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HIPP may pay the premium for a non-Medicaid family member if that member needs to enroll in the group health plan in order to obtain coverage for the Medicaid member. Medicaid will only pay for the premiums of the ineligible family member(s) and not any of their other cost sharing expenses (e.g., prescription co-pays). Medicaid will continue to cover the employer’s health insurance premium, deductibles, and co-insurance for the Medicaid member. 9.4.2 Participation in HIPP Members participating in HIPP will have Medicaid as a backup. If the employer’s health insurance does not cover something that Medicaid does, then Medicaid will pick up the payment. 9.4.3 Cooperation Effective January 1, 2014, HIPP is now voluntary for MAPP members as well as BadgerCare Plus members. 9.4.4 Not Cost-Effective If it is not cost-effective to buy the employer-subsidized insurance, the member will remain eligible for MAPP. This page last updated in Release Number: 15-01 Release Date: 06/10/2015 Effective Date: 06/10/2015 9.5 Casualty Claim Process (Subrogation) 9.5.1 Casualty Claims (Subrogation) Introduction Casualty claims are those claims for Medicaid benefits resulting from an accident or injury for which a third party may be liable. Example 1: Mike receives treatment for injuries suffered when he was hit by a car. The vehicle owner is the third party and may be responsible for reimbursing Medicaid for those benefits. If Mike is working with an attorney or insurance agency to settle the claim, he is legally obligated to give notification to the local agency. Medicaid members should report any casualty claims before the case is settled. The Medicaid ID number of the Medicaid member, date of the accident, and the insurance company or name of the attorney to bill should be included with the referral. 9.5.2 Reporting Accident or Injury Claims If members are in an accident or are injured and receive a cash award or settlement due to the accident or injury and Medicaid (including SSI enrollees) pays for part or all of the care, it must be reported. When Medicaid pays for a claim that is related to an accident, a letter is sent to the member informing him or her of the requirement to report the information. If a member has hired an attorney or is working with an insurance agency to settle the claim, that must also be reported. If a member reports a claim, he or she must report the accident or injury case to the Casualty Recovery Unit using one of the following methods: • Mail: WI Casualty Recovery—HMS