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Model Application Template for the State Children‟s Health Insurance Program

Effective Date:

Approval Date: 6 Amendment. This will allow CHIP eligible children (optional targeted low- income children) to be reported and claimed at the enhanced rate and other newly eligible children to be reported and claimed at the State's standard FMAP. Children eligible for Medicaid as a result of the expansion receive health care services through the same delivery systems that operate in the Medicaid program.

Separate Program: Healthy And Well Kids In Iowa (hawk-i) Program (S-CHIP) The Healthy And Well Kids in Iowa (hawk-i) program covers targeted low- income children up to age 19 in families who income does not exceed 200 percent of the FPL. Effective January 1, 1999, the State implemented the hawk-i program for targeted low-income children up to age 19 in families who income was at or below 185% of the Federal Poverty Level (FPL). The State expanded coverage to 200% of the FPL effective July 1, 2000. Effective July 1, 2009, when determining eligibility, all income between 200 percent and 300 percent of the FPL shall be disregarded.

The hawk-i program has several components and is designed to encompass a variety of entry points into the program. The delivery of services follows a private sector commercial insurance model. Iowa Department of Human Services: The Department of Human Services (DHS) has been designated as the State agency to administer the hawk-i program. hawk-i Board. The Iowa General Assembly authorized the creation of the hawk-i Board to provide direction to the Department of Human Services and to establish policy for the program. The hawk-i Board is made up of eleven members: Director of the Iowa Department of Public Health or their designee Director of the Iowa Department of Education or their designee Commissioner of the Iowa Division of Insurance or their designee Four Governor-appointed public members Four ex-officio legislators (2 Senate/2 House of Representatives)

Third Party Administrator: The Department of Human Services has contracted with a third party administrator to provide, at a minimum, the following services: Distribute applications Determine eligibility