On February 4, 2010, the DOL provided a model notice for use by employers with group health plans, in accordance with the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA).
CHIPRA requires employers offering group health plans to notify all employees of their potential CHIPRA rights to receive premium assistance under a state’s Medicaid or CHIP program. Employers may combine this notice with other information (e.g., open enrollment materials) as long as it goes to the entire employee population, not just participants.
The requirement applies to employers that offer medical care benefits in any of 40 states that currently provide premium assistance. The 10 states that do not currently provide premium assistance are: Connecticut, Delaware, Hawaii, Illinois, Maryland, Michigan, Mississippi, Ohio, South Dakota and Tennessee.
Employers must comply as long as they have participants in at least one of the 40 states. Employers need not notify participants residing in the 10 non-participating states, but they may provide the notice anyway due to administrative convenience. For example, an employer with participants in Illinois, Michigan and Indiana would need to send the notices to Indiana employees but could send to employees in all three states. On the other hand, an employer based wholly in Michigan would not need to send notices under this mandate.
Employers must send the notice annually, starting with the first plan year after February 4, 2010. For plan years from February 4, 2010, through April 30, 2010, the initial notice deadline is May 1, 2010. For plan years starting after May 1, 2010, the notice deadline is the first day of the next plan year. For example, the deadline would be January 1, 2011, for calendar year plans.
CHIPRA also requires group health plans to disclose information about their medical care benefits to State Medicaid and CHIP programs, upon request. The DOL and two other agencies are developing a model disclosure form for this purpose. States may begin requesting this information as of the first plan year after the release of this model disclosure form. The rationale for this rule is that states may want to evaluate whether providing premium assistance is a cost-effective way to provide medical care.
