016.20.02 Ark. Code R. § 015 - Revision to forms DCO-995, ARKids First Application and DCO-975, ARKids Annual Renewal, Implementation of SCHIP Provisions to ARKids B
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Form to be Deleted |
Dated |
|
DCO-995 |
(R 06/01) |
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DCO-975 |
(R. 08/01) |
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DCO-995 |
(R. 09/06/02) |
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DCO-975 |
(R. 09/06/02) |
Summary
Form DCO-995, ARKids First Mail-In Application, and DCO-975, ARKids First Annual Renewal and Eligibility Report Form, have been revised, adding a question to identify ARKids B children not eligible for enhanced funding through SCHIP. The question, at the end of the Income section asks " Do you or your spouse work for Arkansas state government, state university, 2-year college, technical school or public school district?" Children with parents employed by these groups will continue to be eligible for ARKids B, but will not be eligible for the enhanced SCHIP funding from the federal government.
Inquiries to: Jack Tiner, 501-682-8259
Diana Teal, 501-682-1562
Carmen Brown, 501-682-8258
Cindy Gray, 501-682-8254
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ARKids First
Annual Renewal Notice and Eligibility Report Form If you need this material in a different format, such as large print, please call 1-888-543 -7890.
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Notes
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