Q&A with Matthew Cesnik, Eligibility Director for Indiana FSSA’s OMPP

1. Q&A with Matthew Cesnik, Eligibility Director for Indiana FSSA’s OMPP February 4, 2015

2. Questions? Use the chat function or email edaw@indianapca.org Select who you want to receive the message Type and send message

3. Indiana Application for Health Coverage (IAHC) • Completing the application online is the easiest and fastest method • Electronic sources are used to verify income, citizenship, alien status and other eligibility factors • Faxing documents might speed up the application process • Write the name and Social Security Number on each item you fax or mail FAX 1-800-403-0864 MAIL FSSA Document Center PO Box 1810 Marion, Indiana 46952

4. IAHC FAQs • Does the state have a preferred application method? • What documents should be sent in with the application? • How do we submit additional documents for the applicant? • Will the application be sent to the Marketplace if denied due to income? • Does the enrollment period end? • Which is the best avenue to complete HIP 2.0 applications? Via Healthcare.gov or DFR Benefits portal?

5. HIP 2.0 Programs

6. Program Details • HIP Plus will be the automatic method of enrollment • Consumers at or below 100% FPL will default to HIP Basic if: • They fail to make a POWER account contribution (PAC) in the first 60 days • They miss a PAC throughout the year • Coverage will begin the first day of the month that a PAC is received • Example: if payment is received February 23rd, coverage will have commenced on February 1st • Coverage for HIP Basic will begin the first day of the following month after the 60 day payment window

7. Program FAQs • What determines if a person is eligible for the HIP State plan? • Where are current members being transitioned and will there be a lapse in coverage? • Current HIP Members • Hoosier Healthwise • Members enrolled in family planning services only • Marketplace consumers • Hoosiers on the waitlist

8. Medically Frail • Defined as: an individual who has one of the following: • A disabling mental disorder. • A chronic substance abuse disorder. • A serious and complex medical condition. • A physical, intellectual, or developmental disability that significantly impairs the individual’s ability to perform one (1) or more activities of daily living. • How will this be determined?

9. POWER Accounts • Payments will be made directly to the MCEs • POWER account contributions can be made on someone’s behalf at 100% • Unused portions of the POWER account will roll-over and lower the consumer’s required monthly contribution

10. POWER Account Contribution FAQs • How do you make a payment on someone's behalf? • Is there a list of organizations available that help with POWER account contributions? • What can the POWER account be used for specifically?

11. Households Size for IHCP • How is a household determined for IHCP? • Individual-based determination • Individual could be: • Tax filers not claimed as a tax dependent • Tax dependents • Non-filers and not claimed as a tax dependent • Based on expected tax filing status • Household = tax filer and all persons whom taxpayer expects to claim as a tax dependent

12. Tips for Determining a Household • Reminder: • Married couples living together are included in each others household regardless of filing status • Pregnant women include unborn child(ren) (count as 2+)

13. Determining Households Scenarios • How would the following households and income level be determined? • Married mom and dad with their two biological children aged 12 and 14; all need health insurance • 2 unmarried adults, each with one child under 18, each filing taxes as single; one adult and their child need health coverage • 20 year old daughter wants to apply for coverage, but lives with both parents and 2 other siblings • Two adults, who file taxes separately and are not married living at the same address; one has insurance and the other does not • An adult lives with another adult who is already enrolled in an IHCP; do they still need to be inputed on the application? • Does income and other information have to be provided?

14. Gateway to Work • How does this program work? • Individuals who do not work more than 20 hours per week and/or not a full-time student will be referred to the Gateway to Work program • CMS did not make this a conditional requirement • The application will be screened for eligibility, if found eligible, the applicant’s contact and employment information will be shared with the Indiana Department of Workforce Development • Will receive information about the State’s job search and training programs

15. Questions or Comments? Chat your questions now! jellis@indianapca.orgoredaw@indianapca.org (317) 630-0845

16. FAQs • How should a consumer report changes? • Application says: “You are required to report changes in circumstances to the DFR…You must report changes within 10 days of the date on which you are aware of the change…You will be given a form describing your reporting requirements” • How will the fast-track prepayments work, and when will it be implemented? Will Navigators assist with this? • Who is contacting people who are on Marketplace that need to sign up for HIP?

17. FAQs Continued • Should applicants expect to have an interview once application is submitted? • What categories of individuals will be eligible for transportation services? • What does this mean? • 19. Benefits paid on your behalf after you become fifty-five (55) years of age become a preferred claim against your estate. This claim has priority over all claims except prior recorded claims and taxes. (From the Notice Regarding Rights & Responsibilities for Health Coverage—State Form 55367)