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Insurance & Employee Benefits
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Children’s Health Insurance Program Reauthorization Act (“CHIPRA”) notice
U.S. Department of Labor
Employee Benefits Security Administration
March 2010
Under the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA), group health plans and group health insurance issuers must offer new special enrollment opportunities. Effective April 1, 2009, plans and issuers must permit employees and dependents who are eligible for, but not enrolled in, a group health plan to enroll in the plan upon:
- losing eligibility for coverage under a State Medicaid or CHIP program, or
- becoming eligible for State premium assistance under Medicaid or CHIP.
The employee or dependent must request coverage within 60 days of being terminated from Medicaid or CHIP coverage or within 60 days of being determined to be eligible for premium assistance.
There are also new notice and disclosure requirements associated with CHIPRA.
Model Notice for Employers
Employers that maintain a group health plan in a State that provides premium assistance under Medicaid or CHIP must notify all employees of potential opportunities for premium assistance in the State in which the employee resides. On February 4, 2010, the Department of Labor published a notice in the Federal Register announcing the availability of a model notice and providing guidance on how to comply. Employers are required to provide this notice by the date that is the later of:
- the first day of the first plan year after February 4, 2010, or
- May 1, 2010.
Source: http://www.dol.gov/ebsa/newsroom/fschip.html
Segment of the Model Notice from the Department of Labor:
Medicaid and the Children’s Health Insurance Program (CHIP)
Offer Free Or Low-
If you are eligible for health coverage from your employer, but are unable to afford the premiums, some States have premium assistance programs that can help pay for coverage. These States use funds from their Medicaid or CHIP programs to help people who are eligible for employer-
If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, you can contact your State Medicaid or CHIP office to find out if premium assistance is available.
If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your State Medicaid or CHIP office or dial 1-
Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP, your employer’s health plan is required to permit you and your dependents to enroll in the plan – as long as you and your dependents are eligible, but not already enrolled in the employer’s plan. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance.
Full Version can be downloaded from the DOL’s webiste:
Word version at: http://www.dol.gov/ebsa/chipmodelnotice.doc
Or the PDF version at: http://www.dol.gov/ebsa/pdf/chipmodelnotice.pdf
Employer Resources
Understanding Your Fiduciary Responsibilities Under A Group Health Plan by DOL.gov
