CHIPRA

The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) extends and expands the state Children's Health Insurance Program (CHIP). The following key provisions affect group health plans. Employers and group health plan administrators should note that some obligations were required to be complied with by April 1, 2009.

Premium Assistance Subsidy for Employer Coverage

States may elect to offer a premium assistance subsidy to help CHIP and Medicaid eligible children obtain "qualified employer-sponsored coverage". The subsidy may be provided as a reimbursement directly to the employee or as a direct payment to the employer. Employers can opt-out of direct payments.

ERISA

The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that sets minimum standards for retirement and health benefit plans in private industry. ERISA does not require any employer to establish a plan. It only requires that those who establish plans meet certain minimum standards.

ERISA covers retirement, health and other welfare benefit plans (e.g., life, disability and apprenticeship plans). Among other things, ERISA provides that those individuals who manage plans (and other fiduciaries) must meet certain standards of conduct. The law also contains detailed provisions for reporting to the government and disclosure to participants. There also are rules aimed at assuring that plan funds are protected and that participants who qualify receive their benefits.

The Federal Family and Medical Leave Act

The Family and Medical Leave Act (FMLA) provides certain employees with up to 12 weeks of unpaid, job-protected leave per year. It also requires that their group health benefits be maintained during the leave.

The FMLA is designed to help employees balance their work and family responsibilities by allowing them to take reasonable unpaid leave for certain family and medical reasons. It also seeks to accommodate the legitimate interests of employers, and promote equal employment opportunity for men and women.

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