Children's Health Insurance Program (CHIP) Update to HIPAA Special Enrollment

This notice is being provided to all employees eligible for medical coverage under the University of Pennsylvania Medical Plan. If you are declining enrollment for medical coverage for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll yourself and your dependents for medical, prescription, dental and vision coverage under this plan in the following circumstances:

If you or your dependents lose eligibility for that other coverage (or if the employer stops contributing towards your or your dependents' other coverage),

If you or your dependents lose Medicaid or Children's Health Insurance Program ("CHIP") coverage as a result of a loss of eligibility for such coverage, or

If you or your dependents become eligible for a premium assistance subsidy under Medicaid or CHIP.

Note: This enrollment right does not apply to the Health Spending Account.

You must request enrollment within 30 days after your or your dependents' other coverage ends (or after the employer stops contributing toward the other coverage), or within 60 days in the case of changes related to Medicaid or CHIP.

In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents for medical coverage under this plan. However, you must request enrollment within 31 days after the marriage, birth, adoption, or placement for adoption.

If you'd like more information or a printed copy of this notice, please contact us 215-898-3539 or contact us online.