•  
 /  About Us / Details
September 6, 2012

DOL Issues Revised Medicaid/CHIPRA Notice

A few 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 Program (CHIP) 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).  

The DOL has recently released an updated model Medicaid/CHIP notice that can be obtained from its website (the pdf version of the model notice can be accessed here; the word version of the notice is available here).  The revised notice, current as of July 31, 2012, makes the following changes from the January 2012 version:

  1. Revised title of the notice;
  2. Revised introductory paragraphs; and
  3. Revised contact information (website and/or phone) for Georgia, Maine, Nebraska and New Hampshire. 

The current list of states that provide some form of premium assistance are:

 

States with Premium Assistance

Alabama

Kansas

New Hampshire

South Carolina

Alaska

Kentucky

New Jersey

South Dakota

Arizona

Louisiana

New Mexico

Texas

Arkansas

Maine

New York

Utah

Colorado

Massachusetts

North Carolina

Vermont

Florida

Minnesota

North Dakota

Virginia

Georgia

Missouri

Oklahoma

Washington

Idaho

Montana

Oregon

West Virginia

Indiana

Nebraska

Pennsylvania

Wisconsin

Iowa

Nevada

Rhode Island

Wyoming

 

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 information contained in this Benefit Beat is not intended to be legal, accounting, or other professional advice, nor are these comments directed to specific situations.

As required by U.S. Treasury rules, we inform you that, unless expressly stated otherwise, any U.S. federal tax advice contained in this Benefit Beat is not intended or written to be used, and cannot be used, by any person for the purpose of avoiding any penalties that may be imposed by the Internal Revenue Service.

Insights in Your Inbox
Find Us
  • OR