Several years ago, two additional HIPAA special enrollment events were added to the law by the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA). These special enrollment events relate specifically to Medicaid. One special enrollment event arises if an individual loses eligibility for Medicaid. The other arises when an individual becomes eligible for premium assistance through Medicaid. “Premium assistance” means that a State’s Medicaid or Children’s Health Insurance Premium (CHIP) program will pay all or a portion of the employer-provided coverage. Employers sponsoring health plans are obligated to annually provide a premium assistance notice to their workforce. This notification can be accomplished by using a model notice provided by the Department of Labor (DOL)(see links below).
The DOL has recently updated its model Medicaid/CHIP notice. The revised notice, current as of July 31, 2014, makes the following changes from the January 31, 2014 version:
The current list of states that provide some form of premium assistance are:
States with Premium Assistance
The notice explaining the right to premium assistance must be provided to anyone residing in these States, without regard to where the employer is located, or where the plan is sitused. The employer can provide the notice to all of its employees, or just to those who are residing in the above-listed states.
The revised Medicaid/CHIP notice can be viewed and/or saved from these website addresses:
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