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| 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 | 3x 3x 3x 3x 3x | import { PdfList, Template } from "../utils";
// MAGI Eligibility & Methods
export const CHP_MAGI_TEMPLATES: Template[] = [
{
title: "CS 7",
text: "Eligibility - Targeted Low-Income Children",
href: "/chp/CS7.pdf",
},
{
title: "CS 8",
text: "Eligibility - Targeted Low-Income Pregnant Women",
href: "/chp/CS8.pdf",
},
{
title: "CS 9",
text: "Eligibility - Coverage From Conception to Birth",
href: "/chp/CS9.pdf",
},
{
title: "CS 10",
text: "Eligibility - Children Who Have Access to Public Employee Coverage",
href: "/chp/CS10.pdf",
},
{
title: "CS 11",
text: "Eligibility - Pregnant Women Who Have Access to Public Employee Coverage",
href: "/chp/CS11.pdf",
},
{
title: "CS 12",
text: "Eligibility - Dental Only Supplemental Coverage",
href: "/chp/CS12.pdf",
},
{
title: "CS 13",
text: "Eligibility - Deemed Newborns",
href: "/chp/CS13.pdf",
},
{
title: "CS 15",
text: "MAGI-Based Income Methodologies",
href: "/chp/CS15.pdf",
},
{
title: "CS 16",
text: "Other Eligibility Criteria - Spenddowns",
href: "/chp/CS16.pdf",
},
];
// XXI Medicaid Expansion
export const CHP_MED_EXPANSION_TEMPLATES: Template[] = [
{
title: "CS 3",
text: "Eligibility for Medicaid Expansion Program",
href: "/chp/CS3.pdf",
},
];
// Eligibility Processing
export const CHP_ELIGIBILITY_TEMPLATE: Template[] = [
{
title: "CS 24",
text: "General Eligibility - Eligibility Processing",
href: "/chp/CS24.pdf",
},
];
// Non-Financial Eligibility
export const CHP_NON_FIN_TEMPLATE: Template[] = [
{
title: "CS 17",
text: "Non-Financial Eligibility - Residency",
href: "/chp/CS17.pdf",
},
{
title: "CS 18",
text: "Non-Financial Eligibility - Citizenship",
href: "/chp/CS18.pdf",
},
{
title: "CS 19",
text: "Non-Financial Eligibility - Social Security Number",
href: "/chp/CS19.pdf",
},
{
title: "CS 20",
text: "Non-Financial Eligibility - Substitution of Coverage",
href: "/chp/CS20.pdf",
},
{
title: "CS 21",
text: "Non-Financial Eligibility - Non-Payment of Premiums",
href: "/chp/CS21.pdf",
},
{
title: "CS 23",
text: "Non-Financial Requirements - Other Eligibility Standards",
href: "/chp/CS23.pdf",
},
{
title: "CS 27",
text: "General Eligibility - Continuous Eligibility",
href: "/chp/CS27.pdf",
},
{
title: "CS 28",
text: "General Eligibility - Presumptive Eligibility for Children",
href: "/chp/CS28.pdf",
},
{
title: "CS 29",
text: "General Eligibility - Presumptive Eligibility for Pregnant Women",
href: "/chp/CS29.pdf",
},
{
title: "CS 31",
text: "Incarcerated CHIP Beneficiaries",
href: "/chp/CS31.pdf",
},
];
export const ChipSpaTemplates = () => (
<section>
<p>
CHIP eligibility SPA templates can be downloaded at the links below. After downloading and
completing the templates you need, upload them as part of the SPA submission. The template
PDFs can only be opened using Adobe Reader or Acrobat.
</p>
<ul className="pl-7 space-y-2 py-4" role="list">
<li className="space-y-2">
<p>MAGI Eligibility & Methods</p>
<PdfList
list={CHP_MAGI_TEMPLATES}
label="template"
ulClassName="list-disc pl-7 space-y-2"
/>
</li>
<li className="space-y-2">
<p>XXI Medicaid Expansion</p>
<PdfList
list={CHP_MED_EXPANSION_TEMPLATES}
label="template"
ulClassName="list-disc pl-7 space-y-2"
/>
</li>
<li className="space-y-2">
<p>Eligibility Processing</p>
<PdfList
list={CHP_ELIGIBILITY_TEMPLATE}
label="template"
ulClassName="list-disc pl-7 space-y-2"
/>
</li>
<li className="space-y-2">
<p>Non-Financial Eligibility</p>
<PdfList
list={CHP_NON_FIN_TEMPLATE}
label="template"
ulClassName="list-disc pl-7 space-y-2"
/>
</li>
</ul>
</section>
);
|