ELIGIBILITY									110.1- 130.1
f.	A Cuban or Haitian entrant, as defined under Section 501(e)(2) of the U.S. Refugee Education Assistance Act of 1980; or
g.	An individual who:
1.  Was born in Canada and possesses at least 50 percent American Indian blood; or
2.   Is a member of an Indian tribe, as defined in 25 U.S.C. Section 450(b)e.
h.	Admitted into the United States as an Amerasian immigrant under Section 584 of the U.S. Foreign Operations, Export Financing, and Related Programs Appropriation Act of 1988, as amended by P.L. 100-461; or
i.	A lawfully admitted, permanent resident, who is a Hmong or Highland Lao veteran of the Vietnam conflict; and
C.	Be a resident of Colorado; and
D.	Have family income less than or equal to 200% of the Federal Poverty Level, adjusted for family size.
120	INSUFFICIENT ACCESS TO OTHER HEALTH COVERAGE
120.1	To be eligible for the Children’s Basic Health Plan, an eligible person shall not:
A.	Be covered under a group health plan or under health insurance coverage; or
	B.	Currently have, or have had within the three months prior to application, comparable (as defined in Title XXI of the Social Security Act, Section 2103) health coverage through an employer where the employer contributes at least fifty percent of the premium cost for the individual unless the individual lost health coverage due to a change in or loss of employment; or
C.	Be a member of a family that is eligible for health benefits coverage under a State health benefits plan on the basis of a family member's employment with a public agency in the State of Colorado; or
D.	Be eligible to receive assistance under Title XIX of the Social Security Act; or
E.	Be an inmate of a public institution or a patient in an institution for mental diseases.
130	DOCUMENTATION
130.1	To be eligible for the Children’s Basic Health Plan, an eligible person shall provide the following:
A.	Verification of earned income for the family of the applicant if money has been earned within 30 days of the date of application.  Verification may include one of the following:
1.	Current wage stubs; or
2.	A note from an employer; or
3.	A phone call to an employer (if permitted by applicant); or
4.	Ledgers or receipts for self-employed applicants.
COLORADO DEPARTMENT OF HEALTH CARE POLICY AND FINANCING
CHILDREN'S BASIC HEALTH PLAN

ELIGIBILITY									130.1- 150.1
B.	Eligible persons age 18 and over applying for benefits on and after August 1, 2006, shall provide the following certified, notarized photocopies or original documents prior to being enrolled in the Children’s Basic Health Plan:
1.	A valid Colorado driver’s license or a Colorado state issued identification card; or
2.	A United States military card or a military dependent’s identification card; or
3.	A United States Coast Guard Merchant Mariner card; or
4.	A Native American tribal document; or
5.	Other forms of identification or a waiver process to ensure that an individual proves lawful presence in the United States as authorized by the Executive Director of the Colorado Department of Revenue pursuant to 24-76.5-130(5)(a),C.R.S. 

AND

C.   An executed and notarized affidavit stating:
1.	That he or she is a United States citizen or legal permanent resident; or
2.	That he or she is otherwise lawfully present in the United States pursuant to federal law.

D. For an applicant who has executed an affidavit stating that he or she is an alien lawfully present in the United States, verification of lawful presence shall be made through the Federal Systematic Alien Verification of Entitlement Program operation by the United States Department of Homeland Security or a successor program designated by the United States Department of Homeland Security.  Until such verification of lawful presence is made, the affidavit may be presumed to be proof of lawful presence.

E. Photocopies of the identification listed in 130.1 B and C shall be acceptable identification if the photocopies meet the following criteria:
1.	A notary public must have certified that he or she saw the original document and that the photocopy is a true copy of that original; or
2.	A county caseworker or medical assistance site worker attests in writing on the photocopy that he or she saw the original documentation and that the photocopy is a true copy of that original.

F.	The person described in §110.1.A.2. shall be presumed eligible for the Children’s Basic Health Plan if their self reported income meets self-declared income guidelines.
140. REDETERMINATION
140.1	Eligibility shall be redetermined when twelve (12) months have passed since the last eligibility determination.
150	CALCULATION OF FAMILY INCOME
150.1	Income includes all employment, self-employment, and unearned income, with the following exceptions:
COLORADO DEPARTMENT OF HEALTH CARE POLICY AND FINANCING
CHILDREN'S BASIC HEALTH PLAN