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Section 8. Cost Sharing and Payment (Section 2103(e)) Check here if the state elects to use funds provided under Title XXI only to provide expanded eligibility under the state’s Medicaid plan, and continue on to Section 9. There is no cost sharing requirements for children enrolled in presumptive eligibility under S-CHIP. There is no cost sharing requirement for eligibles from confirmed pregnancy through birth (0-200% FPL). For eligibles from confirmed pregnancy through birth in households with income 200-300% FPL, there is a family contribution of 1.5% of the families’ annual income. 8.1. Is cost-sharing imposed on any of the children covered under the plan? (42CFR 457.505) 8.1.1. YES 8.1.2. NO, skip to question 8.8. 8.2. Describe the amount of cost-sharing, any sliding scale based on income, the group or groups of enrollees that may be subject to the charge and the service for which the charge is imposed or time period for the charge, as appropriate. (Section 2103(e)(1)(A)) (42CFR 457.505(a), 457.510(b) &(c), 457.515(a)&(c)) 8.2.1. Premiums: Purchasing Pool Premiums Family Value Package. MRMIB will designate one or more “Family Value Packages” (FVP’s) in each geographic area. The FVP is the combination of health, dental, and vision plans which offer the best prices to the program. MRMIB has the ability to designate a range of prices as the “lowest” cost value to the state. The exact range will be designated by MRMIB in the program regulation process. Only plans that fall within the FVP range may be purchased in the program The family contribution amounts have been increased for highest income families pursuant to Chapter 157, Statutes of 2009, California Children and Families Act of 1998 (Assembly Bill 1422) which takes effect on November 1, 2009 for families with income above or greater than 150 % - and less than or Effective Date: Approval Date: November 1, 2009 HFP Family Contribution Increase November 1, 2009 HFP Co-Payment Increase November 1, 2009 HFP Limited Dental Plan Choice for New Subscribers
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