers • Consumers making copayments in HIP Basic and POWER Account contributions in HIP Plus • Providers accepting HIP will be paid Medicare rates

20. Rolling it Out KEY GOALS FOR ASSISTERS: • Become familiar with HIP 2.0 programs • Make a public comment online until September 21st • Track consumers who may be eligible for HIP 2.0 • Use commit cards or a secure database like Get Covered Data • Educate your community about notices and key dates and deadlines • Incorporate into current outreach and inreach

21. Questions or Comments? jellis@indianapca.org or edaw@indianapca.org (317) 630-0845