Entering ESI Through Caseworker Portal – All Household Members Insured

*The following is a mitigation guide to be used until CHIP functionality is updated in MEDES.

*MO Employer Sponsored Insurance and MO Covered Member evidence will be used for CHIP determinations. Please do not use Employer Sponsored Insurance or Covered Member evidence located under Income evidence.

ENTERING ESI THROUGH THE CASEWORKER PORTAL – HOUSEHOLD MEMBERS ARE ALL INSURED

  1. Application Flow > Additional Household Information Additional Household Members Check Point section > Additional Information for Insured Household Members question
  2. For the question, ‘Please choose any of the people below who are enrolled in employer-sponsored coverage. Coverage could be either through their own employment or as an individual related to the employee.’ Check anyone who is insured by ESI
  3. In the Is the policy holder a household member question, click the dropdown and select Yes
  4. In the ‘If the policy holder is a household member, please select from the below household members box’, click the radio button under the policy holder
  5. Under the ‘Please check which of the following household members are currently enrolled in this plan?’ question, check all applicable household members
  6. Under the Policy Details section:

NOTE: The fields with an asterisks* are mandatory fields

    1. Policy Number
    2. Policy Start Date
    3. Group Policy Number
    4. * Monthly premium amount for all of the selected members (from question 5) who are enrolled in the plan
    5. * Name of the insurance company
    6. Employer Name
  1. Under the Family Planning Services heading, click the dropdown and select Yes or No
  2. Under the Maternity Services heading, click the dropdown and select Yes or No

NOTE: Selecting Yes for the question ‘Does this plan provide access to Maternity Services?’ will generate 3 additional questions. Click the dropdown next to each question and select Yes or No

  1. Click Next Next Button button

When the Application Case is created (drops) you will see both MO Employer Sponsored Insurance and MO Covered Member evidences created. The insured members will be shown as enrolled on MO Covered Member evidence.

When the Eligibility Check is ran, if the income puts the child(ren) who are insured at a CHIP Level of Care (LOC), the child(ren) will show as ineligible.

A corrected rejection notice must be sent stating (insert P&P approved verbiage here). DO NOT delete the system generated IM-33.