2024 CHIP Notice

Premium Assistance Under Medicaid and the Children ’ s Health Insurance Program (CHIP)

If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare.gov.

If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available.

If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan. If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272).

If you live in one of the following states, you may be eligible for assistance paying your employer health plan premiums. The following list of states is current as of July 31, 2023. Contact your State for more information on eligibility –

ALABAMA – Medicaid

ALASKA – Medicaid

Website: http://myalhipp.com/

The AK Health Insurance Premium Payment Program Website: http://myakhipp.com/ Phone: 1-866-251-4861 Email: CustomerService@MyAKHIPP.com Medicaid Eligibility: https://health.alaska.gov/dpa/Pages/default.aspx

Phone: 1-855-692-5447

ARKANSAS – Medicaid

CALIFORNIA – Medicaid

Website: http://myarhipp.com/

Health Insurance Premium Payment (HIPP) Program Website:

Phone: 1-855-MyARHIPP (855-692-7447)

http://dhcs.ca.gov/hipp Phone: 916-445-8322 Fax: 916-440-5676 Email: hipp@dhcs.ca.gov

COLORADO – Health First Colorado

FLORIDA – Medicaid

(Col orado’s Medicaid Program) & Child Health Plan Plus (CHP+) Health First Colorado Website:

Website:

https://www.healthfirstcolorado.com/

https://www.flmedicaidtplrecovery.com/flmedicaidtplrecover

Health First Colorado Member Contact Center:

y.com/hipp/index.html Phone: 1-877-357-3268

1-800-221-3943/State Relay 711

CHP+: https://hcpf.colorado.gov/child-health-plan-plus CHP+ Customer Service: 1-800-359-1991/State Relay 711 Health Insurance Buy-In Program (HIBI): https://www.mycohibi.com/ HIBI Customer Service: 1-855-692-6442

GEORGIA – Medicaid

INDIANA – Medicaid

GA HIPP Website: https://medicaid.georgia.gov/health- insurance-premium-payment-program-hipp Phone: 678-564-1162, Press 1 GA CHIPRA Website: https://medicaid.georgia.gov/programs/third-party- liability/childrens-health-insurance-program-reauthorization- act-2009-chipra Phone: 678-564-1162, Press 2

Healthy Indiana Plan for low-income adults 19-64 Website: http://www.in.gov/fssa/hip/ Phone: 1-877-438-4479 All other Medicaid Website: https://www.in.gov/medicaid/ Phone: 1-800-457-4584

KANSAS – Medicaid

IOWA – Medicaid and CHIP (Hawki)

Medicaid Website:

Website: https://www.kancare.ks.gov/

https://dhs.iowa.gov/ime/members Medicaid Phone: 1-800-338-8366

Phone: 1-800-792-4884

HIPP Phone: 1-800-967-4660

Hawki Website: http://dhs.iowa.gov/Hawki Hawki Phone: 1-800-257-8563 HIPP Website: https://dhs.iowa.gov/ime/members/medicaid- a-to-z/hipp HIPP Phone: 1-888-346-9562 KENTUCKY – Medicaid Kentucky Integrated Health Insurance Premium Payment Program (KI-HIPP) Website: https://chfs.ky.gov/agencies/dms/member/Pages/kihipp.aspx Phone: 1-855-459-6328 Email: KIHIPP.PROGRAM@ky.gov KCHIP Website: https://kidshealth.ky.gov/Pages/index.aspx Phone: 1-877-524-4718 Kentucky Medicaid Website: https://chfs.ky.gov/agencies/dms

LOUISIANA – Medicaid

Website: www.medicaid.la.gov or www.ldh.la.gov/lahipp Phone: 1-888-342-6207 (Medicaid hotline) or 1-855-618-5488 (LaHIPP)

MAINE – Medicaid

MASSACHUSETTS – Medicaid and CHIP

Enrollment Website:

Website: https://www.mass.gov/masshealth/pa

https://www.mymaineconnection.gov/benefits/s/?language=en

Phone: 1-800-862-4840

_US

TTY: 711

Phone: 1-800-442-6003

Email: masspremassistance@accenture.com

TTY: Maine relay 711 Private Health Insurance Premium Webpage: https://www.maine.gov/dhhs/ofi/applications-forms

Phone: 1-800-977-6740 TTY: Maine relay 711

MINNESOTA – Medicaid

MISSOURI – Medicaid

Website:

Website:

https://mn.gov/dhs/people-we-serve/children-and- families/health-care/health-care-programs/programs-and-

http://www.dss.mo.gov/mhd/participants/pages/hipp.htm

Phone: 573-751-2005

services/other-insurance.jsp Phone: 1-800-657-3739

MONTANA – Medicaid

NEBRASKA – Medicaid

Website:

