CHIPRA Notice Requirements for Employers

Date of Publication: March 9, 2010


The CHIP Reauthorization Act of 2009 (CHIPRA) created a new notice requirement for employers who offer group health plans to their employees. The purpose of the notice is to let employees know that they may be eligible for assistance from their state in paying for health insurance premiums for their children. Regardless of the location of your company or where your health plan is insured, if you have employees who reside in a state that offers medical assistance under a state Medicaid or child health assistance plan, you must send this notice by the latter of the first day of the first plan year after February 4, 2010 or May 1, 2010. California, along with 39 other states, falls into this category.

The notice may be provided to employees along with the group health plan’s eligibility and enrollment information, open enrollment packets, or summary plan description; however, this must be a separate notice presented in a manner that ensures that employees will appreciate its significance. The Department of Labor has published a model notice (see “Employer CHIP Notice“), which employers may customize. Alternatively, employers with employees residing in more than one state may prefer to send the model notice, without customization, to all employees. Please note that this model notice will be updated annually.

Additionally, an employer must provide a “special enrollment” opportunity to enroll in the employer’s plan to those employees and dependents who: lost eligibility for coverage under a state Medicaid or CHIP program; or became eligible for State premium assistance under Medicaid or CHIP coverage. This special enrollment opportunity must be made available if the employee or dependent requested this coverage within 60 days of being terminated from Medicaid or CHIP coverage or within 60 days of being determined to be eligible for premium assistance. Further information is available at www.dol.gov/ebsa or, for California, www.cms.hhs.gov.

To learn if additional states have elected to offer this premium assistance since March 3, 2010 (when the model notice information was confirmed), please contact the U.S. Department of Labor’s Employee Benefits Security Administration at www.dol.gov/ebsa or 1-866-444-EBSA (3272); or the U.S. Department of Health and Human Services’ Centers for Medicare & Medicaid Services at www.cms.hhs.gov or 1-877-267-2323, Extension 61565.

Employers may be assessed $100 per day for failure to provide the requisite notice.

What should employers do?

  • Determine your company’s due date for providing this notice to your employees.
  • Based upon their state of residence, determine which of your employees must receive this notice.
  • Adopt the DOL model notice or customize one for use by your Company. For California employers, Vantaggio has created a sample notice that has been customized with information about the particular assistance programs within our state. Please contact us if you would like a copy of this notice.
  • Contact your medical insurance broker to ensure that your benefits plan has the appropriate procedures in place to handle the special enrollment requirements described above.

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