On February 4th President Obama signed the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) into law in an effort to address a certain income gap for employees whose income is near the poverty line but not close enough to qualify for Medicaid health insurance.

Although CHIPRA is a federal law, much of it will be coordinated through state programs. Adopting states will be permitted to arrange enrollment of eligible children (and in some cases their families) in qualified employer coverage. In other words, if you employ the mother or father of an eligible child(ren), then they must be allowed enrollment opportunities to your plan.

If the parents agree to such enrollment, CHIPRA will pay the employee's portion of the premium  generally the difference between single and family (or parent/child) coverage, less any premium cost sharing by the employer. That payment will reimburse the employer. However, the employer can opt out of the state premium subsidy program in which case the payment goes directly to the employee.

CHIPRA requires plans to allow two new special enrollments beginning April 1, 2009.

One: If an employee or their dependent loses Medicare or CHIPRA eligibility they have a 60-day window to enroll in your plan; and

Two: Allow employees and their dependents that are eligible under terms of your plan to enroll within 60 days of a notice of their eligibility for Medicare or CHIPRA premium assistance.

The difference is the extension from 30 to 60 days. This will require amending certain plans  certainly all Flex, Premium Offset and Cafeteria Plans  to incorporate these new special enrollment opportunities.

What's next? you might ask. In 2010 and once the U.S. Department of Labor provides us with a model notice, all employers will have to provide participants with explanatory notices. The notice can be distributed in one of two ways: either through inclusion with the Summary Plan Description or as a separate piece.

The Secretary of Labor is developing a model disclosure so that plan administrators (employers) may disclose to states their health plan(s) information, enabling the state to determine whether the plan is cost effective compared to the state alternatives.

As you can see there will be plan amendments, notices and annual disclosures as well as potential administration for this new CHIPRA. And I thought there was no diving allowed&