HEALTH PLAN NOTICES Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP) ALABAMA –Medicaid CALIFORNIA –Medicaid Website: http://myalhipp.com/ Website: If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, Phone: 1-855-692-5447 Health Insurance Premium Payment (HIPP) Program your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or http://dhcs.ca.gov/hipp CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium Phone: 916-445-8322 assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Fax: 916-440-5676 Marketplace. For more information, visit www.healthcare.gov. Email: [email protected] If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your ALASKA –Medicaid COLORADO –Health First Colorado (Colorado’s Medicaid State Medicaid or CHIP office to find out if premium assistance is available. Program) & Child Health Plan Plus (CHP+) If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your The AK Health Insurance Premium Payment Program Health First Colorado Website: dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1-877- Website: http://myakhipp.com/ https://www.healthfirstcolorado.com/ KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that Phone: 1-866-251-4861 Health First Colorado Member Contact Center: might help you pay the premiums for an employer-sponsored plan. Email: [email protected] 1-800-221-3943/ State Relay 711 CHP+: Medicaid Eligibility: https://www.colorado.gov/pacific/hcpf/child-health- If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your https://health.alaska.gov/dpa/Pages/default.aspx plan-plus employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is CHP+ Customer Service: 1-800-359-1991/ State Relay 711 called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible Health Insurance Buy-In Program for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of (HIBI): https://www.colorado.gov/pacific/hcpf/health- Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272). insurance-buy-program To see if any other states have added a premium assistance program since July 31, 2022, or for more information on HIBICustomer Service: 1-855-692-6442 special enrollment rights, contact either: U.S. Department of Labor S U.S. Department of Health and Human Services ARKANSAS –Medicaid FLORIDA –Medicaid Employee Benefits Security Administration Centers for Medicare & Medicaid Services Website: www.dol.gov/agencies/ebsa www.cms.hhs.gov http://myarhipp.com/ Website: 1-866-444-EBSA (3272) 1-877-267-2323, Menu Option 4, Ext. 61565 Phone: 1-855-MyARHIPP (855-692-7447) https://www.flmedicaidtplrecovery.com/flmedicaidtplreco very.com/hipp/index.html ________________________________________________________________________________________________ Phone: 1-877-357-3268 If you live in one of the following states, you may be eligible for assistance paying your employer health plan GEORGIA –Medicaid MASSACHUSETTS –Medicaid and CHIP premiums. The following list of states is current as of July 31, 2022. Contact your State for more information on GA HIPP Website: https://medicaid.georgia.gov/health- https://www.mass.gov/masshealth/pa eligibility – Website: insurance-premium-payment-program-hipp Phone: 1-800-862-4840 Phone: 678-564-1162, Press 1 TTY: (617) 886-8102 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