- Application Assistance Referral
- Invitation to Participate
- PCIP Certification
- Premium Assistance Program
This program is administered
by the Managed Risk Medical Insurance Board (MRMIB).
Insurance Agent/Broker and Enrollment Entity (EE) Payment Information
An insurance agent/broker and an enrollment entity with PCIP certified CAAs will receive an application assistance payment for application assistance that result in a successful enrollment in the PCIP program.
To qualify for the application assistance payment, section 10 of the PCIP/MRMIP Application, "For Insurance Agents/Brokers or Certified Application Assistants (CAAs)" must be complete when the application is submitted.
Payments are made in arrears each month based on the applicant’s successful enrollment into PCIP.
If you have questions you can call us at 1-877-428-5060, Monday – Friday, from 8 a.m. to 8 p.m. Or, on Saturday, from 8 a.m. to 5 p.m. Or email us at PCIP@maximus.com.
EE Payment Eligibility
- EE must have submitted an Invitation to Participate (ITP) form and the ITP form approved by the PCIP.
- EE's affiliated CAA must be PCIP Certified.
- EE’s affiliated CAA provided application assistance with a PCIP/MRMIP Application.
- EE’s CAA must complete section 10 of the PCIP/MRMIP Application, "For Insurance Agents/Brokers or Certified Application Assistants (CAAs)". This section must be complete when the application is submitted. This information can not be sent after the application is submitted to the program.
Payment DiscontinuanceInsurance agents/brokers and EEs that have met the eligibility requirements to receive application assistance payments from the PCIP have the right to request NOT to receive any future payments. If an organization chooses not to receive payments based on receiving grant monies or other funds from application assisted activities, an organization must complete and submit to the PCIP the Payment Discontinuance Request Form (PDF 42kb). This form must be completed by the authorized contact for the organization.
Please complete and return the form to:
625 Coolidge Drive, Suite 100
Folsom, CA 95630
Or, you may fax the form to 1-916-673-4500, attention EE/CAA Help Desk.
Research on a Payment Transaction
Insurance agents/brokers and EEs must submit a Payment Research Request Form (PDF 48kb) to PCIP to request research on a payment transaction.