CHAPTER I: DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES
SUBCHAPTER b: ASSISTANCE PROGRAMS
PART 123 COVERING ALL KIDS HEALTH INSURANCE PROGRAM
SECTION 123.240 ELIGIBILITY DETERMINATION AND ENROLLMENT PROCESS
Section 123.240 Eligibility Determination and Enrollment Process
a) If the monthly countable income is above 200 percent of the Federal Poverty Level and at or below 300 percent of the Federal Poverty Level for the number of individuals in the family and all other eligibility requirements of this Part are met, the child will be enrolled in All Kids Premium Level 2.
b) If the monthly countable income is above 300 percent of the Federal Poverty Level and at or below 400 percent of the Federal Poverty Level for the number of individuals in the family and all other eligibility requirements of this Part are met, the child will be enrolled in All Kids Premium Level 3.
c) If the monthly countable income is above 400 percent of the Federal Poverty Level and at or below 500 percent of the Federal Poverty Level for the number of individuals in the family and all other eligibility requirements of this Part are met, the child will be enrolled in All Kids Premium Level 4.
d) If the monthly countable income is above 500 percent of the Federal Poverty Level and at or below 600 percent of the Federal Poverty Level for the number of individuals in the family and all other eligibility requirements of this Part are met, the child will be enrolled in All Kids Premium Level 5.
e) If the monthly countable income is above 600 percent of the Federal Poverty Level and at or below 700 percent of the Federal Poverty Level for the number of individuals in the family and all other eligibility requirements of this Part are met, the child will be enrolled in All Kids Premium Level 6.
f) If the monthly countable income is above 700 percent of the Federal Poverty Level and at or below 800 percent of the Federal Poverty Level for the number of individuals in the family and all other eligibility requirements of this Part are met, the child will be enrolled in All Kids Premium Level 7.
g) If the monthly countable income is above 800 percent of the Federal Poverty Level for the number of individuals in the family and all other eligibility requirements of this Part are met, the child will be enrolled in All Kids Premium Level 8.
h) Applicants will be notified, in writing, regarding the outcome of their eligibility determination.
i) Eligibility determinations for the program made by the 15th day of the month will be effective the first day of the following month. Eligibility determinations for the program made after the 15th day of the month will be effective no later than the first day of the second month following that determination.
j) The duration of eligibility for the program for children will be 12 months unless one of the events described in Section 123.210 (a)(1) or (b)(1) occurs. The 12 months of eligibility will commence when the first child in a family is covered under the program. Children added to a family case after the eligibility period begins will be eligible for the balance of the 12-month eligibility period.
k) Children for whom application to the program is made before the beginning of the fourth month following the month of the child's birth may obtain backdated coverage for a period beginning with the child's day of birth. This coverage shall be subject to the family paying the premiums for the months of backdated
coverage requested.