Special Enrollment Periods Created by CHIPRA
The Children's Health Insurance Program Reauthorization Act (CHIPRA) of 2009 was one of the first pieces of legislation passed by the 111th Congress and signed by President Obama on February 4, 2009. The Act extends and expands the State Children's Health Insurance Program (now referred to as CHIP, not SCHIP) which was enacted a decade ago as part of the Balanced Budget Act of 1997 (BBA). CHIPRA adds $33 billion in federal funds for children's coverage over the next four and half years, and is expected to provide coverage to 4.1 million children in Medicaid and CHIP who otherwise would have been uninsured by 2013.
The law contains several state premium assistance provisions. A state premium assistance program uses federal and state Medicaid and/or CHIP funds to help pay for a portion of the premium costs of employer-sponsored insurance or private health insurance for eligible populations. In Wisconsin, each individual/family is considered on individual basis when the state determines if it is cost effective to enroll them into the Health Insurance Premium Payment program. The law allows children who have access to employer-sponsored plans to stay in the private market, and allows states to create/improve premium assistance programs for employer sponsored coverage. Also, the law created a new qualifying event/special enrollment period for group health plans.
Accordingly, Dean Health Plan will accommodate a new qualifying event effective April 1, 2009, in the event one of the following occurs:
- The eligible person ceases to be eligible for Medicaid or SCHIP coverage; or
- The eligible person becomes newly eligible for a premium subsidy under Medicaid or SCHIP.
While most special enrollment periods have a 30-day limit for the eligible employee to report the event, this enrollment period provides a 60-day reporting window.
Dean Health Plan will comply with any further guidance and all regulations related to this legislation once they are created.
