Of particular concern for employers are provisions of the bill that would increase notification and disclosure requirements and extend the Family and Medical Leave Act for employees with family members injured during military service.

The Children’s Health Insurance Program Reauthorization Act of 2007 was passed by Congress in late September in an attempt to allow millions of uninsured children to enroll in the government health care program. President Bush vetoed the bill, citing concerns about income eligibility levels for the program used by various states and the possibility of moving millions of children with private health insurance into the government health care system.

The Senate recently passed a new version of the bill. President Bush has threatened to veto the new bill. The provisions that affect employers are likely to survive efforts to craft a compromise measure to keep some kind of program in place, observers say. The current program expires November 16.

The State Children’s Health Insurance Program is a joint federal-state effort that provides health care for children in families with income above Medicaid-eligibility thresholds. The states establish and administer the program and receive grants from the federal government to fund a portion of the health care provided to members.

The bill would give states the option to provide premium subsidies for qualified employer-sponsored coverage to low-income employees with children eligible for both the government program and employer-sponsored plans. The provision targets a segment of uninsured children whose parents have access to coverage through their employers but cannot afford the additional premiums for family coverage, says Paul Dennett, vice president, health policy at the American Benefits Council in Washington.

Under the bill, employers must notify employees about their ability to enroll in state health insurance programs and provide information on premium assistance to employees living in the states that offer such assistance. For example, an employer in the District of Columbia whose employees live in several surrounding states would have to comply with the specific requirements of each state where its employees live.

The bill also would create special enrollment periods for employees or dependents who lose eligibility for the government program or become eligible for premium assistance to join an employer health plan. Under the bill, the employee must ask to join the employer-sponsored health plans within 60 days of losing coverage in the government program or gaining eligibility for premium assistance.

Plan sponsors would also be required to disclose information about their benefit plans to states upon request, including information about eligibility for the plan, cost-sharing mechanisms and the scope of coverage. The bill, though, was unclear how extensive the disclosure would have to be to ensure compliance. Since health insurance programs vary from state to state, employers would be forced to comply with different programs and varying requests for information, consultants say.

The bill also would amend the Family and Medical Leave Act to provide for extended leave of up to 26 weeks in a one-year period for an employee to care for an injured member of the armed services. A separate provision would ban employers from denying these family members promotions, employment or bene- fits for a one-year period.
“That represents a significant expansion of FMLA,” says Steve Wojcik, vice president of public policy at the Washington-based National Business Group on Health. “To implement that seems like it would be administratively complicated.”

The Society for Human Resource Management expressed concern about the “overly broad” wording of the amendments, which could have unintended consequences as the family leave law has had, says Lisa Horn, manager of health care in SHRM’s government affairs division. According to a SHRM study, four out of 10 human resource professionals report approving FMLA leave that they believed was not legitimate.

“FMLA isn’t right now working on all cylinders,” Horn says. “The concern is, you’re building on an already broken framework.”

Filed by Gloria Gonzalez of Business Insurance, a sister publication to Workforce Management.