Page 52
46
CA RESPONSE:
1. DHCS continues to improve the state’s Single Streamlined Application to allow enrollment in all programs, including subsidized and unsubsidized coverage in the marketplace. • Having a simplified application in an environment where all eligibility is determined provides ease of access. It also shows the availability of all programs the applicant may be eligible for.
2. Enrollment information packets. • Managed care plans provide mailed out information to provide options and education to what benefits are offered.
Section 6. Coverage Requirements for Children’s Health Insurance
Check here if the State elects to use funds provided under Title XXI only to provide expanded eligibility under the State’s Medicaid plan and proceed to Section 7 since children covered under a Medicaid expansion program will receive all Medicaid covered services including EPSDT.
6.1. The State elects to provide the following forms of coverage to children: (Check all that apply.) (Section 2103(c)); (42CFR 457.410(a))
Guidance: Benchmark coverage is substantially equal to the benefits coverage in a benchmark benefit package (FEHBP-equivalent coverage, State employee coverage, and/or the HMO coverage plan that has the largest insured commercial, non-Medicaid enrollment in the state). If box below is checked, either 6.1.1.1., 6.1.1.2., or 6.1.1.3. must also be checked. (Section 2103(a)(1))
6.1.1.
Benchmark coverage; (Section 2103(a)(1) and 42 CFR 457.420)
Guidance: Check box below if the benchmark benefit package to be offered by the State is the standard Blue Cross/Blue Shield preferred provider option service benefit plan, as described in and offered under Section 8903(1) of Title 5, United States Code. (Section 2103(b)(1) (42 CFR 457.420(b))
6.1.1.1.
FEHBP-equivalent coverage; (Section 2103(b)(1) (42 CFR 457.420(a)) (If checked, attach copy of the plan.)
Guidance: Check box below if the benchmark benefit package to be offered by the State is State employee coverage, meaning a coverage plan that is offered