CHIP Update – DOL Releases Model Employer Notice Forms

If you are eligible for health coverage from your employer, but are unable to afford the premiums, some States have premium assistance programs that can help pay for coverage. These States use funds from their Medicaid or CHIP programs to help people who are eligible for employer-sponsored health coverage, but need assistance in paying their health premiums.

If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, you can contact your State Medicaid or CHIP office to find out if premium assistance is available.

If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, you can ask the State if it has a program that might help you pay the premiums for an employer-sponsored plan.

Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP, your employer’s health plan is required to permit you and your dependents to enroll in the plan as long as you and your dependents are eligible, but not already enrolled in the employer’s plan. This is called a special enrollment opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance.

Download the PDF

If you live in one of the following States, you may be eligible for assistance paying your employer health plan premiums. The following list of States is current as of February 1, 2010. You should contact your State for further information on eligibility.

MAINE Medicaid
Website: http://www.maine.gov/dhhs/oms/
Phone: 1-800-321-5557

MASSACHUSETTS Medicaid and CHIP
Medicaid Website: http://www.mass.gov/MassHealth
Medicaid Phone: 1-800-462-1120
CHIP Website: http://www.mass.gov/eohhs
Click on For Consumers, then Insurance (including Mass Health), then Additional Insurance and Assistance Programs, then Children’s Medical Security Plan
CHIP Phone: 1-800-841-2900

NEW HAMPSHIRE Medicaid
Website: http://www.dhhs.state.nh.us/DHHS/MEDICAIDPROGRAM/default.htm
Phone: 1-800-852-3345 x 5254

RHODE ISLAND Medicaid
Website: http://www.dhs.ri.gov/People/FamilieswithChildren/HealthCare/RIteShare/tabid/212/Default.aspx
Phone: 401-462-5300

VERMONT Medicaid
Website: http://ovha.vermont.gov/
Telephone: 1-800-250-8427

To see if any more States have added a premium assistance program since February 1, 2010, or for more information on special enrollment rights, you can contact either:

U.S. Department of Labor
Employee Benefits Security Administration
www.dol.gov/ebsa
1-866-444-EBSA (3272)

U.S. Department of Health and Human Services
Centers for Medicare & Medicaid Services
www.cms.hhs.gov
1-877-267-2323, Ext. 61565

Employers should make sure they are in compliance with these new regulations which are now in effect. Please contact us for information or assistance.

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