Website: http://www.ACCESSNebraska.ne.gov

http://dphhs.mt.gov/MontanaHealthcarePrograms/HIPP

Phone: 1-855-632-7633 Lincoln: 402-473-7000 Omaha: 402-595-1178

Phone: 1-800-694-3084

Email: HHSHIPPProgram@mt.gov

NEVADA – Medicaid

NEW HAMPSHIRE – Medicaid

Medicaid Website: http://dhcfp.nv.gov Medicaid Phone: 1-800-992-0900

Website: https://www.dhhs.nh.gov/programs-

services/medicaid/health-insurance-premium-program Phone: 603-271-5218 Toll free number for the HIPP program: 1-800-852-3345, ext. 5218

NEW JERSEY – Medicaid and CHIP

NEW YORK – Medicaid

Medicaid Website:

Website: https://www.health.ny.gov/health_care/medicaid/

http://www.state.nj.us/humanservices/

Phone: 1-800-541-2831

dmahs/clients/medicaid/ Medicaid Phone: 609-631-2392 CHIP Website: http://www.njfamilycare.org/index.html CHIP Phone: 1-800-701-0710 NORTH CAROLINA – Medicaid

NORTH DAKOTA – Medicaid

Website: https://medicaid.ncdhhs.gov/

Website: https://www.hhs.nd.gov/healthcare

Phone: 919-855-4100

Phone: 1-844-854-4825

OKLAHOMA – Medicaid and CHIP

OREGON – Medicaid

Website: http://www.insureoklahoma.org

Website: http://healthcare.oregon.gov/Pages/index.aspx

Phone: 1-888-365-3742

Phone: 1-800-699-9075

PENNSYLVANIA – Medicaid and CHIP

RHODE ISLAND – Medicaid and CHIP

Website:

Website: http://www.eohhs.ri.gov/

https://www.dhs.pa.gov/Services/Assistance/Pages/HIPP-

Phone: 1-855-697-4347, or

Program.aspx

401-462-0311 (Direct RIte Share Line)

Phone: 1-800-692-7462 CHIP Website: Children's Health Insurance Program (CHIP) (pa.gov) CHIP Phone: 1-800-986-KIDS (5437) SOUTH CAROLINA – Medicaid

SOUTH DAKOTA - Medicaid

Website: https://www.scdhhs.gov

Website: http://dss.sd.gov Phone: 1-888-828-0059

Phone: 1-888-549-0820

TEXAS – Medicaid

UTAH – Medicaid and CHIP

Website: Health Insurance Premium Payment (HIPP)

Medicaid Website: https://medicaid.utah.gov/ CHIP Website: http://health.utah.gov/chip Phone: 1-877-543-7669

Program | Texas Health and Human Services Phone: 1-800-440-0493 VERMONT – Medicaid

VIRGINIA – Medicaid and CHIP

Website: Health Insurance Premium Payment (HIPP) Program Website: https://coverva.dmas.virginia.gov/learn/premium- | Department of Vermont Health Access assistance/famis-select Phone: 1-800-250-8427 https://coverva.dmas.virginia.gov/learn/premium- assistance/health-insurance-premium-payment-hipp-programs Medicaid/CHIP Phone: 1-800-432-5924

WASHINGTON – Medicaid

WEST VIRGINIA – Medicaid and CHIP

Website: https://www.hca.wa.gov/

Website: https://dhhr.wv.gov/bms/

Phone: 1-800-562-3022

http://mywvhipp.com/ Medicaid Phone: 304-558-1700 CHIP Toll-free phone: 1-855-MyWVHIPP (1-855-699-8447)

WISCONSIN – Medicaid and CHIP

WYOMING – Medicaid

Website:

Website:

https://www.dhs.wisconsin.gov/badgercareplus/p-10095.htm

https://health.wyo.gov/healthcarefin/medicaid/programs-and-

Phone: 1-800-362-3002

eligibility/ Phone: 1-800-251-1269

To see if any other states have added a premium assistance program since July 31, 2023, or for more information on special enrollment rights, contact either:

U.S. Department of Labor

U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services

Employee Benefits Security Administration

www.dol.gov/agencies/ebsa

www.cms.hhs.gov

1-866-444-EBSA (3272)

1-877-267-2323, Menu Option 4, Ext. 61565

Paperwork Reduction Act Statement

According to the Paperwork Reduction Act of 1995 (Pub. L. 104-13) (PRA), no persons are required to respond to a collection of information unless such collection displays a valid Office of Management and Budget (OMB) control number. The Department notes that a Federal agency cannot conduct or sponsor a collection of information unless it is approved by OMB under the PRA, and displays a currently valid OMB control number, and the public is not required to respond to a collection of information unless it displays a currently valid OMB control number. See 44 U.S.C. 3507. Also, notwithstanding any other provisions of law, no person shall be subject to penalty for failing to comply with a collection of information if the collection of information does not display a currently valid OMB control number. See 44 U.S.C. 3512. The public reporting burden for this collection of information is estimated to average approximately seven minutes per respondent. Interested parties are encouraged to send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Labor, Employee Benefits Security Administration, Office of Policy and Research, Attention: PRA Clearance Officer, 200 Constitution Avenue, N.W., Room N-5718, Washington, DC 20210 or email ebsa.opr@dol.gov and reference the OMB Control Number 1210-0137.

OMB Control Number 1210-0137 (expires 1/31/2026)

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