Benefits for 2022 Legal Notices IOWA –Medicaid and CHIP (Hawki) MONTANA –Medicaid https://dhs.iowa.gov/ime/members http://dphhs.mt.gov/MontanaHealthcarePrograms/HIPP Medicaid Website: Website: Medicaid Phone: 1-800-338-8366 Phone: 1-800-694-3084 Hawki Website: http://dhs.iowa.gov/Hawki Hawki Phone: 1-800-257-8563 KANSAS –Medicaid NEBRASKA –Medicaid Website: http://www.kdheks.gov/hcf/default.htm Website: http://www.ACCESSNebraska.ne.gov Phone: 1-800-792-4884 Phone: (855) 632-7633 Lincoln: (402) 473-7000 Omaha: (402) 595-1178 KENTUCKY –Medicaid NEVADA –Medicaid Kentucky Integrated Health Insurance Premium Payment Program Medicaid Website: http://dhcfp.nv.gov/ (KI-HIPP) Website: Medicaid Phone: 1-800-992-0900 https://chfs.ky.gov/agencies/dms/member/Pages/kihipp.aspx Phone: 1-855-459-6328 Email: [email protected] KCHIP Website: https://kidshealth.ky.gov/Pages/index.aspx Phone: 1-877-524-4718 Kentucky Medicaid Website: https://chfs.ky.gov LOUISIANA – Medicaid NEW HAMPSHIRE –Medicaid Website: www.medicaid.la.gov or www.ldh.la.gov/lahipp Website: https://www.dhhs.nh.gov/oii/hipp.htm Phone: 1-888-342-6207 (Medicaid hotline) or 1-855-618-5488 Phone: 603-271-5218 (LaHIPP) Toll free number for the HIPP program: 1-800-852-3345, ext 5218 MAINE –Medicaid NEW JERSEY –Medicaid and CHIP Website: http://www.maine.gov/dhhs/ofi/public-assistance/index.html Medicaid Website: Phone: 1-800-442-6003 http://www.state.nj.us/humanservices/dmahs/clients/medicaid/ TTY: Maine relay 711 Medicaid Phone: 609-631-2392 Private Health Insurance Premium Webpage: CHIP Website: http://www.njfamilycare.org/index.html https://www.maine.gov/dhhs/ofi/applications-forms CHIP Phone: 1-800-701-0710 Phone: -800-977-6740. TTY: Maine relay 711 MASSACHUSETTS –Medicaid and CHIP NEW YORK –Medicaid Website: http://www.mass.gov/eohhs/gov/departments/masshealth/ Website: https://www.health.ny.gov/health_care/medicaid/ Phone: 1-800-862-4840 Phone: 1-800-541-2831 MINNESOTA – Medicaid NORTH CAROLINA –Medicaid Website: https://medicaid.ncdhhs.gov/ Website: https://mn.gov/dhs/people-we-serve/children-and-families/health- Phone: 919-855-4100 care/health-care-programs/programs-and-services/other- insurance.jsp Phone: 1-800-657-3739 MISSOURI – Medicaid NORTH DAKOTA –Medicaid Website: http://www.dss.mo.gov/mhd/participants/pages/hipp.htm Website: http://www.nd.gov/dhs/services/medicalserv/medicaid/ Phone: 573-751-2005 Phone: 1-844-854-4825 OKLAHOMA –Medicaid and CHIP UTAH –Medicaid and CHIP Website: http://www.insureoklahoma.org Medicaid Website: https://medicaid.utah.gov/ Phone: 1-888-365-3742 CHIP Website: http://health.utah.gov/chip Phone: 1-877-543-7669 OREGON –Medicaid VERMONT–Medicaid Website: Website: http://www.greenmountaincare.org/ http://healthcare.oregon.gov/Pages/index.aspx Phone: 1-800-250-8427 http://www.oregonhealthcare.gov/index-es.html Phone: 1-800-699-9075 PENNSYLVANIA –Medicaid VIRGINIA – Medicaid and CHIP Website: https://www.dhs.pa.gov/providers/Pages/Medical/HIPP- Website: http://www.coverva.org/hipp/ Program.aspx Medicaid Phone: 1-800-432-5924 Phone: 1-800-692-7462 CHIP Phone: 1-855-242-8282 2022 Employee Benefit Guide This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations, and exclusions set forth in each insurance 23 carrier or provider’s contract.