DHHS - CHIP Policy Manual
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  CHIP Policy

220-9 Coordination With the Federally Facilitated Marketplace (FFM)

Effective Date: June 1, 2025

Previous Policy

 

A.  Coordination Requirement

The agency is required to coordinate enrollment for children between the FFM and CHIP (with the exception of State CHIP).  Applications may be received from the FFM when an individual reports a change or directly from the family.  

Evaluate all children in the home to determine their eligibility for CHIP.  If the only reason a child would not qualify for CHIP is because of enrollment in the FFM plan, the agency must offer the applicant the opportunity to terminate the FFM plan and enroll the child in CHIP. Notify the family of the child’s eligibility and what actions that must be taken.

B.  Effective Date of Enrollment

When the agency receives an application from individuals with health coverage through the FFM, determine the effective date of enrollment in CHIP as described below.

  1. A newborn child, newly adopted child, child placed for adoption, or a child placed for foster care that is not already insured may be added to the CHIP program if the request or application is within 60 days of the event. The effective date of the child’s coverage will be the date of the event.
    • If the request or application is filed more than 60 days after the event, the effective date of CHIP enrollment is the first day of the month in which the request or application was filed.
  2. For all other children in the household:
    1. Children who are enrolled in an FFM plan at the time of application, the effective date to enroll in CHIP is the day following the termination date of the FFM plan. 
    2. Children who are not enrolled in a health plan at the time of application, the effective date to enroll in CHIP is the first day of the application month. (See Section 701-2)