The General Assembly has appropriated $13 million in funds for premium assistance to make monthly premiums more affordable for low-income participants.
The AccessTN Board has determined that premium assistance:
•
Will be available for applicants up to 350% of federal poverty level, up to an annual household income of $75,000.
•
Is limited to available funding; not all of those meeting eligibility criteria will necessarily qualify.
•
Will range from 20% of premium to 90% of premium based on household income.
•
Will only be available for Plan 1000, which has the lowest deductible and highest premiums.
Rates below reflect 2008 FPL effective 3/1/08.
Income Guidelines for Premium Assistance
Persons in Household
Federal Poverty Level (FPL)
Up to 150% FPL
Up to 200% FPL
Up to 250% FPL
Up to 350% FPL
1
$10,400
$15,600
$20,800
$26,000
$36,400
2
$14,000
$21,000
$28,000
$35,000
$49,000
3
$17,600
$26,400
$35,200
$44,000
$61,600
4
$21,200
$31,800
$42,400
$53,000
$74,200
5
$24,800
$37,200
$49,600
$62,000
up to $75,000
6
$28,400
$42,000
$56,800
$71,000
up to $75,000
7
$32,000
$48,000
$64,000
up to $75,000
up to $75,000
8
$35,600
$53,400
$71,200
up to $75,000
up to $75,000
State Premium Assistance Pays
90%
80%
60%
40%
20%
Member Share of Premium
10%
see table F below
20%
see table E below
40%
see table D below
60%
see table C below
80%
see table B below
Important: You DO NOT have to figure your premium to apply for AccessTN!
We will figure it for you when your coverage is approved, and if you request premium assistance, your proof of income has been reviewed.
B) 20% State Premium Assistance - Member Pays 80%
PLAN 1000*: $1,000 deductible
Target Weight or Below
Above Target Weight
Age
Non Tobacco User
Tobacco User
Non Tobacco User
Tobacco User
<30
$310
$356
$344
$395
30-39
$360
$414
$400
$459
40-49
$437
$502
$486
$558
50-59
$519
$598
$578
$664
60-64
$613
$705
$681
$783
65+
$723
$832
$804
$925
C) 40% State Premium Assistance - Member Pays 60%
PLAN 1000*: $1,000 deductible
Target Weight or Below
Above Target Weight
Age
Non Tobacco User
Tobacco User
Non Tobacco User
Tobacco User
<30
$232
$267
$258
$296
30-39
$270
$310
$300
$344
40-49
$328
$377
$364
$419
50-59
$389
$448
$433
$498
60-64
$460
$529
$511
$587
65+
$542
$624
$603
$694
D) 60% State Premium Assistance - Member Pays 40%
PLAN 1000*: $1,000 deductible
Target Weight or Below
Above Target Weight
Age
Non Tobacco User
Tobacco User
Non Tobacco User
Tobacco User
<30
$155
$178
$172
$198
30-39
$180
$207
$200
$230
40-49
$218
$251
$243
$279
50-59
$260
$299
$289
$332
60-64
$306
$352
$340
$392
65+
$362
$416
$402
$462
E) 80% State Premium Assistance - Member Pays 20%
PLAN 1000*: $1,000 deductible
Target Weight or Below
Above Target Weight
Age
Non Tobacco User
Tobacco User
Non Tobacco User
Tobacco User
<30
$77
$89
$86
$99
30-39
$90
$103
$100
$115
40-49
$109
$126
$121
$140
50-59
$130
$149
$144
$166
60-64
$153
$176
$170
$196
65+
$181
$208
$201
$231
F) 90% State Premium Assistance - Member Pays 10%
PLAN 1000*: $1,000 deductible
Target Weight or Below
Above Target Weight
Age
Non Tobacco User
Tobacco User
Non Tobacco User
Tobacco User
<30
$39
$44
$43
$49
30-39
$45
$52
$50
$57
40-49
$55
$63
$61
$70
50-59
$65
$75
$72
$83
60-64
$77
$88
$85
$98
65+
$90
$104
$100
$116
*Premiums will be slightly higher for Portability eligibility enrolling directly from COBRA, TennCare or other qualifying coverage.
