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March 18, 2014

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 updated their model Medicaid/CHIP notice.  The revised notice, current as of January 31, 2014, makes the following changes from the July 31, 2013 version:

  1. In Idaho, the Medicaid website has changed and this state no longer has a CHIP office.
  2. Revised website address for the Medicaid office in Washington. 

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 York

Texas

Arkansas

Maine

North Carolina

Utah

Colorado

Massachusetts

North Dakota

Vermont

Florida

Minnesota

Oklahoma

Virginia

Georgia

Missouri

Oregon

Washington

Idaho

Montana

Pennsylvania

West Virginia

Indiana

Nebraska

Rhode Island

Wisconsin

Iowa

Nevada

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

 

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