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17 Transmittal Number SPA Group PDF # Description Superseded Plan Section(s)

Approval Date: 7/22/2014 Effective/Imple mentation Date: January 1, 2014

2101(f) Group for Medicaid as a Result of the Elimination of Income Disregards under section 4.1 CA-14-0004

Approval Date: Not yet approved. Effective/Imple mentation Date: October 1, 2013 Eligibility Processing CS24 Eligibility Process

CA-14-0005

Approval Date: 4/9/2015 Effective/Imple mentation Date: January 1, 2014

Non- Financial Eligibility CS17

CS18

CS19

CS20

CS21

CS27

CS28 Non-Financial Eligibility – Residency

Non-Financial Eligibility – Citizenship

Non-Financial Eligibility – Social Security Number

Non-Financial Eligibility – Substitution of Coverage

Non-Financial Eligibility – Non-Payment of Premiums

General Eligibility – Continuous Eligibility Supersedes the current section 4.1.5

Supersedes the current sections 4.1.0; 4.1-LR; 4.1.1-LR

Supersedes the current section 4.1.9.1

Supersedes the current section 4.4.4

Supersedes the current section 8.7

Supersedes the current section 4.1.8

Supersedes the current section 4.3.2