CHIP Administration & Eligibility

Template CS27 – General Eligibility - Continuous Eligibility

Statute: 2105(a)(4)(A)

Regulation:

INTRODUCTION

To be completed by States with separate child health assistance programs.

In template CS27, States indicate if they elect the option to provide continuous eligibility (CE) coverage and if so, provide information as to the administration of continuous eligibility.

BACKGROUND

States have the option to extend coverage to children for up to a full 12 month period if certain conditions are met, although a change in family circumstances might otherwise result in the termination of eligibility.

TECHNICAL GUIDANCE

This template is broken down into the following sections:

Policy Statement

Selection of Continuous Eligibility Option

Age and CE Period

Exceptions to CE

Policy Statement

Template CS27 begins with a policy statement that ‘ The CHIP Agency may provide that children who have been determined eligible under the state plan, shall remain eligible until either the end of a period (not to exceed 12 months) following determination, or the time the child exceeds an age specified by the state (not to exceed 19), whichever is earlier.’

Selection of Continuous Eligibility Option

In this section, States respond to a Y/N question as to whether it elects to provide continuous eligibility.

If the answer is no, no additional entries are required by the State on this screen.

If the answer is yes, the State must complete the next two sections

Age and CE Period

For age, States must enter the age of children up to which the State will apply continuous eligibility. .

Validation: The system will not accept a number for age that exceeds19.

For eligibility period, States must select one of the two options listed.

If the State selects the first option, it must then select the number of months from a drop down list of the numbers 1 through 12 appearing in descending order.

Exceptions to CE

This section displays 6 options for exceptions to continuous eligibility, from which the State can select none, one or more.

If the State selects ‘Other’, it must enter a description in the text box provided. States should also include the rationale for the exception. If the State has more than one additional exception, it can re-check the box next to other and repeat the process until all exceptions have been entered.

Review Criteria

The description should be sufficiently clear, detailed and complete to permit the reviewer to determine that the State’s election meets applicable federal statutory, regulatory and policy requirements.

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