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Missouri Application for the State Children’s Health Insurance Program Effective Date: 05/01/2009 Approval Date: Bolded/Italics Added Information Prior Approval Date: 09/28/2007 Strikethrough Deleted Information - 27 - paid to obtain comparable coverage only of the targeted low-income children involved; and (Describe the associated costs for purchasing the family coverage relative to the coverage for the low income children.) (Section 2105(c)(3)(A)) (42 CFR 457.1010(a)) Response: The Health Insurance Premium Payment (HIPP) Program is a MO HealthNet Program that pays for the cost of health insurance premiums, coinsurance, deductibles, and copayments for certain MO HealthNet participants. The program purchases health insurance for MO HealthNet eligible persons when it is determined cost effective. Similarly, the HIPP Program purchases health insurance for MO HealthNet For Kids eligible children when it is determined the health insurance does not meet the affordability test, but is found to be cost effective. Cost effective means that it costs less to buy the health insurance to cover medical care than to pay for the same services with MO HealthNet funds. When determining the cost effectiveness of a health insurance plan, the following data is considered: the cost of the insurance premium, coinsurance and deductible; the scope of services covered, the average anticipant MO HealthNet utilization by age, sex, geographic location and coverage group, and annual administrative expenditures. The analysis is based on the data of the MO HealthNet participants enrolled in the insurance plan. The average MO HealthNet expenditures are based upon a peer grouping consisting of age, sex, coverage group and county from the previous year. If the cost of the insurance premiums and cost sharing for the insurance plan is likely to be less than the average MO HealthNet expenditures, the policy is considered to be cost effective. See Attachment 12 for a specific example. The HIPP Program cannot find health insurance policies for MO HealthNet recipients, rather it purchases policies already available to recipients through employers, former employers, labor