PROGRAM DETAILS
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C-CHIP Application Packet
- Application Requirements (pdf)
- Model Contract
- Healthy families Regulations
- Federal Income Guidelines (pdf)
- Sample Applicant Correspondence (pdf)
- HFP/C-CHIP Health Benefits & Copayment Matrix (pdf)
- HFP/C-CHIP Dental Benefits & Copayment Matrix (pdf)
- HFP/C-CHIP Vision Benefits & Copayment Matrix (pdf)
- HFP/C-CHIP Premiums Matrix (pdf)
- Sample C-CHIP Invoice Form (pdf)
- Sample C-CHIP Enrollments & Expenditures Budget Form (pdf)
- How to Navigate to the California SPA on the CMS Web Page (pdf)
- SPA Template (pdf)
- Chapter 648, Statutes of 2001 (pdf)
- Chapter 687, Statutes of 2003 (pdf)
- State of California Certificate of Compliance (pdf)