32.1-351.1 - Assistance with employer-sponsored health insurance. - Virginia Statutes

§ 32.1-351.1. Assistance with employer-sponsored health insurance.

A. For purposes of this chapter, "employer-sponsored health insurance" or"ESHI" means comprehensive health insurance offered by the employer whenthe employer contributes to the cost of dependent or family coverage asdefined in the Virginia Plan for Title XXI of the Social Security Act, or asotherwise approved by the Centers for Medicare & Medicaid Services in theU.S. Department of Health and Human Services.

B. For purposes of this chapter, ESHI shall be deemed cost-effective when thepayment by the Department of Medical Assistance Services for health insurancecoverage of the enrollee or enrollees under the Family Access to MedicalInsurance Security Plan shall be no greater than what would have otherwisebeen paid by the Department or its designee for the enrollee or enrollees.

C. If a family chooses to participate in ESHI and ESHI is deemedcost-effective, the Department of Medical Assistance Services shallcontribute to the cost of ESHI for eligible dependent children for thoseprogram participants that have access to ESHI. Participants receiving ESHIunder the Family Access to Medical Insurance Security Plan shall apply forthe full premium contribution available from the employer. Those eligible forFamily Access to Medical Insurance Security Plan with access to ESHI mayenroll in their designated ESHI at the first available opportunity and shallbe covered under the Family Access to Medical Insurance Security Plan untilcoverage under ESHI becomes available.

(2000, cc. 824, 848; 2003, c. 513; 2009, c. 578.)