MISSOURI – Medicaid
NEW YORK – Medicaid
Website: http://www.dss.mo.gov/mhd/participants/pages/hipp.htm Phone: 573-751-2005 PENNSYLVANIA – Medicaid Website: http://www.dhs.pa.gov/provider/medicalassistance/health insurancepremiumpaymenthippprogram/index.htm Phone: 1-800-692-7462
Website: http://www.health.ny.gov/health_care/medicaid/ Phone: 1-800-541-2831
To see if any other states have added a premium assistance program since July 31, 2020, or for more information on special enrollment rights, contact either:
U.S. Department of Labor
U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services
Employee Benefits Security Administration
www.dol.gov/agencies/ebsa
www.cms.hhs.gov
1-866-444-EBSA (3272)
1-877-267-2323, Menu Option 4, Ext. 61565
OMB Control Number 1210-0137 (expires 12/31/2019)
Revised 9/2020
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