2912 Health Insurance Premium Payment System (HIPPS) - Based on federal law, States are permitted to purchase employer-based health insurance for all clients who have access to such coverage and if it is determined to be cost effective. This includes "COBRA" continuation coverage which allows for continued health insurance coverage through a person's former employer. If it is known such coverage exists for an individual, the case is to be referred as indicated in item 2912.1 below.
This optional provision has been adopted in Kansas and applies to both Medicaid and MediKan clients except those eligible only under SOBRA provisions. It is not applicable to CHIP families. Thus all employed TANF recipients are impacted. Families receiving coverage only under SOBRA or CHIP are not to be referred. In addition, the requirement also affects persons who are legally responsible for a recipient but who are not eligible or for whom assistance is not requested (i.e., a noneligible parent or spouse such as an excluded stepparent). It is not, however, applicable to absent parents currently providing coverage for their dependents. However, if there is coverage available, but the absent parent is not currently providing such coverage, the case should be referred to the HIPPS unit.
2912.1 Impact on Eligibility - As mentioned previously, the client must cooperate in providing information to complete the form as well as enrolling for and retaining employer health insurance coverage that has been determined cost-effective. Per 2124, failure to do so in either the cash or medical programs would result in ineligibility for the affected individual. That individual would be the person who is employed.
For TANF purposes, if the individual is a parent or other caretaker, only that individual would be rendered ineligible.
There is a potential for good cause to be granted in some instances. As situations become known that may involve good cause, they are to be referred to KDHE-DHCF Policy.