Are you in one of the 40 states that require employers to provide another health care notice to employees if a group insurance program is offered?
The Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) provides new requirements for additional enrollment opportunities to those employees who are eligible for company group health plans and group health insurance. These new opportunities provide free or low cost health care insurance to employees and their families if the employee is not currently enrolled in the group health plan and group health insurance. CHIPRA applies to individuals and families when an eligible employee:
1. Loses their eligibility for State Medicaid or Children’s Health Insurance Program (CHIP)
-or-
2. Becomes eligible for State Medicaid or Children’s Health Insurance Program (CHIP)
Upon time of eligibility or termination of coverage under State Medicaid or CHIP, an employee and/or dependent is required to request coverage within 60 days of the qualifying event.
What Does This Mean for You as an Employer?
Employers in any of the 40 states who offer State Medicaid or CHIP and offer group health plans and group health insurance to their employees are required to notify all employees of these opportunities at the beginning of the next benefit plan year and annually thereafter.
Why Does This Matter Now?
With Open Enrollment looming in the distance or (thankfully) winding down, you must be aware of your requirement to provide the notice to your employees. The most effective way to do so for current employees is to include the notice in the Open Enrollment materials. For new employees, including the notice in the new hire enrollment materials is ideal.
Where Can I Find This Notice and Additional Information?
The Department of Labor’s Employee Benefits Security Administration and the U.S. Department of Health and Human Services’ Centers for Medicare & Medicaid Services have provided the CHIP model notice that can be used to satisfy the notice requirement as well as additional information regarding individual state premium assistance programs. This information is available at www.dol.gov/ebsa and www.cms.hhs.gov.




Most open enrollment periods for benefits programs happen in the fall so use the summer months to get a head start. After researching what health care reform requirements will impact you, schedule a meeting with your insurance broker. Draw on the agent’s expertise to walk through your benefits plans, plan by plan, and make changes where necessary (such as to the dependent age coverage limitations, which are increasing to age 26). Be sure that the broker and insurance carrier work together to present you with revised plan documents, as necessary. KPA offers a free webinar and white paper on How Healthcare Reform Impacts Dealerships.