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Virginia FAMIS MOMS and FAMIS Select Section 1115 Demonstration Demonstration Period: October 25, 2019 through June 30, 2029; Amended November 18, 2021 Page 43 of 61

FAMIS Select: The demonstration will operate a cost-effective health insurance subsidy program that offers a consistently high-quality experience for FAMIS Select members over the course of the 10-year demonstration renewal period by:

• Assuring that consumer experience of FAMIS Select participants, with respect to customer service and health care access, is satisfactory or better • Ensuring the FAMIS Select program is cost-effective for DMAS

Maintain or improve healthcare access and health outcomes for women enrolled in FAMIS MOMS over the course of the 10-year demonstration renewal period Facilitate access to prenatal care for FAMIS MOMS participants Maintain or increase rates of FAMIS MOMS receiving adequate prenatal care (at least 80% of prenatal visits) Improve birth outcomes for babies born to FAMIS MOMS participants Maintain or decrease the proportion of births to FAMIS MOMS participants that are preterm (less than 37 weeks gestation) Maintain or decrease the incidence of low birth weights (birth weight less than 5 pounds, 8 ounces or 2500 grams) for babies born to FAMIS MOMS Operate cost-effective health insurance subsidy program that offers a consistently high quality experience for FAMIS Select members over the course of the 10-year demonstration renewal period Assure that consumer experience of FAMIS Select participants, with respect to customer service and health care access, is satisfactory or better FAMIS Select members’ families will report that they are satisfied with the service offered by the Select program, a subsidy for private or employer- sponsored insurance Families will report that children in FAMIS Select have a satisfactory level of access to health care services through their private or employer- sponsored insurance subsidized by FAMIS Select Ensure the FAMIS Select program is cost-effective for DMAS Average per-enrollee, per- month cost associated with FAMIS Select program will not exceed per-enrollee, per-month cost of providing the FAMIS benefit plan Aim Primary Drivers Secondary Drivers Aim Primary Drivers Secondary Drivers