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DELAWARE HEALTHY CHILDREN PROGRAM (DHCP) 14
Transmittal # DHCP SPA #5 Approval Date July 28, 2009 Supersedes Transmittal # DHCP SPA #4 Effective Date April 1, 2009
• death of parent, • disability of parent, • termination of employment, • change to a new employer who does not cover dependents, • change of address so that no employer-sponsored coverage is available, • expiration of the coverage periods established by COBRA • employer terminating health coverage as a benefit for all employees.
The recommendation for enforcement of this provision is:
Simple declaration at the time of application and during each redetermination.
The joint application asks whether the applicant currently has health insurance. The Third Party Liability Unit verifies this information.
Delaware will monitor the data collected from the application on private coverage, looking for trends on substitution of coverage over time.
4.4.4.2
Coverage provided to children in families over 200% and up to 250% FPL: describe how substitution is monitored and identify specific strategies to limit substitution if levels become unacceptable.
4.4.4.3. Coverage provided to children in families above 250% FPL: Describe how substitution is monitored and identify specific strategies in place to prevent substitution.
4.4.4.4. If the state provides coverage under a premium assistance program, describe:
The minimum period without coverage under a group health plan, including any allowable exceptions to the waiting period.
The minimum employer contribution.
The cost-effectiveness determination.
4.4.5 Child health assistance is provided to targeted low-income children in the state who are American Indian and Alaska Native. (Section 2102)(b)(3)(D)) (42 CFR 457.125(a))