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28 Effective Date: July 1, 2001

Approval Date: 5) Child’s medical coverage ended because the child reached the maximum lifetime coverage amount. 6) Coverage under a COBRA extension period ended. 7) Children could not get medical services locally (they have to travel to another city or state to get care for their children). 8) Domestic violence led to loss of coverage. 9) The family’s total out-of-pocket maximum for employer-sponsored dependent coverage is 2.5 percent per month or more of family countable income. If none of the exceptions apply, the child must serve a 4-month waiting period prior to enrollment in CHIP. Another way we monitor for substitution of coverage is through the review of a monthly report of currently eligible CHIP clients. MPA researches this report for health insurance coverage to ensure there was no substitution of coverage at the time of application or re-determination.

4.4.4.3. Coverage provided to children in families above 250% of the FPL. Describe how substitution is monitored and identify specific strategies in place to prevent substitution.

The same strategies that are used to prevent substitution of coverage as described in 4.4.4.2 will be utilized in establishing eligibility for children in the 250%-300%FPL group.

4.4.4.4. If the State provides coverage under a Premium Assistance Program, describe: The minimum period without coverage under a group health plan, including any allowable exceptions to the waiting period. The minimum employer contribution. The cost-effectiveness determination.

4.4.5 Child health assistance is provided to targeted low-income children in the State who are American Indian and Alaska Native. (Section 2102)(b)(3)(D)) (42 CFR 457.125(a))

Targeted low-income children who are American Indian or Alaska Native (AI/AN) will