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Delaware General AssemblyDelaware RegulationsMonthly Register of RegulationsNovember 2014

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Delaware Health and Social Services (“Department”) / Division of Medicaid and Medical Assistance (DMMA) initiated proceedings to amend the Title XXI Delaware Healthy Children Program State Plan and the Division of Social Services Manual (DSSM) regarding Cost Sharing and Payment, specifically, Premium Requirements. The Department’s proceedings to amend its regulations were initiated pursuant to 29 Delaware Code Section 10114 and its authority as prescribed by 31 Delaware Code Section 512.
The Department published its notice of proposed regulation changes pursuant to 29 Delaware Code Section 10115 in the September 2014 Delaware Register of Regulations, requiring written materials and suggestions from the public concerning the proposed regulations to be produced by September 30, 2014 at which time the Department would receive information, factual evidence and public comment to the said proposed changes to the regulations.
Title XXI of the Social Security Act, State Children’s Health Insurance Program
42 CFR Part 457, State Children's Health Insurance Programs (SCHIPs)
Agency Response: DMMA appreciates and thanks the GACEC for its endorsement.
These premium levels had already been implemented effective January 1, 2014. See Summary of Proposal at p. 184 and attached DMMA Administrative Notice 01-2014, last page. However, the Delaware Healthy Children State Plan had not been amended to conform to practice. The proposed regulation amends the Delaware Healthy Children Program plan to reflect the current premium structure.
Agency Response: DMMA appreciates and thanks the SCPD for its endorsement.
THEREFORE, IT IS ORDERED, that the proposed regulation to amend Delaware Title XXI Delaware Healthy Children Program State Plan regarding Cost Sharing and Payment, specifically, Premium Requirements, is adopted and shall be final effective November 11, 2014.
 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 continue on to Section 9.
8.1.1. YES
8.1.2. NO, skip to question 8.8.
8.2.1. Premiums: $10 per family per month (PFPM) for families with incomes between 101% and 133% of the FPL, $15 PFPM for families with incomes between 134% and 166% of the FPL, and $25 PFPM for families with incomes between 167% and 200% of the FPL (see Section 4.3 for information on effect of non-payment of premiums). Incentives for pre-payment of premiums will be considered. Fifteen dollars ($15.00) per family per month for families with incomes between 134% and 166% of the Federal Poverty Level (FPL) and twenty-five dollars ($25.00) per family per month for families with incomes between 167% and 212% of the FPL. (See Section 4.3 and CHIP MAGI State Plan Page CS21 for information on the effect of non-payment of premiums).
Incentives for pre-payment of premiums include the following: Pay three (3) months get one (1) premium free month; pay six (6) months get two (2) premium free months; pay nine (9) months get three (3) premium free months.
>142% FPL < or =176% FPL 134% FPL = 176% FPL
177% FPL < or = 212%FPL 177% FPL = 212% FPL
Payments that are less than one (1) month’s premium will not be accepted.
Pay three (3) months – get one (1) premium free month
Pay six (6) months – get two (2) premium free months
Pay nine (9) months – get three (3) premium free months.
Last Updated: December 31 1969 19:00:00.
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