Medicaid and Children's Health Insurance Program Notice
(CHIP)

Summary

This Medicaid and Children's Health Insurance Program (CHIP) Notice is for employers that sponsor group health plans subject to the Employee Retirement Income Security Act (ERISA) to alert eligible employees about any available Medicaid and CHIP benefits in participating states. This form includes practical guidance and drafting notes. Pursuant to the Children's Health Insurance Program Reauthorization Act (CHIPRA), covered employers sponsoring health plans must notify all plan-eligible employees before enrollment and annually (regardless of enrollment status) of potential opportunities available in the state in which the employees reside regarding Medicaid or CHIP coverage or premium assistance for the purchase of coverage for the employee or the employee's dependents under the plan. The annual notice must be issued before the beginning of the plan year and is generally provided with other open enrollment period materials. ERISA § 701(f)(3(B)(i)) (29 U.S.C. § 1181(f)(3)(B)(i)); I.R.C. § 9801(f)(3)(B)(i). See also Open Enrollment Notices Checklist (Health and Welfare Plans). This template is based on the Department of Labor's model language, which is updated periodically. See DOL, Model CHIP Notice for Employers. The employer may provide the notice concurrently with the furnishing of (1) materials notifying the employee of health plan eligibility, (2) materials provided to the employee in connection with initial enrollment or an open enrollment period, or (3) with the summary plan description. However, the Medicaid and CHIP notice must be provided to all employees entitled to receive it and the notice must appear separately and in a manner reasonably anticipated to allow the recipient to appreciate its significance. The notice may be sent by first-class mail. Alternatively, it can be distributed electronically if the employer follows the ERISA guidelines for electronic delivery of ERISA plan disclosures. For information in that regard, see {Electronic Disclosure Rules (ERISA Safe Harbors)}. You may distribute the notice with other annually required health-care notices like the Women's Health Care and Cancer Rights Act (WHCRA) Notice required under ERISA § 713(b) (29 U.S.C. § 1185b(b)). Foreign language version. Regulations require an Offer of Assistance in Non-English Language in the SPD of an employee benefit plan subject to ERISA. 29 C.F.R. § 2520.102-2(c) to provide non-English speaking participants of their rights and obligations under the plan. Most employers provide employees with an English and Spanish version of the CHIP notice, using the DOL's model CHIP notice, which is available in both English and Spanish. For further Department of Labor information regarding the Children's Health Insurance Program Reauthorization Act (CHIPRA), see website. HIPAA special enrollment. Under the Health Insurance Portability and Accountability Act (HIPAA), an employer sponsor of a group health plan must provide at least 60 days for an eligible employee to request special enrollment coverage after the employee or the employee's dependent loses coverage under a group health plan (including eligibility for Medicaid or CHIP benefits) or (as amended by CHIPRA) the employee or dependent becomes eligible for Medicaid or CHIP benefits. ERISA § 701(f)(3)(A)(ii) (29 U.S.C. § 1181(f)(3)(A)(ii)). Employer sponsors of group health plans are also required to furnish a notice to eligible employees regarding their HIPAA special enrollment rights. For additional information on Medicaid and CHIP special enrollment rights, see Health Insurance Answer Book (CCH) Q 2:90, "Do employers have notice requirements related to the Children's Health Insurance Program?" and HIPAA Special Enrollment Rights — Special Enrollment Rights upon Eligibility for or Loss of Medicaid or CHIP Coverage or Premium Assistance. For a notice informing an employee of their special enrollment rights upon certain events, including the employee's or his or her dependent's becoming eligible for premium assistance, or such individual's loss of coverage under state Medicaid and/or CHIP programs, see HIPAA Special Enrollment Rights Notice. For additional references to required notices in ERISA health and welfare plans, see Participant Disclosure Checklist (Health and Welfare Benefit Plans). See also the Open Enrollment Notices Checklist (Health and Welfare Plans) for notifications that should be provided during an open enrollment period.