Benefits for 2022 Legal Notices 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 www.askebsa.dol.gov or call 1-866-444-EBSA (3272). in your employer plan, contact the Department of Labor at If you live in one of the following states, you may be eligible for assistance paying your employer health plan premiums. The COLORADO –Health First Colorado (Colorado’s Medicaid following list of states is current as of July 31, 2020. Contact your State for more information on eligibility – ALABAMA –Medicaid Program) & Child Health Plan Plus (CHP+) Website: http://myalhipp.com/ Health First Colorado Website: https://www.healthfirstcolorado.com/ Phone: 1-855-692-5447 Health First Colorado Member Contact Center: 1-800-221-3943/ State Relay 711 CHP+: https://www.colorado.gov/pacific/hcpf/child-health-plan-plus CHP+ Customer Service: 1-800-359-1991/ State Relay 711 Health Insurance Buy-In Program (HIBI): https://www.colorado.gov/pacific/hcpf/health-insurance-buy- program HIBI Customer Service: 1-855-692-6442 ALASKA –Medicaid FLORIDA –Medicaid The AK Health Insurance Premium Payment Program Website: Website: http://myakhipp.com/ https://www.flmedicaidtplrecovery.com/flmedicaidtplrecovery.com/hi Phone: 1-866-251-4861 pp/index.html Email: [email protected] Phone: 1-877-357-3268 Medicaid Eligibility: http://dhss.alaska.gov/dpa/Pages/medicaid/default.aspx ARKANSAS –Medicaid GEORGIA –Medicaid Website: http://myarhipp.com/ Website: https://medicaid.georgia.gov/health-insurance-premium- Phone: 1-855-MyARHIPP (855-692-7447) payment-program-hipp Phone: 678-564-1162 ext 2131 CALIFORNIA –Medicaid INDIANA – Medicaid Website: Healthy Indiana Plan for low-income adults 19-64 https://www.dhcs.ca.gov/services/Pages/TPLRD_CAU_cont.aspx Website: http://www.in.gov/fssa/hip/ Phone: 916-440-5676 Phone: 1-877-438-4479 All other Medicaid Website: https://www.in.gov/medicaid/ Phone 1-800-457-4584 2022 Employee Benefit Guide This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations, and exclusions set forth in each insurance 22 carrier or provider’s contract.