Forms

GHS Benefit Plans

• Adults with Developmental Disabilities LOC
  A description of the level of care for Adults with Developmental Disabilites.
• Adults with Severe Mental Illness LOC
  A description of the level of care for Adults with Severe Mental Illness and Co-Occurring Disorders
• Benefit Plans - Adult DD
  A grid that shows the plan service amounts per 12-month period by level of care for each service code for DD adults.
• Benefit Plans - Adult MI-COD
  A grid that shows the plan service amounts per 12-month period by level of care for each service code for MI or COD Adults.
• Benefit Plans - Children DD
  A grid that shows the plan service amounts per 12-month period by level of care for each service code for DD children.
• Benefit Plans - Children SED-COD
  A grid that shows the plan service amounts per 12-month period by level of care for each service code for SED and COD children.
• Children LOC
  A description of the level of care for Children with Severe Emotional Disorders or Developmental Disabilities.
• Service Authorization Packages
  A listing of initial and ongoing service authorization packages for all eligibility groups.