Enrollment of child in Medicaid - a change in family status?

[Guest kristinlobell]

We have an employee that has enrolled her child in medicaid. Does this constitute a change in family status to release her from the cafeteria plan.

[Guest b2kates]

As always, review the plan document

See Treas. Regulation 1.125-4(e) provides:

(e) Entitlement to Medicare or Medicaid. If an employee, spouse, or

dependent who is enrolled in an accident or health plan of the employer

becomes entitled to coverage (i.e., enrolled) under Part A or Part B of

Title XVIII of the Social Security Act (Medicare) or Title XIX of the

Social Security Act (Medicaid), other than coverage consisting solely of

benefits under section 1928 of the Social Security Act (the program for

distribution of pediatric vaccines), a cafeteria plan may permit the

employee to make an election change to cancel coverage of that employee,

spouse or dependent under the accident or health plan.

[Mary C]

Be careful on what the child is actually enrolled in. Final regulation guidance does allow for canceling coverage if the plan the child is enrolled in is Medicaid, but the regulations also say

"The regulations do not allow a cafeteria plan participant tio cease participation in a cafeteria plan if he or she becomes eligible for SCHIP coverge during the year because of a concern that such a rule would violate a fundamental principal of Title XXI of the Social Security Act that SCHIP coverage not supplant existing public or private coverage."

SCHIP stants for State Children Health Insuran Program and typically use "Healthy Kids" or "Healthy Start" or something similar in their name and are admistered by Medicaid.