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temporary income from the decennial Census from the eligibility and cost sharing calculations for State Children’s Health Insurance Program (SCHIP) applicants and enrollees.

• On October 1, 2008, the State submitted its twenty-first amendment to allow persons, who were determined eligible for State Children’s Health Insurance Program (SCHIP) renewal in August and had to pay an enrollment fee by the September cut off date, to have until the cut off date in November to pay the fee. As a result of Hurricane Ike, the mail delivery system was disrupted and may have affected either payments that may have been sent or had prevented families from mailing their enrollment fee timely.

Children Covered Under Program

• The State reported that 585,461 children were ever enrolled in SCHIP in FFY 2006.

Administration

• The Texas Health and Human Services Commission is the entity that administers SCHIP.

Health Care Delivery System

• Services for the child health program are delivered through a managed care model and an exclusive provider organization (EPO) model. Under the HMO/EPO model, plans are required to provide the range of children’s health services for a contracted per member per month cost. The areas serviced are organized into CHIP Service Areas (CSAs). The EPO service area includes 170 primarily rural Texas counties.

Benefit Package

• The benefits package is approved as Secretary-approved coverage. The benefit package includes well-baby and well-child services, immunizations, emergency services, inpatient and outpatient care, prescription drugs, diagnostic services, durable medical equipment, and inpatient and outpatient mental health and substance abuse treatment and services.

• The State offers a three-tiered dental benefit. Each tier of benefits includes preventive services up to $250. The limit on the amount of therapeutic services available varies (ranging from $280 to $565) depending upon when an individual re- enrolls in the program at the end of a 12-month enrollment period.

Cost Sharing Monthly premiums and copayments are described below.

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