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STATE CHILD HEALTH PLAN UNDER TITLE XXI OF THE SOCIAL SECURITY ACT

STATE: Virginia Page 6-48

Effective Date: 07/01/05

48 Approval Date: _____________/06

The families of targeted low-income children who have access to health insurance through their employer may be eligible for premium assistance for the purchase of their employer-sponsored health insurance if certain conditions are met. However, the goal of the FAMIS Plan is to provide coverage for eligible children under their parents' employer-sponsored plan. Any coverage of individuals not eligible for FAMIS is incidental.

6.4.2.1. Purchase of family coverage is cost-effective relative to the amounts that the state would have paid to obtain comparable coverage only of the targeted low-income children involved; and (Describe the associated costs for purchasing the family coverage relative to the coverage for the low income children.) (Section 2105(c)(3)(A)) (42CFR 457.1010(a))

6.4.2.2. The state assures that the family coverage would not otherwise substitute for health insurance coverage that would be provided to such children but for the purchase of family coverage. (Section 2105(c)(3)(B)) (42CFR 457.1010(b))

6.4.2.3. The state assures that the coverage for the family otherwise meets title XXI requirements. (42CFR 457.1010(c))