NR = not reported   NA = not applicable      -- = the state was not required to complete this section of the state plan             template and did not volunteer the information.

Identifiers				Procedural Assurances
				Provisions to Prevent Substitution of Private Coverage
State	Program	Phase or Component	Amend.#	Mandatory Period of No Coverage	Mandatory Period of No Coverage (Months)	Other Insurance Subsidy Programs	Check Against Database of Insurance Holders	Other Provisions	Specify Other Provisions
AK	AK Denali KidCare		NA	Yes	12	--	--	--
AL	AL SCHIP	Phase 1
AL	AL SCHIP	Phase 1	NA	--	--	--	--	--
AL	AL SCHIP	All Kids (Phase 2)
AL	AL SCHIP	All Kids (Phase 2)	1	NR	NR	Yes	Yes	Yes	Premiums are required.
AL	AL SCHIP	All Kids (Phase 2)	2
AL	AL SCHIP	Plus (Phase 3)
AL	AL SCHIP	Plus (Phase 3)	2	NR	NR	Yes	Yes	Yes	Premiums are required.
AR	AR SCHIP	Phase I - ARKids A
AR	AR SCHIP	Phase I - ARKids A	NA	--	--	--	--	--
AR	AR SCHIP	Phase II - ARKids B
AR	AR SCHIP	Phase II - ARKids B	1	Yes	6	NR	NR	NR
AS	AS SCHIP		NA	--	--	--	--	--
AZ	KidsCare		NA	Yes	6	Yes	NR	NR
AZ	KidsCare		1
AZ	KidsCare		2
AZ	KidsCare		3
AZ	KidsCare		4
CA	Healthy Families	Medi-Cal Expansion
CA	Healthy Families	Medi-Cal Expansion	NA	NR	NR	--	--	--
CA	Healthy Families	Medi-Cal Expansion	1
CA	Healthy Families	Medi-Cal Expansion	2
CA	Healthy Families	Health Insurance Plan (MRMIB)
CA	Healthy Families	Health Insurance Plan (MRMIB)	NA	Yes	3	NR	NR	Yes	Copayments are required. Applications are monitored.
CA	Healthy Families	Health Insurance Plan (MRMIB)	2
CA	Healthy Families	Health Insurance Plan (MRMIB)	3
CA	Healthy Families	Health Insurance Plan (MRMIB)	4
CA	Healthy Families	Health Insurance Plan (MRMIB)	5
CA	Healthy Families	Access for Infants and Mothers (AIM)
CA	Healthy Families	Access for Infants and Mothers (AIM)	NA	NR	NR	NR	NR	Yes	Copayments are required. Applications are monitored.
CA	Healthy Families	Access for Infants and Mothers (AIM)	2
CA	Healthy Families	Access for Infants and Mothers (AIM)	3
CA	Healthy Families	Access for Infants and Mothers (AIM)	4
CA	Healthy Families	Access for Infants and Mothers (AIM)	5
CA	Healthy Families	Child Health and Disability Prevention Program
CA	Healthy Families	Child Health and Disability Prevention Program	NA	NR	NR	NR	NR	NR
CA	Healthy Families	Child Health and Disability Prevention Program	2
CA	Healthy Families	Child Health and Disability Prevention Program	3
CA	Healthy Families	California Children`s Services
CA	Healthy Families	California Children`s Services	NA	NR	NR	NR	NR	NR
CA	Healthy Families	California Children`s Services	2
CA	Healthy Families	County Mental Health Program
CA	Healthy Families	County Mental Health Program	NA	NR	NR	NR	NR	NR
CA	Healthy Families	County Mental Health Program	2
CO	CHP+		NA	Yes	3	NR	NR	Yes	State verifies information with employers.
CO	CHP+		1
CO	CHP+		2
CT	HUSKY Program	Part A
CT	HUSKY Program	Part A	NA	No	NA	--	--	--
CT	HUSKY Program	Part A	0
CT	HUSKY Program	Part A	1
CT	HUSKY Program	Part B
CT	HUSKY Program	Part B	NA	Yes	6	NR	NR	Yes	Enrollment broker will contact enrollees' employers in 20 percent of cases to verify insurance status. (Sample size may be adjusted over time.)
