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September 12, 2013

DOL Issues Revised Medicaid/CHIPRA Notice

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).  

The DOL has recently released an updated model Medicaid/CHIP notice that can be obtained from its website.  The revised notice, current as of July 31, 2013, makes the following changes from the January 1, 2013 version:

  1. Revised phone number for Oregon’s Medicaid/CHIP office;
  2. Revised phone number for national CMS office. 

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 revised Medicaid/CHIP notice can be viewed and/or saved from these website addresses:

English

Spanish

 

The information contained in this article is provided as general guidance and may be affected by changes in law or regulation. This article is not intended to replace or substitute for accounting or other professional advice. Please consult a CBIZ professional. This information is provided as-is with no warranties of any kind. CBIZ shall not be liable for any damages whatsoever in connection with its use and assumes no obligation to inform the reader of any changes in laws or other factors that could affect the information contained herein.

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