Medicaid/CHIP Premium Assistance Notice
Informs employees about state premium assistance programs that may help pay for employer coverage. Send annually to all employees, enrolled or not.
Companies Eligible
Employers with a group health plan and employees living in a state that offers premium assistance under Medicaid or CHIP.
The model notice lists the states; DOL refreshes the list every January 31 and July 31. Most employers send it to every employee rather than track residence, and that is what we recommend.
What it is
The DOL model notice tells employees they may qualify for state help paying their share of the employer plan premium, lists each state's contact, and reminds them that losing Medicaid or CHIP, or becoming eligible for premium assistance, is a 60-day special enrollment event.
What needs to be done
- When: Once a year, before the start of the plan year. Sending it with OE materials is the common practice.
- To whom: All employees, enrolled or not (or at minimum those living in a listed state).
- Who performs: Employer; AAB supplies the current template each cycle.
- Customize: None — use the current DOL version, which is dated. Replace the template after each January 31 and July 31 refresh.
- Deliver: Separately, or with other plan materials as long as it appears separately and prominently rather than buried in a packet. Paper by hand or first-class mail to the home always works. Electronic delivery meets the DOL safe harbor only for employees who use a computer where they work as an integral part of their duties; anyone else (spouses, former employees, employees without work computers) has to consent in advance.
- Keep: Date, method and recipient list. Failures carry ERISA civil penalties per day, per employee.