Appendix E 

Local office open enrollment For Chip B and Children’s Access Card

1. Screening for CHIP B OR ACCESS

• Occurs at the local field office on the day the application is received

• Occurs at the local office only for applications received on the AFA or Common Enrollment form (applications are screened up to the CHIP B income level)

• Applications registered at the local office are screened and in the order received

• Will use trial eligibility (at this time)

• Applications are screened for all potential coverage groups i.e. Family Medicaid, & CHIP A and CHIP B

• Completed trial eligibility is copied, retained with the case file, or faxed with screened CHIP B/Access application to the consolidated unit.

This process has been altered as we are not near the enrollment cap. If CHIP B or Access eligible, the application should be mailed to the CHIP Unit within two days along with a copy of the trial eligibility and any pertinent information.

• Clerical support gathers all provided documentation with the form, copies and routes based on outcome of trial eligibility.

2. Application for Health coverage on AFA

• Date Stamp Application

• Review Application for completeness

• If there are adult applicants with children register MA or MU and keep in local office

• Keep envelope for mail in applications

• If no adult applicant is with the children run trial eligibility with the reported income:

• Register for PW if appropriate and keep in local office

• If trial eligibility indicates a CHIP B program

  • Immediately fax application, and postmarked envelope to the CU

  • Fax trial eligibility result

This process has been altered as we are not near the enrollment cap. If CHIP B or Access eligible, the application should be mailed to the CHIP Unit within two days along with a copy of the trial eligibility and any pertinent information.

• The CHIP unit will register the CHIP B application.

• Within two business days

• Send hard copy application

• All documents provided by applicant

• Copy of trial eligibility

• Choice agreement (if received)

3. Application for CHIP B/Access on the CHIP application form (if sent to the local office)

• Date Stamp application

• Fax application and envelope if received by mail  to the CU immediately

This process has been altered as we are not near the enrollment cap. If CHIP B or Access eligible, the application should be mailed to the CHIP Unit within two days along with a copy of the trial eligibility and any pertinent information.

• Send choice agreement if included

• Within 2 days send hard copy application and any documents received with application (include postmarked envelope)

4. Application During Open Enrollment to Local Office on AFA or Common Enrollment Form – Multi Program

• Date Stamp application

• Run trial Eligibility (using reported income)

• Fax application, date stamped envelope and choice agreement immediately

This process has been altered as we are not near the enrollment cap. If CHIP B or Access eligible, the application should be mailed to the CHIP Unit within two days along with a copy of the trial eligibility and any pertinent information.

• Within 2 days send copy of application and any documentation/verifications received to the CU

• Local Office register the non-CHIP programs from the application

• Keep originals in the local office

• Use separate case numbers (whichever location registers the 2nd application will tie the two cases together)

The above instructions were developed for implementation of CHIP B and Access. In red are modifications to these procedures which will change when we are close to the enrollment CAP.

Those situations where the field office screens an application as PWC or CHIP A and then discovers that the family is really CHIP B should take action on their registered case. Once the discovery is made please send the following to the CHIP B unit:

• a copy of the application, pertinent information

• a note that they just discovered the family was CHIP B eligible (CHIP B unit  will act on the applications).

• contact the family and let them know the situation. (3/28/06)