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Transitioning from Medicaid to Employer-Provided Coverage

It is estimated that as many as 18 million people may lose access to Medicaid coverage over the next year as a result of the unwinding process. More than half of those (approximately 54%) who are no longer eligible for Medicaid coverage will have access employer-provided coverage. Employer-provided coverage delivers access to health care for workers across all industries and company sizes and their families.

More than half of all Americans – nearly 180 million hardworking individuals and their families – receive their health coverage through their jobs. Unlike Medicaid, which is a state-run program designed to offer health coverage to those with limited income, employer-provided coverage is a private health insurance plan that employers provide for their employees and their dependents. Employers select a health plan to meet the needs of their workforce and typically share the cost of health insurance with employees. On average, employers pay 83% of the coverage costs for a single person, and 72% of the coverage costs for a family. Employers not only offer high-quality coverage but also and contribute directly to the cost of the employee’s premium, lowering the premium amount for which the employee is responsible and increasing access to quality, affordable care for their employees.
Resource
Description
Date
HHS, DOL, and Treasury Letter on Medicaid Unwinding & Employer-Provided Coverage
The letter requests employers, plan sponsors, and issuers to support employer-provided coverage enrollment flexibilities by providing employees more than the required 60 days to enroll in EPC and allowing them to enroll anytime during the Medicaid unwinding period.
​July 20, 2023
​​AHIP Resource: Moving from Medicaid to Employer-Provided Coverage (Click here for the English version, and here for the Spanish version).
​​​This resource is designed to help people understand how to move to Employer-Provided coverage and the key differences between Medicaid and Employer-Provided coverage.​
May 15, 2023
​​​Departments of Health and Human Services, Labor, and Commerce: Medicaid Unwinding Briefing for Employers Webinar​
This webinar explains the various ways employers can support their employees with the redeterminations process. It also features a Question & Answer session with Administration experts.
April 12, 2023
​​​ASPE Report: Medicaid Enrollees Who are Employed: Implications for Unwinding the Medicaid Continuous Enrollment Provision​
​This report from ASPE details the intersection between Medicaid and employment as the pandemic-related Medicaid continuous enrollment ends.
​​April 10, 2023
​​Department of Labor Medicaid Unwinding Flyer for Employers (English version) (Spanish version)
​​This flyer outlines ways employers can help employees and their families transition to other coverage if they lose Medicaid coverage.​
​​April 2023
CMS Recommendations: Medicaid Unwinding & Employer Actions​
These slides provide a “punchlist” of policy and operational strategies that SBMs and the FFM are utilizing to improve Medicaid to Marketplace coordination and maximize enrollee transitions and coverage retention. ​
​​February 2, 2023
Frequently Asked Questions (FAQs) regarding implementation of the Families First Coronavirus Response Act (FFCRA), the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), and the Health Insurance Portability and Accountability Act (HIPAA) Part 58
​​​The HHS and DOL FAQs address topics of interest to group health plans, health insurance issuers, and health care providers related to the end of the COVID-19 Public Health Emergency (PHE), which is set to expire on May 11, 2023. FAQs Part 58 include important information regarding coverage of COVID-19 diagnostic testing and vaccines, extension of certain timeframes for employee benefit plans, special enrollment periods (SEPs), and implications for Health Savings Accounts (HSAs) and High Deductible Health Plans (HDHPs).
​January 2023
Department of Labor Medicaid Unwinding Flyer for Employer
​​​This DOL resource for employers emphasizes “If you are losing Medicaid or CHIP coverage, you may have other health coverage options!”
2023
​CMS Communications Toolkit: Medicaid and CHIP Eligibility Renewals
​This toolkit provides key communications about Medicaid unwinding for stakeholders and consumers.
​January 2023
​NABIP Slide Video: Finding Affordable Health Coverage
​​This slide video from the National Association of Benefits and Insurance Professionals​ offers instructions for Medicaid enrollees on finding affordable health care coverage during the redetermination process.
​2022
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  • Home
  • Resources
    • Partner Resources
    • Fraud Prevention
    • Unwinding Guidance
    • Engagement Strategy
    • TCPA
    • ACA Coverage
    • Employer Coverage
  • Newsroom
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  • CCC Briefing