OBSOLETE POLICY CHIP MANUAL |
An individual, who has been determined eligible for CHIP, must enroll in a CHIP health plan before they can access their benefits. Molina Healthcare and SelectHealth have both contracted with CHIP as a health plan choice. A CHIP eligible individual must also enroll in a dental plan to access their dental benefits. CHIP has contracted with DentaQuest and Premier Access.
Enrollees, who have selected Molina Healthcare or SelectHealth as their health plan during a past CHIP enrollment and have not moved since their CHIP ended, will be automatically re-enrolled with the same health plan. Clients automatically enrolled in a plan due to past coverage, may select a new plan within 90 days by contacting their Health Program Representative (HPR).
Once approved for CHIP, the enrollee receives an approval notice with Managed Health Care contact information. The Department of Health MMCS computer system will send a separate CHIP Welcome Letter. This letter will explain the enrollee's health and dental plan options for their area and that a selection must be made before coverage can begin. Enrollees have 14 days, from the date of the MMCS letter, to choose one of the plans or they will be auto assigned to a plan.
Enrollees receive the following contact options to make their health plan choice:
A name and phone number for the Bureau of Managed Health Care Health Program Representative (HPR) serving in their area.
The CHIP HPR email address, chiphpr@utah.gov.
Information through the CHIP website, http://www.health.utah.gov/chip/.
Self return fax selection form included with the CHIP Member Guide.
Once the health plan receives the enrollment information, the plan mails the benefit cards, provider directories and the master policy explaining co-payments and coverage information.
If an enrollee fails to make a health plan selection within 14 days from the date of the MMCS letter, they will be auto assigned. A letter is sent to inform the enrollee of his or her plan.
Enrollees who are auto assigned are allowed a maximum of 90 days to change plans. After the 90 days they are not allowed to change plans until the next health plan switch period.
Wasatch Front - An enrollee who lives along the Wasatch Front (Weber, Davis, Salt Lake or Utah Counties) must make a dental plan selection. They may choose either DentaQuest or Premier Access. If the enrollee fails to make a dental plan selection within 14 days from the date of the MMCS letter, they will be auto assigned. A letter is sent to inform the enrollee of his or her plan.
Enrollees who are auto assigned are allowed a maximum of 90 days to change plans. After the 90 days they are not allowed to change plans until the next health plan switch period.
Outside the Wasatch Front (Rural Counties) - Enrollees who live outside the Wasatch Front will be auto assigned to Premier Access.
The Bureau of Managed Health Care HPR (Health Program Representative) will provide consumer education tools and help with choosing a health and/or dental plan.
Every CHIP Enrollee will receive the following education options:
CHIP Member Guide will be auto mailed once eligibility is authorized.
Access to self directed online CHIP education.
Phone number for the Health Program Representative (HPR) serving their area.
Enrollees may request to meet with their HPR in person to learn more about their benefits. Enrollees should contact the customer service number for the selected health or dental plan with specific CHIP coverage questions.
It will be the responsibility of the CHIP enrollee to read the member guide and other education materials provided to learn about their benefits.
Unless an enrollee has made a specific request, the HPR will not be contacting the clients directly for benefit education or health plan selection.
Health and dental plan choice requirements and information will be included with all consumer education materials.
Under certain circumstances the enrollee may change their health or dental plan outside of the annual ‘plan switch’ period. Enrollees should contact the HPR serving their area with any specific requests. Enrollees must notify their local HPR before the 15th of the month in order to change their health plan for the following month.