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State Children’s Health Insurance Program

Phase 1 Effective Date: April 1, 1998

Revised: 1/26/98, 2/19/98, 3/3/98, 3/6/98 Phase 2 Effective Date: July 1, 1998

Revised: 8/20/98, 8/24/98, 10/1/99, 7/28/00, 1/31/01, 7/02/02, 7/22/02, 1/3/03, 2/13/04, 9/27/04, 11/15/04, 8/11/05, 10/1/06, 7/1/09, 7/1/10, 7/1/11, 7/1/12 57 • When a family reports an income change that exceeds 200% of the federal poverty level, the child(ren) will receive the remainder of their 12 month continuous eligibility period with no change in their subsidized premium. Exceptions: Six-month transition period is given if the child obtains access to employer- sponsored health insurance costing less than 5% of gross family income. • When a family reports a decrease in income, a Medicaid screening will be done and if potentially eligible, the account will be referred to the Department of Children and Families for a complete Medicaid determination, regardless of their 12 month continuous eligibility period. • The 12 month continuous eligibility period may be different for each family member if adding a new child. At the time of the next renewal cycle, all individuals will be placed on the same 12 month continuous eligibility period. Renewal Process Each family must have their eligibility redetermined every 12 months. The renewal form is mailed to the family two months prior to the month of renewal. The deadline to return the renewal form and the required documentation is the 10th of the month prior to the renewal month. For example: Renewal is due October 1, the notice is mailed to the family the first week in August. The renewal form and documentation is due September 10th. A cancellation notice is mailed to the family the day after the renewal deadline if the renewal form and the documentation are not received. If neither the renewal form nor the documentation is received, coverage is terminated effective the next month. If the family returns at least one document, indicating their intention to comply, the family is given a one month grace period and coverage continues. Coverage is cancelled effective the next month if the remaining documentation is not returned during the one month grace period. During this process, the family will also receive autodialer calls as reminders. An administrative renewal process will begin September 2011. Data matches will be conducted with the Department of Revenue and the Agency for Workforce Innovation the week prior to the renewal initiation period. If income data is available, the income sections of the renewal form will be pre-populated with this information. When the family receives the renewal form they can confirm the information is correct by either signing the paper form or accessing the website and completing the electronic signature. If the information is not correct or incomplete, the family will need to provide verification. In the event that all or a portion of the state is declared a disaster area by the Governor