Changes to Group Health Plans Required by CHIPRA Take Effect April 1, 2009 (PDF-49kb)
Changes to Group Health Plans Required by CHIPRA Take Effect April 1, 2009 Authors: Lori PartrickThe Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) extends and expands the State Children's Health Insurance Program (CHIP). CHIP is a federal-state program designed to reduce the number of low-income children without health coverage. The legislation permits (but does not require) states to subsidize premiums for employer-sponsored group health coverage for eligible children and families. The new law also establishes two new special enrollment rights for employees and their dependents who gain or lose Medicaid or CHIP coverage. In addition to these new special enrollment rights, CHIPRA establishes new notice and disclosure obligations for employers that maintain group health plans.
Premium Assistance Subsidies
CHIPRA authorizes states to subsidize some or all of the cost of "qualified employer-sponsored coverage" for eligible children, and in some cases their families. "Qualified employer-sponsored coverage" is coverage where: (i) the employer contribution toward the premium is 40% or more; (ii) the coverage is "creditable coverage" under the Health Insurance Portability and Accountability Act of 1996 (HIPAA); and (iii) the coverage is available to a reasonable classification of employees (as defined in Section 105(h) of the Internal Revenue Code). Health flexible spending arrangements and high deductible health plans are excluded from the definition of qualified employer coverage.To read this publication in its entirety, click the link in the adjacent "Downloads" section.