Last year, Congress passed the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA), which changed some eligibility and enrollment features of group health plans. CHIPRA created special enrollment rights for eligible employees and dependents to enroll in employer group health plans (1) after losing eligibility for coverage under Medicaid or a state Children's Health Insurance Program (CHIP) or (2) after becoming eligible for a premium assistance subsidy under Medicaid or CHIP. CHIPRA also added to the barrage of annual health plan notices.
Each year, employers maintaining group health plans must provide a CHIPRA notice to every employee, even those not enrolled in the plan, who resides in a state that provides premium assistance under Medicaid or CHIP. Employers must provide the first notice by the later of (1) the first day of the first plan year beginning after February 4, 2010, or (2) May 1, 2010. For employers with calendar year plans, this means the initial notice must be provided by January 1, 2011. Subsequent notices must be distributed before the beginning of each plan year. The Department of Labor recently posted a model notice for employers to use as a starting point. The model notice is available at www.dol.gov/ebsa.
To streamline the annual notice process, employers can provide the CHIPRA notice along with other group health plan documentation, for example, with open enrollment materials or a summary plan description, so long as these materials are provided in advance of the relevant plan year. The notices must include contact information for state-specific subsidy assistance programs.
Companies with employees residing in multiple states may wish to include in the notice contact and subsidy information for all of the states in which its employees reside, rather than creating multiple notices differentiating among employee populations. If the CHIPRA notice is provided along with other plan materials, it must be separate and prominent, so that an employee or dependent who might be eligible for premium assistance is likely to understand and be aware of the availability of the subsidy.