18-01 Version of 7.7 Health Insurance Premium Payment

7.7.1 Introduction
7.7.2 Cost Effectiveness
7.7.3 Participation in HIPP
7.7.4 Cooperation

7.7.1 Introduction

Wisconsin’s HIPPHealth Insurance Premium Payment. HIPP pays the employee's portion of the employer subsidized health care coverage when the Fiscal Agent determines it is more cost effective to buy the employer's insurance than enroll them in BC+ or MAPP. program helps BadgerCare Plus families pay the employee contribution of their employer sponsored insurance. The HIPP program pays the family’s share of the monthly premium, co-insurance, and deductibles associated with the family health plan along with any BadgerCare covered services not included in the family health plan through fee-for-service (wrap around).

HIPP will be considered for BadgerCare Plus members when it is cost effective to do so.

In addition to families with employer sponsored health insurance plans, the following BadgerCare Plus families may also be considered for HIPP:

Farm and other self-employed families
Members with Self-funded insurance plans

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: 18-01
Release Date: 04/13/2018
Effective Date: 04/13/2018