Page 34 - Willscot I Mobile Mini Open Enrollment Guide

MAINE – Medicaid
NEW JERSEY – Medicaid and CHIP
Enrollment Website: https://www.maine.gov/dhhs/ofi/applications-forms Phone: 1-800-442-6003 TTY: Maine relay 711
Private Health Insurance Premium Webpage: https://www.maine.gov/dhhs/ofi/applications-forms
Phone: 1-800-977-6740 TTY: Maine relay 711
Medicaid Website:
http://www.state.nj.us/humanservices/dmahs/clients/medicaid/
Medicaid Phone: 609-631-2392
CHIP Website: http://www.njfamilycare.org/index.html CHIP Phone: 1-800-701-0710
MASSACHUSETTS – Medicaid and CHIP
NEW YORK – Medicaid
Website: https://www.mass.gov/info-details/masshealth-premium-assistance-pa Phone: 1-800-862-4840
Website: http://www.dss.mo.gov/mhd/participants/pages/hipp.htm Phone: 573-751-2005
Website: http://www.insureoklahoma.org Phone: 1-888-365-3742
Website: http://healthcare.oregon.gov/Pages/index.aspx http://www.oregonhealthcare.gov/index-es.html
Phone: 1-800-699-9075
Website:
https://www.dhs.pa.gov/providers/Providers/Pages/Medical/HIPP-Program.aspx
Phone: 1-800-692-7462
Website: http://www.eohhs.ri.gov/
Phone: 1-855-697-4347, or 401-462-0311 (Direct RIte Share Line)
Website: https://www.scdhhs.gov Phone: 1-888-549-0820
Website: http://dss.sd.gov Phone: 1-888-828-0059
Website: http://gethipptexas.com/ Phone: 1-800-440-0493
Website: https://www.health.ny.gov/health_care/medicaid/ Phone: 1-800-541-2831
Website: http://www.nd.gov/dhs/services/medicalserv/medicaid/ Phone: 1-844-854-4825
Medicaid Website: https://medicaid.utah.gov/
CHIP Website: http://health.utah.gov/chip Phone: 1-877-543-7669
Website: http://www.greenmountaincare.org/ Phone: 1-800-250-8427
Website: https://www.coverva.org/en/famis-select https://www.coverva.org/en/hipp
Medicaid Phone: 1-800-432-5924 CHIP Phone: 1-800-432-5924
Website: https://www.hca.wa.gov/ Phone: 1-800-562-3022
Website: http://mywvhipp.com/
Toll-free phone: 1-855-MyWVHIPP (1-855-699-8447)
Website: https://www.dhs.wisconsin.gov/badgercareplus/p-10095.htm Phone: 1-800-362-3002
Website:
https://health.wyo.gov/healthcarefin/medicaid/programs-and-eligibility/
Phone: 1-800-251-1269
MINNESOTA – Medicaid
NORTH CAROLINA – Medicaid
Website:
https://mn.gov/dhs/people-we-serve/children-and-families/health-care/ health-care-programs/programs-and-services/other-insurance.jsp Phone: 1-800-657-3739
Website: https://medicaid.ncdhhs.gov/ Phone: 919-855-4100
MISSOURI – Medicaid
NORTH DAKOTA – Medicaid
OKLAHOMA – Medicaid and CHIP
UTAH – Medicaid and CHIP
OREGON – Medicaid
VERMONT– Medicaid
PENNSYLVANIA – Medicaid
VIRGINIA – Medicaid and CHIP
RHODE ISLAND – Medicaid and CHIP
WASHINGTON – Medicaid
SOUTH CAROLINA – Medicaid
WEST VIRGINIA – Medicaid
SOUTH DAKOTA - Medicaid
WISCONSIN – Medicaid and CHIP
TEXAS – Medicaid
WYOMING – Medicaid
To see if any other states have added a premium assistance program since July 31, 2021, or for more information on special enrollment rights, contact either: U.S. Department of Labor U.S. Department of Health and Human Services
Employee Benefits Security Administration
www.dol.gov/agencies/ebsa
1-866-444-EBSA (3272)
PAPERWORK REDUCTION ACT STATEMENT
Centers for Medicare & Medicaid Services
www.cms.hhs.gov
1-877-267-2323, Menu Option 4, Ext. 61565
According to the Paperwork Reduction Act of 1995 (Pub. L. 104-13) (PRA), no persons are required to respond to a collection of information unless such collection displays a valid Office of Management and Budget (OMB) control number. The Department notes that a Federal agency cannot conduct or sponsor a collection of information unless it is approved by OMB under the PRA, and displays a currently valid OMB control number, and the public is not required to respond to a collection of information unless it displays a currently valid OMB control number. See 44 U.S.C. 3507. Also, notwithstanding any other provisions of law, no person shall be subject to penalty for failing to comply with a collection of information if the collection of information does not display a currently valid OMB control number. See 44 U.S.C. 3512.
The public reporting burden for this collection of information is estimated to average approximately seven minutes per respondent. Interested parties are encouraged to send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Labor, Employee Benefits Security Administration, Office of Policy and Research, Attention: PRA Clearance Officer, 200 Constitution Avenue, N.W., Room N-5718, Washington, DC 20210 or email ebsa.opr@dol.gov and reference the OMB Control Number 1210-0137.
OMB Control Number 1210-0137 (expires 1/31/2023)
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