Current through Register Vol. 49, No. 18, September 16, 2024
PURPOSE: The rule establishes the policy of the board
of trustees in regards to the Strive for
Wellness® Tobacco-Free Incentive and the method
and timeframes in which the requirements of the incentive must be completed and
submitted.
(1) Strive for
Wellness® Tobacco-Free Incentive-The
Tobacco-Free Incentive is a voluntary program that eligible members may elect
to participate in to earn a reduction in premium. Eligible members are
responsible for completing requirements.
(2) Tobacco-Free Incentive-The Strive for
Wellness® Tobacco-Free Incentive is a reduction
in premium of forty dollars ($40) per month per eligible participant who is
compliant with this rule.
(3)
Eligibility-The following members enrolled in a Missouri Consolidated Health
Care Plan (MCHCP), Preferred Provider Organization (PPO), or Health Savings
Account (HSA) Plan are eligible to participate in the Tobacco-Free Incentive:
(A) Active employee subscribers;
(B) Non-Medicare spouses covered by a
Tobacco-Free Incentive eligible subscriber and Medicare primary spouses of
active employee subscribers; and
(C)
Non-Medicare subscribers.
(4) Limitations and exclusions-The following
members are not eligible to participate in the Tobacco-Free Incentive:
(A) Members under the age of eighteen (18)
years;
(B) Dependent
children;
(C) Subscriber (with the
exception of active employee subscriber) who has Medicare as primary
coverage;
(D) Spouse (with the
exception of spouse of active employee subscriber) who has Medicare as primary
coverage;
(E) TRICARE Supplement
Plan subscriber;
(F) Spouse covered
by ineligible subscriber; and
(G)
The subscriber and/or spouse will become ineligible to continue to participate
the first day of the month in which Medicare becomes his/her primary
payer.
(5) Participation.
(A) Each eligible member must participate
separately.
(B) In order to receive
the Tobacco-Free Incentive, eligible members must complete one (1) of the
following every plan year, for the incentive to be effective the first day of
the second month after MCHCP receives the Tobacco Promise form and applicable
requirements are completed:
1. Submit a
Tobacco-Free Promise form; or
2.
Submit a Quit Tobacco Promise form and agree to receive the Quit Tobacco Road
Map.
(C) Eligible members
adding medical coverage must complete one (1) of the following within
thirty-one (31) days of his/her medical coverage effective date for the
incentive to be effective the first day his/her medical coverage is effective:
1. Submit a Tobacco-Free Promise form;
or
2. Submit a Quit Tobacco Promise
form and agree to receive the Quit Tobacco Road Map.
(D) All forms can be completed through the
eligible member's myMCHCP account or downloaded from MCHCP's website and
printed for completion. Completed printed forms must be submitted to MCHCP by
fax, mail, in person, or uploaded to the eligible member's myMCHCP
account.
(E) Eligible members
participating in the Tobacco-Free Incentive whose coverage ends due to the
subscriber's termination of all employment with the state and who then regains
coverage effective in the same plan year because the subscriber is rehired as a
new state employee, will receive the Tobacco-Free Incentive effective the first
day his/her medical coverage is effective after the subscriber is
rehired.
(F) An eligible member
completing the Tobacco-Free Incentive requirements in October of a plan year,
who is eligible for but not currently receiving the Tobacco-Free Incentive,
will receive the incentive for December of the current plan year, in addition
to the next plan year.
(G) Eligible
members who completed the Tobacco-Free Promise form and who, thereafter, use a
tobacco product, must notify MCHCP by phone, fax, or mail the next business day
and MCHCP will mail the Quit Tobacco Road Map.
(H) The Tobacco Free Incentive shall begin
January 1 and end December 31 of each plan year.
(6) A waiver may be granted if an eligible
member requests a waiver in writing along with a provider's written
certification that it is medically inadvisable for the eligible member to quit
tobacco.
(7) MCHCP and/or its vendor
may audit participation information for accuracy. Misrepresentation or fraud
could lead to loss of the Tobacco-Free Incentive and/or prosecution.
(8) MCHCP and/or its vendor may utilize
participation data for purposes of offering additional programs in accordance
with the MCHCP privacy policy.
*Original authority: 103.059, RSMo
1992.
