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Employer Responsibilities for Children's Health Insurance Program Reauthorization Act (CHIPRA)

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Employer Responsibilities for Children's Health Insurance Program Reauthorization Act (CHIPRA)

By sarahmillican
Published: December 7, 2010

Since taking office President Obama has initiated a number of laws impacting the healthcare system in America and the responsibilities of employers to employees.

This article focuses on the Children's Health Insurance Program Reauthorization Act (CHIPRA), a law aiming to improve access to health care for children across the country, signed into effect by President Obama on April 1, 2009. CHIPRA requires businesses to inform employees of health care assistance opportunities that are available in their state. Read on to understand your requirements as an employer.

Background

CHIPRA is an extension of the 1997 law, Children's Health Insurance Program (CHIP). CHIP was enacted to help states provide uninsured children with health care coverage, and to date has impacted over 5 million of the nation's uninsured children.

CHIP was reauthorized on February 4, 2009, when President Obama signed into law the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA), which ensures financing for CHIP through fiscal year 2013.

Information for Employers

Included in CHIPRA is a requirement mandating employers to inform their employees of health care premium assistance opportunities currently available in their state.

To assist employers in developing the appropriate language for these notices, the Department of Labor provides what is called a which includes the language employers will need to share with employees.

The notices are also required to include information on how an employee may contact the State in which the employee resides for additional information regarding potential opportunities for premium assistance, including how to apply for such assistance.

An English text version and a Spanish text version of the CHIPRA model notice is available through the Department of Labo-s Employee Benefits Security Administration.

As of January 22, 2010, the Department of Health and Human Services, in collaboration with State Medicaid and CHIP offices, listed 40 states as having one or more programs requiring the distribution of CHIPRA model notices:

  • Alabama, Alaska Arizona Arkansas, California, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Minnesota, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming.*

However, regardless of the employer's location, if a group health plan provides benefits for medical care or through insurance or reimbursement to employees, beneficiaries, or providers in any of the states listed above, you are required to provide the Employer CHIP Notice.

Consider the following illustration provided by the Federal Register:

  • An employer located in the District of Columbia sponsors a group health plan that provides reimbursement for medical care to plan participants or beneficiaries living in the District of Columbia, Virginia, Maryland, West Virginia, Delaware, and Pennsylvania.

  • Even though the employer is located in the District of Columbia, where the CHIPRA model notices are not required, the plan is considered maintained in all six states where the employees are living so the employer is subject to the Employer CHIP Notice requirement.

Employers were required to begin providing these notices by the first day of the first plan year after Feb. 4, 2010, or May 1, 2010.

  • Accordingly, for plan years beginning from Feb. 4, 2010, through April 30, 2010, the Employer CHIP Notice must be provided by May 1, 2010.

  • For employers whose next plan year begins on or after May 1, 2010, the Employer CHIP Notice must be provided by the first day of the next plan year (Jan. 1, 2011, for calendar-year plans).

The DOL plans to update the notice annually, with current information about which states are providing premium assistance programs. If you have additional question talk with an expert at the U.S. Department of Labor.

Additional Resources

  • *Employers should check with their stat's department of labor for the most accurate/timely information about their local requirements.

About the Author:

Sarah Millican
I'm a digital strategy consultant with ENC Strategy (www.encstrategy.com) and work full-time to support the Small Business Administration in growing and developing this online community to the best that it can be.

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