COMMONWEALTH CARE & CHOICE UPDATE- QUICK FACTS

Commonwealth CARE (Under 300% FPL)

1. Reduced premiums – details in last month’s newsletter. Will be on our website soon.

2. All Commonwealth Care members currently have Free Care as wrap-around coverage.

   a). Free Care still available until October 1, 2007. Still unclear what will happen then. Expect to know more soon and that this wrap-around will be eliminated in October.

   b). Premium Hardship Waivers and Co-Pay Hardship Waivers – forms now available. Will be more important once Free Care wrap-around is eliminated.

Commonwealth CHOICE (Over 300% FPL)

1. Undocumented can purchase.

2. Premiums vary by plan, but also individual’s age, geography, and employment industry (e.g., construction vs. office work).

3. Coverage does not start until first premium is received.

4. Individual Mandate

a). Though the July 1 date got a lot of press, enforcement doesn’t really begin yet. For this year’s taxes, just need to show covered by 12/31/07.

b). OR show that you are exempt from mandate- no “affordable coverage” available through employer or if not through employer that none of the Choice plans offer a plan with a premium at or below your individual “Affordability” level. Charts will be on website soon.

Free Care

1. On October 1, 2007 becomes “Health Safety Net Care Fund”

2. Will change from a block grant to a claims basis.

3. See accompanying story for more detail.

-Adapted from materials presented by Kim Simonian, MPH, Partners Community Benefits.

7/07