CT	HUSKY Program	Part B	1
CT	HUSKY Program	HUSKY Plus Plan for Children with Special Physical Health Needs	NA	Yes	6	NR	NR	Yes	Enrollment broker will contact enrollees' employers in 20 percnet of cases to verify insurance status. (Sample size may be adjusted over time.)
CT	HUSKY Program	HUSKY Plus Plan for Children with Special Physical Health Needs	1
CT	HUSKY Program	HUSKY Plus Behavioral Health Plan	NA	Yes	6	NR	NR	Yes	Enrollment broker will contact enrollees' employers in 20 percent of cases to verify insurance status. (Sample size may be adjusted over time.)
CT	HUSKY Program	HUSKY Plus Behavioral Health Plan	1
DC	DC Healthy Kids		NA	No	NA	--	--	--
DE	Delaware Healthy Children`s Program		NA	Yes	6	NR	NR	Yes	State accepts simple declaration at time of application and redetermination as to coverage during preceding 6 months. Managed Care Organizations perform TPL processing.
DE	Delaware Healthy Children`s Program		1
FL	FL KidCare	Medicaid expansion
FL	FL KidCare	Medicaid expansion	NA	--	--	--	--	--
FL	FL KidCare	Medicaid expansion	1
FL	FL KidCare	Healthy Kids
FL	FL KidCare	Healthy Kids	NA	NR	NR	NR	NR	Yes	Children may enroll only during limited open enrollment periods.
FL	FL KidCare	Healthy Kids	1
FL	FL KidCare	Healthy Kids	3
FL	FL KidCare	Healthy Kids	4
FL	FL KidCare	Medi-Kids	1	NR	NR	NR	NR	Yes	Children may enroll only during limited enrollment periods.
FL	FL KidCare	Medi-Kids	4
FL	FL KidCare	CMS	1	NR	NR	NR	NR	--
FL	FL KidCare	CMS	4
GA	Peach Care for Kids		NA	Yes	3	NR	NR	Yes	State conducts periodic checks of Department of Labor files to determine changes in employment.
GA	Peach Care for Kids		0
GA	Peach Care for Kids		1
GU	Guam SCHIP		NA	--	--	--	--	Yes	Guam will impose penalties, including disqualification, for applicants who purposely disenroll from private health insurance coverage in an effort to qualify for government health insurance coverage.
HI	HI SCHIP	Phase I	NA	Yes	3	--	--	Yes	State will monitor signs of crowd-out. Should crowd-out occur, the period of no coverage will extend to 6 months.
HI	HI SCHIP	Phase I	1
IA	Hawk-I	Medicaid Expansion	NA	--	--	--	--	--
IA	Hawk-I	Medicaid Expansion	4
IA	Hawk-I	Separate State Program	1	Yes	6	NR	NR
IA	Hawk-I	Separate State Program	2
IA	Hawk-I	Separate State Program	3
IA	Hawk-I	Separate State Program	4
ID	ID SCHIP		NA	--	--	--	--	--
ID	ID SCHIP		1
ID	ID SCHIP		2
IL	Kidcare	Phase 1	NA	--	--	--	--	--
IL	Kidcare	Phase 2	1	Yes	3	Yes	NR	Yes	The use of premiums is a deterrent to families dropping existing coverage.
IN	Hoosier Healthwise	Phase 1	NA	--	--	--	--	Yes	Applicant must not have other health insurance.
IN	Hoosier Healthwise	Phase 1	0
IN	Hoosier Healthwise	Phase 2	2	Yes	3	Yes	Yes	Yes	Use of premiums will deter crowd out.
KS	HealthWave		NA	Yes	6	NR	NR	NR
KS	HealthWave		1
KY	KCHIP	Medicaid Expansion
KY	KCHIP	Medicaid Expansion	NA	--	--	--	--	--
KY	KCHIP	Medicaid Expansion	1
KY	KCHIP	Insurance Product
KY	KCHIP	Insurance Product	NA	Yes	6	NR	NR	NR
KY	KCHIP	Insurance Product	1
KY	KCHIP	Insurance Product	2
LA	LaCHIP		NA	Yes	3	--	--	--
LA	LaCHIP		1
MA	MassHealth	Standard	NA	No	NA	Yes	Yes	--
MA	MassHealth	Family Assistance Direct Coverage	NA	No	NA	Yes	Yes	NR
MA	MassHealth	Family Assistance Premium Assistance	NA	No	NA	Yes	Yes	NR
MA	MassHealth	Common Health	NA	No	NA	Yes	Yes	NR
MD	Maryland Children`s Health Program	Phase I	NA	Yes	6	--	--	--
MD	Maryland Children`s Health Program	Phase I	1
MD	Maryland Children`s Health Program	Phase II	2	Yes	6	No	NR	Yes	Phase II includes premium subsidies for employer-spnsored insurance.
