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19 Effective Date: July 1, 2009

Approval Date:

Amendment 10 - This amendment increased funding from CHIP for additional outreach activities as a part of the passage of Cover All Kids legislation. Submitted: April 3, 2008 Approved: December 17, 2008 Effective date: July 1, 2007 Amendment 11 - This amendment proposes increasing the income limit to 300% FPL and creating a two-tiered premium structure for CHIP. The premium amount will also be increased. Good cause for dropping employer sponsored insurance is also amended from a cost of $50 to a cost of 2.5% household income. Submitted: April 14, 2008 Approved: April 3, 2009 Effective date: January 1, 2009 Amendment 12 - This amendment expanded the delivery of mental health services. Submitted: May 14, 2008 Approved: January 16, 2009 Effective date: July 1, 2008 Amendment 13 – This amendment is to provide federal funding for the Washington Poison Center (WAPC) under a health services initiative; expand CHIP coverage to lawfully residing alien children under age 19 ; require verification of citizenship; describe the CHIP dental coverage package; reference FQHC/RHC reimbursement methodology; and eliminate the 3 month sanction for failing to pay required premiums. Submitted date: June 29, 2010 Approved date: Effective date: July 1, 2009 for WAPC funding and Lawfully residing alien children.

October 1, 2009 for dental coverage and FQHC/RHC descriptions.

January 1, 2010 for citizenship verification requirement.

April 1, 2010 for elimination of 3 month sanction penalty.