Page 2

under age 19, including unborn children, with family income at or below 250 percent of the FPL, and who are not eligible for Medicaid or TennCare Standard. • On July 17, 2007, the State submitted its third State plan amendment, to add dental and vision services to the benefit package for children from 0 up to 19 years of age. Dental benefits only were added to the prenatal services available in the benefit package for unborn children. Administration: • Phase I: The Bureau of TennCare administered this program as a Medicaid expansion. • CoverKids: The Division of Insurance Administration, Tennessee Department of Finance and Administration, will administer this program as a separate child health program. Children Covered Under Program: • Phase I: Tennessee estimated 9,732 children would be covered. • CoverKids: Tennessee estimates the target population for CoverKids is 75,000 children whose family income is too high to qualify for TennCare. Enrollment began in the third quarter of FFY 2007, with 1,727 children ever enrolled in the quarter. Health Care Delivery System: • Phase I: Services were provided through the current mandatory managed care delivery system for the Title XIX program, which operates as a Section 1115 demonstration known as TennCare. • CoverKids: Services will be provided through a health plan managed by the Division of Insurance Administration. The Division will contract with a commercially licensed insurance plan to provide coverage statewide. Benefit Package: • Phase I: The benefit package under the TennCare Section 1115 demonstration was provided. It was more generous than the usual Medicaid package in that most service limits were removed. • CoverKids: The benefit package will be Secretary-approved coverage that includes benchmark coverage plus additional coverage. The benchmark plan is the HMO option of the State Employee Health Plan; additional coverage will be an increased number of visits for outpatient mental health/substance abuse and physical therapy/occupational therapy/speech services. Coverage of dental and vision services (dental only for unborn children) was added effective October 1, 2007.