1840.030.20 Closing Letter – DSS Manuals

IM-153 November 30, 2017

The Closing Letter is sent to participants who either:

have not requested a hearing by the due date noted on the Notice of Case Action;

whose premium payment has not been received by the hearing request due date; or

have requested a hearing and subsequently either withdrew the request or have received notification that their hearing request did not affirm the participant

The Closing Letter for families with income over 150% of federal poverty level (FPL) up to 225% FPL (CHIP 73 and CHIP 74) states coverage may start again when the premium payment is received, and contains an Initial Invoice. The Closing Letter for families with income over 225% FPL but less than 300% FPL (CHIP 75 cases) states coverage ends and the child(ren) will not be eligible for coverage for 90-day.

Both Closing Letters give the participant the right to appeal the decision for ninety (90) days.

MHD will automatically stop coverage upon notification that the premium was not paid by the due date (date of Closing Letter). The ending eligibility date on the MXIX screen will not reflect the actual date coverage ended. Check the MCII screen for the correct beginning and ending date of coverage for the Premium Group (CHIP73/74). The enrollment stop date is the last day of coverage.

If contacted by a participant who states they did pay the premium, FSD staff should refer the participant to the MHD Stakeholder Services Unit (formerly the Premium Collections Unit) at 800-392-2161.