MD	Maryland Children`s Health Program	Phase II- ESI	2	Yes	6	No	NR	Yes	Phase II includes premium subsidies for employer-spnsored insurance.
ME	ME CHIP Medicaid Expansion		NA	Yes	3	--	--	--
ME	Cubcare		NA	Yes	3	NR	NR	NR
ME	Cubcare		1
MI	MI SCHIP	MI CHILD	NA	Yes	6	NR	Yes	NR
MI	MI SCHIP	MI CHILD	1
MI	MI SCHIP	MI CHILD	2
MI	MI SCHIP	Medicaid Expansion	1	--	--	--	--	--
MI	MI SCHIP	Medicaid Expansion	2
MN	Minnesota Medical Assistance Program		NA	--	--	--	--	--
MO	MC+ for Kids		NA	Yes	6	--	--	Yes	State will not cover non-emergent transportation, so as not to provide a significant incentive for families to drop private coverage.
MO	MC+ for Kids		1						State will not cover non-emergent transportation, so as not to provide a significant incentive for families to drop private coverage. Also, the state requires that parents in families with income between 225 and 300% FPL certify that their children do not have access to affordable employer-sponsored coverage.
MP	CNMI SCHIP		NA	--	--	--	--	Yes	Does not cover children that have other health insurance.
MS	MS SCHIP	Phase I
MS	MS SCHIP	Phase I	NA	--	--	--	Yes	--
MS	MS SCHIP	Phase II
MS	MS SCHIP	Phase II	1	Yes	3	No	Yes	NR
MS	MS SCHIP	Phase II	2		6
MS	MS SCHIP	Phase II	3
MS	MS SCHIP	Employer-sponsored coverage	1	Yes	3	No	Yes	NR
MT	MT SCHIP		NA	Yes	3	NR	NR	NR
MT	MT SCHIP		1
NC	NC SCHIP		NA	Yes	6	NR	NR	NR
NC	NC SCHIP		1
NC	NC SCHIP		2
NC	NC SCHIP		3
NC	NC SCHIP		4
NC	NC SCHIP		5
ND	Healthy Steps	Phase I
ND	Healthy Steps	Phase I	NA	--	--	--	--	--
ND	Healthy Steps	Phase II
ND	Healthy Steps	Phase II	1	Yes	6	NR	NR	NR
NE	Kid`s Connection		NA	--	--	--	--	--
NE	Kid`s Connection		1
NH	Healthy Kids	Gold	NA	--	--	--	--	--
NH	Healthy Kids	Gold	1
NH	Healthy Kids	Silver	NA	Yes	6	NR	NR	NR
NJ	KidCare	Plan A	NA	No	NA	Yes	--	Yes	State will conduct outreach to employers and child support agencies to determine if coverage is offered or included.
NJ	KidCare	Plan B	NA	Yes	12	Yes	NR	Yes	State will conduct outreach to employers and child support agencies to determine if coverage is offered or included.
NJ	KidCare	Plan B	1		6
NJ	KidCare	Plan B	3
NJ	KidCare	Plan B	4
NJ	KidCare	Plan C	NA	Yes	12	Yes	NR	Yes	State will conduct outreach to employers and child support agencies to determine if coverage is offered or included.
NJ	KidCare	Plan C	1		6
NJ	KidCare	Plan C	3
NJ	KidCare	Plan C	4
NJ	KidCare	Plan D	2	Yes	6	Yes	NR	Yes	State will conduct outreach to employers and child support agencies to determine if coverage is offered or included.
NJ	KidCare	Plan D	3
NJ	KidCare	Plan D	4
NJ	KidCare	1115 Demonstration	NA
NM	NM SCHIP		NA	Yes	12	Yes	--	NR
NM	NM SCHIP		2
NM	NM SCHIP	1115 Demonstration	NA
NV	Nevada Check-Up		NA	Yes	6	NR	NR	NR
NV	Nevada Check-Up		1
NY	NY SCHIP	CHPLUS
NY	NY SCHIP	CHPLUS
NY	NY SCHIP	CHPLUS	NA	NR	NR	Yes	NR	Yes	Insurer collects health insurance information quarterly.
