On February 4, 2009, the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) was signed into law by President Obama. The law provides two specific provisions that you should be aware of.
CHIPRA provides a special enrollment period for employees and/or their eligible dependents for loss of coverage, or becoming eligible for premium assistance, under Medicaid or a State’s Children’s Health Insurance Program. If a non-enrolled employee (or dependent) is covered under Medicaid or a State child health plan, and that coverage is terminated based on loss of eligibility, the employee (or dependent) can enroll in an employer’s group health plan due to the loss of coverage. Loss of coverage has always been a qualifying event for HealthTrust enrollees so the impact of this legislation is negligible. Enrollment for this specific situation, however, must be requested within 60 days of the loss of coverage, rather than the 30 day notification requirement for other eligible qualifying events.
An additional provision of the law requires employers to provide an annual written notice to all active employees (even if they are not eligible for or enrolled in the employer’s health plan) informing them of potential opportunities to obtain premium assistance from their state of residence. Annual notice requirements began July 1, 2010 for members with plan years beginning July 1, and January 1, 2011 for members with plan years beginning January 1. Please note that there are considerable civil penalties for employers who do not comply with this annual notice requirement.
Attached is the most recent Department of Labor model notice; you can access this document at http://www.dol.gov/ebsa/chipmodelnotice.doc. This document can be provided electronically, in printed format or with open enrollment materials but must be provided prior to your plan year of July 1, 2015 in order to fulfill your annual notice obligations.