Special Enrollment Rights Under “CHIP”

(Effective April 1, 2009)

Effective April 1, 2009, the “Children’s Health Insurance Program Reauthorization Act of 2009” (“CHIP”) requires group health plans to offer special 60 day enrollment periods to employees and their dependents who are not covered by the group plan in two situations:
 

• When the employee loses eligibility for Medicaid, Vermont Health Access Program or Dr. Dynasaur; or
   
• When the employee becomes eligible for Vermont’s Employer-Sponsored Insurance Premium Subsidy program.

The employee must request coverage not later than 60 days after termination from Medicaid or CHIP or the date the employee is determined to be eligible for premium assistance.  The employee may choose either the date coverage ends or the first of the month following receipt of a valid enrollment request as the effective date for coverage under the group health plan.

The employee (and any affected dependent) must submit proof that he was cancelled from one of those programs or has become eligible for subsidy.

Employee Notification Requirements Under "CHIP"

(Effective for plan years that start after February 4, 2010)

Employers are required to provide written notices to employees describing premium assistance programs and the benefits that may be available to them under those programs.  Employers must comply with the notice requirement for the first plan year after February 4, 2010.  A model notice from the Department of Labor has been drafted for employer use: 
 

• CHIP Model Notice