208.202. Premium offset program, pilot project authorized, eligibility.

MISSOURI STATUTES AND CODES

208.202. Premium offset program, pilot project authorized, eligibility.

Premium offset program, pilot project authorized, eligibility.

208.202. 1. The director of the MO HealthNet division, incollaboration with other appropriate agencies, is authorized to implement,subject to appropriation, a pilot project premium offset program for makingstandardized private health insurance coverage available to qualifiedindividuals. Subject to approval by the oversight committee created insection 208.955, the division shall implement the program in two regions inthe state, with one in an urban area and one in a rural area. Under theprogram:

(1) An individual is qualified for the premium offset if theindividual has been uninsured for one year;

(2) An individual's income shall not exceed one hundred eighty-fivepercent of the federal poverty level;

(3) The premium offset shall only be payable for an employee if theemployer or employee or both pay their respective shares of the requiredpremium. Absent employer participation, a qualified employee, or qualifiedemployee and qualified spouse, may directly enroll in the MO HealthNetpremium offset program;

(4) The qualified uninsured individual shall not be entitled to MOHealthNet wraparound services.

2. Individuals qualified for the premium offset program establishedunder this section who apply after appropriation authority is depleted topay for the premium offset shall be placed on a waiting list for that statefiscal year. If additional money is appropriated the MO HealthNet divisionshall process applications for MO HealthNet premium offset services basedon the order in which applicants were placed on the waiting list.

3. No employer shall participate in the pilot project for more thanfive years.

4. The department of social services is authorized to pursue either afederal waiver or a state plan amendment, or both, to obtain federal fundsnecessary to implement a premium offset program to assist uninsuredlower-income Missourians in obtaining health care coverage.

5. The provisions of this section shall expire June 30, 2011.