MIChild, premium payment and what Michigan has said about employer plans
MIChild is Michigan’s children’s health insurance program. This page sets out what Michigan’s CHIP state plan says about employer coverage, what a special-needs children’s program pays toward premiums, and what we could not confirm.
MIChild and Employer Coverage.
Michigan’s CHIP state plan is on file with the federal Centers for Medicare and Medicaid Services. The copy we read, which includes a 2024 amendment on vaccine coverage, states that Michigan received federal approval to implement MIChild effective May 1, 1998. It also says that comprehensive employer-based coverage from other creditable health insurance precludes enrollment in the program, and that coverage through Children’s Special Health Care Services (CSHCS) or the Indian Health Service does not count as other insurance. We read that as an eligibility rule for the child. The excerpt we reviewed was incomplete, so we cannot give you the full definition of creditable coverage.
We did not confirm that MIChild in that form is still the program MDHHS runs today. MDHHS’s own MIChild pages did not load for us, so check the current program with MDHHS before you tell an employee anything.
Premium Assistance for Employer Coverage.
Federal law lets a state subsidize employer coverage for people eligible for Medicaid. Sections 1906 and 1906A of the Social Security Act, 42 U.S.C. 1396e and 1396e-1, set the rules. Section 1906A requires that the employer pay at least 40 percent of the premium and offer the coverage on a nondiscriminatory basis, makes the individual’s election voluntary, and lets an employer decline to receive subsidy payments directly. Our CHIPRA pages cover the parallel CHIP duty, including the employer notice, so we do not restate it here.
Whether Michigan uses these options is the open question. The state plan excerpt we read described no premium assistance program, and the Michigan Medicaid pages we reached did not describe one. Other states run programs under the name Health Insurance Premium Payment, or HIPP. We found no primary-source description of a Michigan program by that name and do not say one exists.
The CSHCS Insurance Premium Payment Benefit.
MDHHS Bulletin MSA 15-29, issued July 31, 2015 and effective September 1, 2015, added an Insurance Premium Payment Benefit to the CSHCS chapter of the Medicaid Provider Manual. CSHCS may pay a beneficiary’s share of a premium for private insurance, Medicare Part B or Medicare Part D when the premium is cost-effective for CSHCS and the family lacks sufficient resources to pay it. The bulletin is not an employer program, but it touches employers in two ways: an employer statement may be submitted as proof of the premium cost, and a COBRA election form is required when coverage was lost within three months before applying.
A bulletin from 2015 may have been superseded, and we did not confirm that it is current.
What To Do Now.
Decide in advance who in HR signs a premium statement, and make it a routine task. A family waiting on a signature can lose time.
State the employee’s share of the premium, not the total, and the plan and tier the child is in. Use the form the family brings.
Keep your CHIP premium assistance notice process with your open enrollment materials, as our CHIPRA pages describe.
Common Misreadings.
Telling a family that a child does or does not qualify for MIChild. Eligibility is MDHHS’s decision.
Assuming Michigan has a premium assistance program, or assuming it has none. We could not confirm either way.
Mixing up programs. CSHCS is not MIChild, and the state plan says CSHCS coverage does not count as other insurance for MIChild.
Related Rules And Tools.
CHIPRA Premium Assistance and CHIP Special Enrollment
The federal 60-day window and the employer notice.
HIPAA Special Enrollment and the Newborns Act
Special enrollment events and the notices that go with them.
Participant Contribution Timing for Group Health Plans
When employee contributions must reach the plan.
Laws And Sources
Michigan CHIP State Plan Amendment MI-24-0025: The state plan text on file with CMS, including MIChild and other coverage.
MDHHS Bulletin MSA 15-29: The 2015 CSHCS Insurance Premium Payment Benefit bulletin.
42 U.S.C. 1396e: Section 1906, enrollment in group health plans.
42 U.S.C. 1396e-1: Section 1906A, premium assistance for employer-sponsored coverage.
Quick Answers.
Short replies on this page’s topic, each tied to a fuller guide.
Can a child with our group coverage be on MIChild?
The Michigan CHIP state plan we read says that comprehensive employer-based coverage from other creditable health insurance precludes enrollment in MIChild. We could not read the full definition, so confirm a specific case with MDHHS.
Does Michigan pay employees’ share of our premiums?
We could not confirm that Michigan runs such a program for adults or for MIChild. Federal law lets a state do it, and the state plan excerpt we read described none. MDHHS does have a premium payment benefit in its special health care services program, described in a 2015 bulletin whose current status we did not confirm.
What if an employee asks us to sign a premium statement?
The 2015 bulletin says an employer statement may be submitted as proof of the premium cost for that benefit. State the employee’s share and the plan name accurately, and use the form the family’s MDHHS contact supplies. We could not confirm a current form.
The Rest Of This Series.
Michigan Medicaid and Employer Group Health Coverage
The overview page for this series.
The Healthy Michigan Plan and Your Group Plan
Who the program covers and how employer coverage fits.
Third-Party Liability and Medical Child Support
Plan and employer duties when a state agency or support order reaches your plan.
Work Requirements in 2027
The Healthy Michigan Plan work rule and what it may mean for HR.
An independent employee benefits consulting firm. We look at the entire benefits program — cost, plan performance, risk and administration.
Switch to CFH. Unhappy with your broker? Your employees won’t notice. You will. →
Cookies on This Site
We use cookies to keep the site working properly and to understand how it is used. You can decline anything that is not essential. See our Privacy Policy for the detail.
- Essential — needed for the site to load and for you to move around it. These cannot be switched off.
- Analytics — tell us which pages get read, so we know what is worth writing more of.
- Advertising — set by third parties such as ad and social platforms to measure and target campaigns.