NY	NY SCHIP	CHPLUS	2
NY	NY SCHIP	Medicaid Expansion	2	--	--	Yes	--	--
OH	OH Child Health Plan		NA	--	--	--	--	--
OH	OH Child Health Plan		1
OK	SoonerCare		NA	--	--	--	--	Yes	State will not use XXI funds to cover those who already have credible health insurance. State will survey beneficiaires to monitor crowd out.
OK	SoonerCare		1
OR	OR SCHIP		NA	Yes	6	NR	NR	NR
OR	OR SCHIP		2
OR	OR SCHIP		3
PA	PA SCHIP		NA	NR	NR	NR	NR	No
PA	PA SCHIP		1
PA	PA SCHIP		2
PA	PA SCHIP		3
PA	PA SCHIP		4
PR	PR SCHIP		NA	--	--	--	--	--
RI	RIte Care		NA	Yes	12	--	--	--
RI	RIte Care		1		4
RI	RIte Care	1115 Demonstration	NA
SC	Partners for Healthy Children		NA	--	--	--	--	--
SD	SD SCHIP		NA	--	--	Yes	--	Yes	Children with private health insurance are excluded from SCHIP, but may be enrolled in regular Medicaid. Third-party liability and benefit coordination for those with non-comprehensive or high-deductible insurance policies will insure that private coverage will be used for the health care costs of these children.
SD	SD SCHIP		1
SD	SD SCHIP		2
SD	SD SCHIP	CHIP NM	3	Yes	3	NR	No	Yes	The state maintains a database on persons with insurance coverage and persons applying for or receiving medical assistance from the state. The database contains the type of coverage and is available to caseworkers to explore potential group health coverage for applicants.
TN	Tennessee`s CHIP	Phase I	NA	--	--	--	--	--
TX	Texas Healthy Steps	Phase I
TX	Texas Healthy Steps	Phase I	NA	--	--	--	--	--
TX	Texas Healthy Steps	Phase II
TX	Texas Healthy Steps	Phase II	1	Yes	3	NR	NR	NR
UT	UT SCHIP		NA	Yes	3	NR	NR	Yes	The department exchanges information with other state agencies which may have information about the availability of insurance coverage for children applying for or determined eligible for SCHIP.
VA	VA SCHIP	Children's Medical Security Insurance Plan/Family Access to Medical Insurance Security Plan	NA	Yes	12	NR	NR	Yes	The state may also deny coverage if the child has access to parents' employer-sponsored coverage.
VA	VA SCHIP	Children's Medical Security Insurance Plan/Family Access to Medical Insurance Security Plan	1		6
VA	VA SCHIP	Family Access to Medical Insurance Security Plan (FAMIS) - ESI	1	Yes	6	NR	NR	Yes
VI	Virgin Island`s SCHIP		NA	--	--	--	--	Yes	Virgin Islands will ask if the applicant has insurance and the reason for any termination of coverage. Virgin Islands will also monitor crowd-out.
VI	Virgin Island`s SCHIP		1
VT	VT SCHIP		NA	Yes	1	NR	No	NR
VT	VT SCHIP		1
VT	VT SCHIP		2
VT	VT SCHIP		3
WA	WA SCHIP		NA	Yes	1	Yes	Yes	NR
WA	WA SCHIP		1		4
WI	BadgerCare	Medicaid expansion
WI	BadgerCare	Medicaid expansion	NA	Yes	6	--	Yes	--
WI	BadgerCare	Medicaid expansion	1		3
WI	BadgerCare	Employer-sponsored Coverage	1	Yes	3	--	Yes	--
WI	BadgerCare		NA
WV	WV SCHIP	Phase I	NA	Yes	6	--	--	--
WV	WV SCHIP	Phase I	2
WV	WV SCHIP	Phase II	1	Yes	6	Yes	NR	NR
WV	WV SCHIP	Phase II	2
WV	WV SCHIP	Phase II	3
WY	WY SCHIP	CHIP One	NA	Yes	1	Yes	NR	NR