Many states, including Pennsylvania, provide health care coverage to uninsured children if the family’s income falls below a certain level. These programs are known as the Children’s Health Insurance Program (CHIP). Effective February 2009, the Children’s Health Insurance Program Reauthorization Act (CHIPRA) was signed into law. Through CHIPRA, a state CHIP may elect to offer premium assistance to subsidize employer provided health care coverage for eligible low-income children and families. You can find information about Pennsylvania CHIP, including eligibility guidelines, enrollment information, and information about premium assistance, at http://chipcoverspakids.com/ or by calling (800) 986-KIDS.
CHIPRA requires health plan sponsors, such as Franklin & Marshall College, to notify employees of a special health plan enrollment period. Ordinarily, full-time College employees may enroll in the Franklin & Marshall Group Health & Prescription Drug Plan only during the annual "open enrollment" period, with coverage effective the following January 1. Employees and their eligible dependents may enroll in the health plan at other times during the year only in limited circumstances, such as following marriage, birth or adoption of a child, or loss of other health insurance coverage.
Franklin & Marshall permits employees and their dependents who are eligible for health care coverage but are not enrolled through the College's Group Health & Prescription Drug Plan to enroll in the plan within 60 calendar days of either of the following events:
1. The employee's or dependent's Medicaid or CHIP coverage is terminated as a result of loss of eligibility.
2. The employee or dependent becomes eligible for a premium assistance subsidy under Medicaid or CHIP.
A College employee must request to enroll in the Franklin & Marshall Group Health & Prescription Drug Plan within 60 calendar days of the loss of Medicaid or CHIP coverage, or within 60 calendar days of when determined to be eligible for a premium assistance subsidy under Medicaid or CHIP. (Eligible employees may also enroll during any open enrollment period.)
If you or a dependent qualifies for this special enrollment period, please contact a Human Resources Administrator. You must complete and return a Franklin & Marshall Group Health Plan enrollment form within 60 calendar days of loss of Medicaid or CHIP coverage or of becoming eligible for premium assistance through Medicaid or CHIP. You will need to provide verification to Human Resources of loss of coverage through Medicaid or CHIP, or verification that you are eligible for a premium assistance subsidy under Medicaid or CHIP.
If you live outside of Pennsylvania and would like to determine whether another state offers a premium assistance program / CHIP, or for more information regarding special enrollment rights, you may contact either the:
U.S. Department of Health and Human Services
Centers for Medicare & Medicaid Services
(877) 267-2323, ext. 61565
U. S. Department of Labor
Employee Benefits Security Administration