Page 68

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

STATE: Virginia Page 9-68

Effective Date: 07/01/05

68 Approval Date: _____________/06 cost-sharing by enrollees.

SCHIP Budget Plan Template

Federal Fiscal Year Costs – FFY 2007 Enhanced FMAP rate 65% Benefit Costs

Insurance payments

Managed care 89,151,050 per member/per month rate @ # of eligibles $119.50 @ 748,851 months Fee for Service $62,816,498 Total Benefit Costs

(Offsetting beneficiary cost sharing payments)

Net Benefit Costs $151,967,547

Administration Costs

Personnel $1,525,467 General administration $206,750 Contractors/Brokers (e.g., enrollment contractors) $7,083,500 Claims Processing $50,000 Outreach/marketing costs $1,603,002 Other $290,865 Total Administration Costs $10,759,584 10% Administrative Cost Ceiling $16,885,283

Federal Share (multiplied by enh-FMAP rate) $179,238 State Share $96,513 TOTAL PROGRAM COSTS $162,727,131

Note: The Federal Fiscal Year (FFY) runs from October 1st through September 30th.

Funding:

State funding comes from two sources: State General Funds, and the Family Access to Medical