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31 Include whether or not State has opted to use SSA verification option.

Please see approved CS18 template for citizenship verification requirements.

4.1.1 Geographic area served by the Plan if less than Statewide:

Please see approved CS7 and CS9 templates for geographic area requirements.

4.1.2 Ages of each eligibility group, including unborn children and pregnant women (if applicable) and the income standard for that group:

CA RESPONSE: Please see Section 2 above for overview of relevant separate CHIP populations (Populations 1, 2, 3 and 4 above), and also see CS7 template for approved income levels for Populations 1. Also please see CS23 template for approved income levels for Population 4.

4.1.2.1-PC Age: From confirmed pregnancy to birth (SHO #02-004, issued November 12, 2002)

CA RESPONSE:

Please see Section 2 above for overview of relevant separate CHIP populations (Populations 2 and 3) and also see approved CS9 template for approved income levels for the unborn population.

4.1.3 Income of each separate eligibility group (if applicable):

CA RESPONSE: Please see information above for each group.

4.1.3.1-PC 0% of the FPL (and not eligible for Medicaid) through 317% of the FPL (SHO #02-004, issued November 12, 2002).

CA RESPONSE: Please see information above for Populations 2 and 3.

4.1.4 Resources of each separate eligibility group (including any standards relating to spend downs and disposition of resources):

4.1.5 Residency (so long as residency requirement is not based on length of time in state):

CA REPSONSE: Please see approved CS17 template for residency requirements.