The Children’s Health Insurance Program (CHIP) Reauthorization Act of 2009 (H.R. 2) would amend the Employee Retirement Income Security Act (ERISA) to require that employer plans and insurers permit employees and their dependents who are eligible for coverage but not enrolled in a plan to enroll if they become ineligible for coverage under Medicaid or a state child health plan, according news reports. Employers and insurers would also have to permit employees and their dependents who are eligible but not enrolled to enroll if they become eligible for financial assistance from Medicaid or a state child health plan.
Under the legislation, employers are required to notify employees in writing of any state Medicaid and child health assistance available to them and their dependents if they need financial help to pay for employer-sponsored health coverage. In addition, group health plan administrators must disclose detailed information about benefits available requested by state officials to determine if it would be cost effective for the state to provide financial assistance and supplemental benefits to employees.
The bill authorizes the labor secretary to fine employers as much as $100 a day for failing to comply with the notice requirement with each employee or beneficiary treated as a separate violation. In addition, any plan administrator failing to provide to state officials with information required to be disclosed would be fined as much as $100 a day.
A model disclosure form will be provided to employers by a Medicaid, CHIP, and Employer-Sponsored Coverage Coordination Working Group no later than one year after the effective date of the Act – April 1, 2009.
According to news reports, the Children's Health Insurance Program (CHIP) Reauthorization Act of 2009 would require the secretaries of labor and health and human services to establish a Medicaid, CHIP, and Employer-Sponsored Coverage Coordination Working Group no later than 60 days after enactment of the CHIP Reauthorization Act.
The working group would have 30 members representing the health and human services and labor departments; state Medicaid directors; employers, including small business owners, industry representatives, certified human resource and payroll professionals, plan administrators, and plan sponsors of group health plans; health insurance issuers; and children and other beneficiaries of medical assistance under Title XIX of the Social Security Act or other health benefits coverage.
The group would help coordinate coverage available to families of employees whose employers offer group health plans and whose family members are eligible for medical assistance under Medicaid or child health assistance or other health benefits coverage.
No later than 18 months after the effective date of the Act, the group must provide a report to the House and Senate containing recommendations for addressing impediments to coordinating health coverage between group health plans and state plans.
Different versions of the bill from the House and Senate need to be reconciled.
Text of H.R. 2 is here .
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