1427 - Employer Notification Requirements on Premium Assistance Programs
Category
Benefits and Insurance
Audience List
- Employee Relations Officers
- Personnel Officers
- Personnel Transactions Staff
- Personnel Transactions Supervisors
Synopsis
This policy:
Informs on the Children’s Health Insurance Program Reauthorization Act (CHIPRA) for employers to notify employees about premium assistance programs under Medicaid and Children’s Health Insurance Program (CHIP) to help certain individuals pay for their employer-sponsored health coverage.
Introduction
The CHIPRA requires employers to provide the Premium Assistance under Medicaid and Children’s Health Insurance Program (CHIP) Notice to inform employees of premium assistance opportunities in the state where the employee resides to assist them in paying for their employer-sponsored group health coverage.
The state may be subject to penalties for failing to comply with the notification requirements.
Statement
Employer Notification Requirements
Premium Assistance under Medicaid and the Children’s Health Insurance Program (CHIP) Notice
State departments and agencies are required to issue the Premium Assistance under Medicaid and Children’s Health Insurance Program (CHIP) Notice to employees who are newly eligible for state-sponsored health coverage. They should issue the Notice, with the Health Benefits Plan Enrollment Form (CalPERS HBD-12) and Summary of Benefits and Coverage Notice, no later than the first day the employee is eligible to enroll in health coverage and annually thereafter, during Open Enrollment.
The Notice provides information to individuals who are eligible for state-sponsored health coverage on potential opportunities for premium assistance under Medicaid or CHIP in the state where the employee resides. These premium assistance programs may help eligible employees pay for their state-sponsored health coverage. The Notice provides information on who to contact for additional information and how to apply for premium assistance.
Employees who are eligible for state-sponsored health coverage, but not currently enrolled, may enroll within 60 days of becoming eligible for premium assistance under Medicaid or CHIP, or upon termination from these programs.
Departments may distribute the Notice to employees by interoffice mail, first-class mail, or electronically. For electronic distribution, employees must use a computer as part of their daily, normal job function, or have consented to electronic delivery in a manner that demonstrates they can effectively receive the Notice via electronic delivery, per the Department of Labor notification disclosure safe harbor. Additionally, the Notice must be provided to employees upon request.
Application
Not applicable.
Authorities
Resources
Forms
- Health Benefits Plan Enrollment Form: CalPERS HBD-12: Health Benefits Plan Enrollment Form: CalPERS HBD-12
- Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP) Notice: Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP) Notice
- Summary of Benefits and Coverage Template: Summary of Benefits and Coverage Template
Web Pages
- U.S. Department of Labor: Department of Labor: U.S. Department of Labor: Department of Labor
Authorized By
Benefits Division
Benefits Division Inquiries,
Benefits Division
Contact Person
Domestic Partners
CalHR
Phone: 916-322-0300
Email: BenefitsInquiries@calhr.ca.gov
Superseded Policies
Not Applicable.History
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