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Implementation of SCHIP Benefit Structures

At the September 1998 User Liaison Program (ULP) SCHIP Workshop, Shelley Gehshan reviewed the benefit structure options that States have exercised and the issues raised by the various structures. Of the 49 submitted or approved plans (as of September 1998):

  • 25 will use Medicaid benefits.
  • Six will use modified Medicaid benefits through a 1115 waiver program.
  • Two will use "Medicaid look-alike" packages (omitting the Early Periodic Screening Diagnosis and Treatment (EPSDT) obligation).
  • 11 will use State employee coverage as benchmarks.
  • Three will use other benchmark plans.
  • Three will use benchmark equivalent plans.
  • Three existing State programs are grandfathered.
  • One will use coverage approved by the secretary of DHHS.

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