On September 30, the Centers for Medicare and Medicaid Services (CMS) approved the Oklahoma Premium Assistance Plan under the federal Health Insurance Flexibility and Accountability (HIFA) initiative. The Oklahoma Health Care Authority submitted the waiver seeking to cover an additional 50,000 Oklahoma residents with incomes at or below 185 percent of the federal poverty level (FPL) in the Oklahoma Employer/Employee Partnership for Insurance Coverage (O-EPIC).
The increased coverage will be funded by state general fund revenues generated by a tobacco tax, along with federal matching funds under Title XIX and employer and employee contributions. Eligible employer-sponsored insurance populations include adults who work for small employers and have incomes above the Medicaid standard, but no more than 185 percent FPL, and their spouses. O-EPIC began enrollment at the beginning of November; in the first three days, the enrollment office received 103 employer applications.
Eligible state-sponsored insurance populations include the self-employed, unemployed currently seeking work, workers who are not eligible to participate in their employer’s small group health plan, and workers (and their spouses) whose employers do not offer a group health plan and have incomes above the Medicaid standard but no more than 185 percent FPL. Other eligible state-sponsored insurance populations include the working disabled who have incomes above the Medicaid standard, but no more than 200 percent FPL. Enrollment for these individuals will begin in spring 2006.
