​The purpose of this memo is to inform AIDS Drug Assistance Program (ADAP) Enrollment Workers (EW) about the insurance assistance premium threshold increase.

ADAP Policy Update​

Effective January 1, 2025, ADAP will increase the premium threshold to $2,996.00 per month.

ADAP will be increasing the Office of AIDS Health Insurance Premium Payment (OA-HIPP), Medicare Premium Payment Program (MPPP), and Employer Based Health Insurance Premium Payment (EB-HIPP) program's premium threshold to $2,996.00 per month beginning January 1, 2025. This is the combined total for medical, dental, and dental/vision. Currently, the threshold is $1,938.00 per month.

If a client and the spouse/registered domestic partner (RDP) are both enrolled in ADAP, they are each eligible for a monthly medical, dental, and dental/vision premium threshold of $2,996.00. Therefore, their premiums can total up to $5,992.00. Note: A marriage certificate is required for verification purposes.

Partial Payment Agreement

If a client's total monthly premium amount exceeds the premium threshold, then the client must submit to CDPH a completed and signed Partial Payment Agreement form (CDPH 8722) (English | Spanish) (PDF).

As part of the agreement, the client is required to submit their portion (the difference between the total premium amount and the program threshold) by the 1st of each month to PAI. Payments can be sent using one of the methods listed in the payment section below. Note: For clients whose premiums exceed the premium threshold, payment will not be sent to their health insurance plan until PAI receives the client's portion of the premium amount.

 Payment Methods

​​Mail a cashier’s check, money order, or personal check (clients will be responsible for any fees associated with insufficient funds when submitting a personal check):

• Made payable to: “Pool Administrators, Inc./CDPH”
• Send to: Pool Administrators, Inc. (PAI), 628 Hebron Avenue, Suite 502, Glastonbury, CT 06033.
• Electronically submit payment using PayPal:
• Create an account at www.paypal.com
• Select Money
• Select Send or request Money
• Select Pay for Goods or Services
• Enter CDPH_CA_PAY@pooladmin.com and select Next
• Select your method of payment and enter the partial payment amount
• Verify the shipping address: 628 Hebron Avenue, Suite 502, Glastonbury, CT 06033
• Select Send Payment Now.

Clients can contact PAI at (877) 495-0990 if they need additional assistance with submitting an electronic payment using PayPal.​
If you have any questions regarding the information provided in this memo, please contact your OA Advisor.

Thank you,​
​

Joseph Lagrama

ADAP Branch Chief

California Department of Public Health