Tobacco-Free Incentive Provisions and Limitations

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 in centive must be completed and submitted. (1) Strive for Wellness® Tobacco-Free Incentive—The TobaccoFree 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® TobaccoFree 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 sub scriber) 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 re ceive the Quit Tobacco Road Map. (C) Eligible members adding medical coverage must com plete one (1) of the following within thirty-one (31) days of his/ her medical coverage effective date for the incentive to be ef fective 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 re ceive the Quit Tobacco Road Map. (D) All forms can be completed through the eligible mem ber’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 ter mination 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 eligi ble 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 informa tion 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. AUTHORITY: section 103.059, RSMo 2016.* Emergency rule filed Nov. 1, 2011, effective Nov. 25, 2011, expired May 22, 2012. Original rule filed Nov. 1, 2011, effective April 30, 2012. Emergency amend ment filed Aug. 28, 2012, effective Oct. 1, 2012, terminated Feb. 27, 2013. Amended: Filed Aug. 28, 2012, effective Feb. 28, 2013. Emergency amendment filed Aug. 23, 2013, effective Oct. 1, 2013, expired March 29, 2014. Amended: Filed Aug. 23, 2013, effective March 30, 2014. Emergency amendment filed Feb. 28, 2014, ef fective May 1, 2014, terminated Sept. 8, 2014. Amended: Filed Feb. 28, 2014, effective Aug. 30, 2014. Emergency rescission and rule filed Aug. 29, 2014, effective Oct. 1, 2014, expired March 29, 2015. Rescinded and readopted: Filed Aug. 29, 2014, effective March 30, 2015. Emergency rescission and rule filed Aug. 28, 2015, effective Oct. 1, 2015, expired March 28, 2016. Rescinded and readopted: Filed Aug. 28, 2015, effective March 30, 2016. Emergency rescission and rule filed Aug. 26, 2016, effective Oct. 1, 2016, expired March 29, 2017. Rescinded and readopted: Filed Aug. 26, 2016, effective March 30, 2017. Emergency rescission and rule filed Aug. 31, 2017, effective Oct. 1, 2017, expired March 29, 2018. Rescinded and re adopted: Filed Aug. 31, 2017, effective April 30, 2018. *Original authority: 103.059, RSMo 1992.