Page 99

Access to HIPP coverage will be allowed even if single or "plus one" coverage is the only coverage offered by an employer. Minimum employer contribution requirements will be eliminated, and employer-sponsored insurance (ESI) will be based solely on cost effectiveness. 7.7.2 Cost Effectiveness The HIPP Unit of the fiscal agent determines if it is cost effective to buy the employer’s insurance rather than enroll the individual in BadgerCare Plus. The HIPP Unit will identify the cost of wrapping around the Medicaid services with the employer- sponsored plan and then determine cost effectiveness of buy-in on that calculation of cost comparability. This determination will be done on a per person basis. Thus, in any given BadgerCare Plus group, it may be cost effective to enroll all BadgerCare Plus members or only specific members. For example: it may be cost effective to enroll an adult in HIPP but to keep the children in BadgerCare Plus. 7.7.3 Participation in HIPP Members participating in HIPP are enrolled in BadgerCare Plus as a secondary insurance. If the employer’s health insurance does not cover a service that BadgerCare Plus covers, BadgerCare Plus will cover the cost. 7.7.4 Cooperation Parents may not be sanctioned for failing to cooperate with the HIPP program. This policy applies to both current members and new applicants. This page last updated in Release Number: 22-02 Release Date: 08/01/2022 Effective Date: 08/01/2022 7.8 Reserved This page last updated in Release Number: 17-01 Release Date: 04/11/2017 Effective Date: 04/11/2017 8.1 Pregnant Members Note This chapter does not apply to pregnant members in the BadgerCare Plus Prenatal Program. A pregnant member who is enrolled in BadgerCare Plus stays eligible for both: • The duration of the pregnancy. • The postpartum period, which concludes at the end of the month 12 months after the end of the pregnancy. The application does not need to be submitted prior to the end of the pregnancy, but the person must be eligible for BadgerCare Plus or Medicaid for one or more months in which they were pregnant in order for the member to remain enrolled as a pregnant member for the postpartum period. An application for Express Enrollment does not meet this application test.