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

Effective Date:

Approval Date: September 19, 2002 20 Share or Premium until either she is enrolled in Medicaid or she is otherwise disenrolled from the program as described in Section 4.1.8. The State will claim FFP under Title XXI for services she receives while she is enrolled in KidCare Share or Premium.

4.4.3. The State is taking steps to assist in the enrollment in SCHIP of children determined ineligible for Medicaid. (Sections 2102(a)(1) and (2) and 2102(c)(2)) (42CFR 431.636(b)(4))

The single application process ensures that children who are not eligible for Medicaid are reviewed for eligibility for KidCare Share, KidCare Premium, and KidCare Rebate before an application is denied.

4.4.4 The insurance provided under the state child health plan does not substitute for coverage under group health plans. Check the appropriate box. (Section 2102)(b)(3)(C)) (42CFR 457.805) (42 CFR 457.810(a)-(c))

4.4.4.1. Coverage provided to children in families at or below 200% FPL: describe the methods of monitoring substitution.

The State is implementing the State funded KidCare Rebate plan to subsidize employer-sponsored or private insurance. The KidCare Rebate plan serves as a significant “anti-crowd-out” strategy. This plan was designed to bring fairness to families who would be otherwise eligible for KidCare Share or KidCare Premium, but who, because they made the effort to insure their children, would be ineligible for coverage under the Children’s Health Insurance Program. By providing these families with a subsidy to offset the costs of health insurance for their children, the rebate encourages families to retain their private coverage. The rebate also encourages employers to continue offering coverage to their employees’ dependents.

In addition, under KidCare Share and KidCare Premium, the State utilizes the same methods used under Title XIX to identify any third party payers.

The State will monitor the effect of KidCare on private insurers and modify the program if it appears that,