Page 3

3 eligibility for one year, with the debt forgiven, to a family losing eligibility until the debt is paid in-full.

• On April 28, 2006, Idaho submitted its seventh amendment. This amendment implements a school-based health service initiative for low-income children as allowed under the 10 percent administrative cap of CHIP. Grants will be made to school districts to assist with the salary expenses of registered nurses working in schools. Services provided will include health counseling and education, health screenings, prevention services, health coordination, referral to care outside of school, and application assistance leading to enrollment in Title XIX and Title XXI health coverage programs.

• On May 5, 2006, Idaho submitted its eighth amendment. This amendment changes the lower income eligibility level for the separate CHIP program for children from birth through 18 years from 150 percent of the Federal poverty level (FPL) to above 133 percent of the FPL, yielding a revised income eligibility standard of above 133 percent of the FPL through 185 percent of the FPL. This amendment also limits enrollment in the State’s title XXI Medicaid Expansion Program to children ages 6 through 18 years with family income above 100 percent of the FPL through 133 percent of the FPL. The amendment removes the resource limits related to program eligibility and imposes premiums for children with family income above 133 percent of the FPL. Enrollees in the Basic Benchmark Benefit Package with family incomes above 133 percent through 150 percent of the FPL will be subject to a $10 per member per month premium. Enrollees in the Basic Benchmark Benefit Package with family incomes above 150 percent through 185 percent of the FPL will be subject to a $10 per member per month premium for medical services and an additional $5 per month for dental services. Enrollees in the Enhanced Benchmark Benefit Package are not subject to premiums. This amendment also changes the current benefit package to a Secretary-Approved package, entitled the ‘Basic Benchmark Benefit Package’ or, an ‘Enhanced Benchmark Benefit Package,’ for children with special health care needs.

• On January 24, 2007, Idaho submitted its ninth amendment. This amendment established a mechanism to assist participants with their premium payment obligations, called the Wellness Preventative Health Assistance (Wellness PHA). Each enrollee who is required to make premium payments can earn 30 points every 3 months by receiving recommended wellness visits and demonstrating up-to-date immunizations. Each point equals one dollar and can be used to offset premium payments. A child with family income below 150 percent of the Federal Poverty Level (FPL) may have all his premium obligations met by utilizing Wellness PHA. Children in families from 150 percent up to and including 185 percent of the FPL may offset up to two-thirds of their payments. This amendment also adds a nominal co-payment of $3 for participants who seek care at a hospital emergency department or access emergency transportation for a non emergency condition.