CHIP Administration & Eligibility

Template CS34 – General Eligibility - Express Lane Eligibility Components

Statute: Sections 2107(e)(1)(E) and 1902(e)(13) of the SSA

Regulation:

INTRODUCTION

To be completed by States with separate child health assistance programs which elected the option to use Express Lane agencies to determine whether a child meets one or more of the requirements for CHIP eligibility in template CS32.

Template CS34 is used in conjunction with CS32 Express Lane Eligibility. States use this template to specify the eligibility components used by each Express Lane Agency used by the State.

BACKGROUND

States may vary which eligibility components are used by individual Express Lane agencies provided that at a minimum, household income and household size are used by all Express Lane agencies.

Additional background information may be found in the implementation guidance for template CS32.

TECHNICAL GUIDANCE

PREREQUISITE: States must have completed template CS32 through the Express Lane Eligibility Components section within which this template gets displayed and template CS33 (Express Lane Agencies) before completing this template. This template will not display if template CS33 has not been completed.

The system will display each agency that the State has designated as an Express Lane Agency on the CS33 Express Lane Agencies template. For each agency, the State must select from the list displayed, of eligibility findings which are determined by the Express Lane Agency.

If the State selects ‘Other’, is must enter a name (this can be any name that relates to the eligibility component and makes sense to the State) and description . If the Agency uses more than one additional eligibility component, the State must reselect ‘Other’ until all the eligibility components 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.

For each eligibility component checked the State must select Y or N to indicate if the methodology used under the Express Lane option is the same as it otherwise uses in determining eligibility for CHIP.

• If No, the State must describe any differences between the two methodologies in the text box provided.

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.

There is a copy capability in this template so that the State may copy its response from one Express Lane agency to another Express Lane agency and then, if necessary, modify it to reflect any differences.

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