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CHIPRA Model Notice

Model Notice

The Children's Health Insurance Program Reauthorization Act (CHIPRA or the "Act") of 2009 was enacted in February of 2009. CHIPRA extends and expands the State Children’s Health Insurance Program (now referred to as CHIP), which was originally enacted as part of the Balanced Budget Act of 1997. CHIP was designed to expand health coverage for children of low-income families beyond Medicaid through state programs. With the new modifications under CHIPRA, a state CHIP program now may elect to offer premium assistance to subsidize employer-provided coverage for eligible low-income children and families. At the employer's election, the subsidies can be paid directly to the company or directly to the employee.

If you are eligible for health coverage from your employer, but are unable to afford the premiums, you may be eligible for premium assistance from the State. If you or your dependents are already enrolled in Medicaid or CHIP, you can contact the State Medicaid or CHIP office to find out if premium assistance is available.

If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your State Medicaid Office at 1-800-462-1120 or the CHIP Office at 1-800-841-2900 to find out how to apply. If you qualify, you can ask the State if it has a program that might help you pay the premiums for an employer-sponsored plan.

Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP, your employer's health plan is required to permit you and your dependents to enroll in the plan – as long as you and your dependents are eligible, but not already enrolled in the employer's plan. This is called a "special enrollment" opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance.

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