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Effective Date: November 1, 2009 November 1, 2009 November 1, 2009 membership is received, the HFP then determines or solicits additional information if needed to determine the employer’s contribution towards dependent children’s benefits to ensure that these children are truly eligible for the HFP. In addition, if an applying child is an inmate in a public correctional institution, or if they are a patient in an institution for mental illness, they are also ineligible for the HFP. The HFP application includes a declaration that must be signed addressing all the above eligibility exceptions. • At the time of application, children enrolled in C-CHIP cannot be eligible for no cost Medi-Cal or the Healthy Families Program. • To be eligible for AIM, families must agree to pay 1.5% of the family’s gross income. • Eligibles receiving coverage in the Medi-Cal Program and claimed under Title XXI are those not currently (prior to submission of this SPA) eligible for federally funded non- emergency health care services from confirmed pregnancy through birth. • Eligibles receiving overage in the AIM Program and uninsured will be claimed under Title XXI. Insurance status is collected on the AIM application and hence easily identifiable. • As of January 1, 2010, individuals who declare on the joint application that they are United States Citizens/Nationals must comply with citizenship and identity requirements described in Section 6036 of the Deficit Reduction Act (DRA) and Section 211 of the Children’s Health Insurance Reauthorization Act for CHIP eligibility. Funding for these children is from Title XXI. • Lawfully Residing children enrolled in the Healthy Families Program (HFP) are required to provide valid documentation. While enrolled in the HFP, these lawfully residing children are eligible for funding under Title XXI, however will be subjected to Approval Date: HFP Family Contribution Increase HFP Co-Payment Increase HFP Limited Dental Plan Choice for New Subscribers

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