New Enrollment Rules for Medicaid and CHIP

The Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) was enacted by the Federal government earlier this year. CHIPRA extends and expands coverage for children of low-income Michigan families as provided by the State Children’s Health Insurance Program (SCHIP, which is now referred to as CHIP).
  
Effective April 1, 2009, employers must permit eligible employees and dependents to enroll in the employer’s health plan if the employee or dependent:

1. Loses eligibility for Medicaid or CHIP coverage, or
2. Becomes eligible to participate in a premium assistance program under Medicaid or CHIP

In both cases, the employee must request special enrollment within 60 days of the loss of Medicaid/CHIP or of the eligibility determination.    

CHIPRA requires the amendment of plan documents to include the new enrollment rights. We have revised our Certificates of Coverage accordingly. Self-funded plan documents have also been amended. 

Please be aware that CHIP permits states to subsidize employer-plan premiums for eligible children and families. The subsidy may be provided as a reimbursement to the employee or as a direct payment to the employer (unless the employer opts out of receiving direct payments.) To date, Michigan has not yet adopted a premium assistance subsidy program.

If Michigan should decide to provide premium assistance subsidies under CHIPRA, we will let you know as there is an associated notice requirement.

Contact your agent or account representative if you have questions.