The purpose of this memo is to inform ADAP Enrollment Workers of the upcoming Open Enrollment period, the ADAP Open Enrollment webpage, and the upcoming insurance assistance premium threshold increase.
Open Enrollment
The webpage provides both Enrollment Workers and clients with detailed information on Open Enrollment, how to sign up for or renew coverage, information on the various insurance assistance programs and the documentation necessary for each program and will provide links to pertinent resources.
This week, ADAP will begin sending an Open Enrollment flyer with consolidated information to all active ADAP clients who currently do not have comprehensive healthcare coverage or are enrolled into the Office of AIDS Health Insurance Premium Payment (OA-HIPP) Program or Medicare Premium Payment Program (MPPP), advising them of the upcoming 2025 Open Enrollment period. It informs clients without insurance how they can apply for health insurance and enroll into one of ADAP's Insurance Assistance Programs (if eligible). It also informs clients who are currently enrolled in the OA-HIPP and MPPP Programs that action may be needed on their part to maintain their health insurance and enrollment into an ADAP Insurance Assistance Program. The flyer will direct clients to the ADAP Open Enrollment webpage for additional details, and links to various resources, such as Covered California, Medicare, and off-exchange health plans. There is also a Spanish ADAP Open Enrollment webpage available
Insurance Assistance Premium Threshold Increase
Effective January 1, 2025, 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. This is the combined total for medical, dental, and dental/vision. Currently, the threshold is $1,938.00 per month.
Therefore, during Open Enrollment, clients can select a health insurance plan with a monthly premium total of $2,996.00. 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.
If you have any questions regarding the information provided in this memo, or need assistance navigating the Open Enrollment webpage, please contact the ADAP Client Services call center at (844) 421-7050 or your OA Advisor.
Thank you,
Joseph Lagrama
ADAP Branch Chief
California Department of Public Health