As previously disclosed, on February 4, 2009, the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) was signed into law by President Obama. CHIPRA expands and extends coverage of state CHIP Programs through 2013 by establishing a new premium assistance program for individuals enrolled in an employer- sponsored plan and requiring employer-sponsored group health plans to provide special enrollment rights to employees and dependents.
WHAT THIS MEANS TO YOU AS AN EMPLOYER
A group health plan must allow employees and their dependents (if they are otherwise eligible for the plan) to enroll in the plan under special enrollment rights if one of the following situations has occurred:
- The employee’s or dependent’s state Medicaid or CHIP (Children's Health Insurance Program) coverage terminates because the individual ceased to be eligible.
- The employee or dependent becomes eligible for a CHIP premium assistance subsidy under state Medicaid or CHIP (Children's Health Insurance Program).
Unlike the other HIPAA special enrollment events, which require an enrollment period of at least 30 days, the new special enrollment events require an enrollment period of at least 60 days.
WHAT SHOULD I DO NEXT?
By April 1, 2009, you must communicate to your employees the changes in the special enrollment rights click here for a sample notice.
Additionally, an update to your plan document/Summary Plan Description special enrollment language is also required explaining that unlike HIPAA, the Reauthorization Act allows a enrollment period of 60 days for employees when (i) an employee loses eligibility under Medicaid or CHIP; or (ii) an employee becomes newly eligible for premium assistance through Medicaid or CHIP.
If you have any additional questions regarding the information within this eCommunication, please call Corporate Synergies at 1.866.CSG.1719 or click here to contact us today.
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