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

Effective Date:

Approval Date: 9-6

Benefit Costs

Enrollment projections are based on current estimates of funds earmarked for the CHPlus program.

New York Child Health Plus Program Benefit Budget FY 2010

Fiscal Year Year End Enrollment Average Per Member Per Month Total Benefit Cost Premium Offset Net Benefit Cost 2010 327,000 $170.00 $704,776,000 ($27,124,000) $677,652,000

Please note, the FFY 2010 budget reflects 13 months of premium expenditures because only 11 months were paid in FFY 2009.

The participating health plans are reimbursed on a per-member per-month all-inclusive premium for all operational and programmatic costs incurred under this program, except vaccine costs.

The total costs were developed assuming an average monthly premium applied to an estimated monthly enrollment.

Funds are to be distributed from the Health Care Initiatives Pool for the Child Health Plus program in the following amounts:

(i.) $207 million - 1/1/00-12/31/00 (ii.) $235 million - 1/1/01-12/31/01 (iii.) $324 million - 1/1/02-12/31/02 (iv.) $450 million - 1/1/03-12/31/03 (v.) $461 million - 1/1/04-12/31/04 (vi.) $153 million - 1/1/05-12/31/05 (vii.) $325.5 million - 1/1/06-12/31/06 (viii.) $428.6 million - 1/1/07-12/31/07 (ix.) $453.7 million - 1/1/08-12/31/08 (x.) $453.7 million - 1/1/09-12/31/09 (xi.) $453.7 million - 1/1/10-12/31/10