Children's Health Insurance Program Reauthorization Act of 2009 — Impact on Group Health Plans

NEWS

February 2009

On February 4, 2009 President Obama signed the Children's Health Insurance Program Reauthorization Act of 2009 (the "Act") into law. In addition to reauthorizing the program, the Act creates several new obligations for sponsors of group health plans, as the result of the establishment of a premium assistance option that allows states to subsidize an employee's employersponsored group health coverage rather than providing outside coverage.

Because the premium assistance subsidy (the "subsidy") becomes effective on April 1, 2009, plan sponsors of group health plans, both insured and self-insured, must:

  • Decide whether to accept premium assistance subsidies for their employees directly, rather than having the employee receive the subsidy as a reimbursement; and

  • Implement two additions to the HIPAA special enrollment periods.

    Generally, under the Act, an eligible employee must be now be permitted to enroll him/herself or his/her dependent in the group health plan within the 60-day period following either losing eligibility for coverage under Medicaid or the Act or becoming eligible for premium assistance under Medicaid or the Act.

These changes may require amendment of health plan and/or cafeteria plan documents.

New notice and disclosure requirements regarding the availability of the subsidy will also apply, with penalties authorized under ERISA for failure to comply.

We will address this matter in more detail very shortly in our next issue.




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