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February 12, 2019

DOL Issues Revised Model Medicaid/CHIP Premium Assistance Notice (article)

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’s Employee Benefit Security Administration (EBSA).

The model Medicaid/CHIP notice has been revised and is current as of January 31, 2019. The revised notice differs from the model notice issued in July 31, 2018, as follows:

  1. The state of Colorado is no longer offering premium assistance through its Health First Colorado (Colorado’s Medicaid program) or Child Health Plan Plus (CHP+) program;
  2. The website address and phone number for the Medicaid agency in New Hampshire has changed;
  3. The website address for the Medicaid office in Georgia and Wyoming has changed.

The revised model Medicaid/CHIP notice is available for viewing and/or downloading from the DOL’s website, in both English (pdf or word) and Spanish (pdf or word),

Method of distributing notice. The Medicaid/CHIP premium assistance notice can be included in other plan materials, such as open enrollment materials, or a summary plan description. Alternatively, it can be provided as a separate document. If the notice is to be included with other plan material, it must be clearly delineated as a unique document. The notice can be provided in written form; or, electronically, as long the DOL’s electronic disclosure rules are followed.

Employers are welcome to modify the model notice; though, it is very important that the document provided to affected individuals clearly explains the right to premium assistance; and most importantly, provides at least minimal information about how to contact the relevant state Medicaid or CHIP office.

Who gets the notice?  The notice explaining the right to premium assistance must be provided to employees residing in the below-listed states at least once annually, without regard to where the employer is located, or where the health plan is sitused: 

States with Premium Assistance

Alabama

Minnesota

Pennsylvania

Alaska

Missouri

Rhode Island

Arkansas

Montana

South Carolina

Florida

Nebraska

South Dakota

Georgia

Nevada

Texas

Indiana

New Hampshire

Utah

Iowa

New Jersey

Vermont

Kansas

New York

Virginia

Kentucky

North Carolina

Washington

Louisiana

North Dakota

West Virginia

Maine

Oklahoma

Wisconsin

Massachusetts

Oregon

Wyoming

 

 

 

 

Penalty for failure to provide notice.   Beginning January 23, 2019, failure to notify employees of premium assistance opportunities could result in a penalty assessment of up to $117 per day, per employee.


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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