CONNECTICUT CARPENTERS HEALTH FUND

IMPORTANT NOTICE – May 2011

Medicaid and the Children’s Health Insurance Program (CHIP)

Offer Free or Low-Cost Health Coverage to Children and Families

This Notice is being sent to you because you are eligible for coverage under the Connecticut Carpenters Health Fund (Health Fund or Fund) and live in one of these States:

Alabama	Idaho	Minnesota	New York	Texas
Alaska	Indiana	Missouri	North Carolina	Utah
Arizona	Iowa	Montana	North Dakota	Vermont
Arkansas	Kansas	Nebraska	Oklahoma	Virginia
California	Kentucky	Nevada	Oregon	Washington
Colorado	Louisiana	New Hampshire	Pennsylvania	West Virginia
Florida	Maine	New Jersey	Rhode Island	Wisconsin
Georgia	Massachusetts	New Mexico	South Carolina	Wyoming

If you are eligible for coverage but are unable to afford it (for example, you cannot afford any applicable "buy-in" cost or the cost for retirees coverage), some States have assistance programs that can help pay for Fund coverage.  These States use monies from their Medicaid or CHIP programs to help people who are eligible for Fund coverage, but need assistance in paying for it.  Please note that Connecticut is not one of the States that currently offers this assistance, but we recognize that some individuals eligible for Fund coverage live in States other than Connecticut.

If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed above, you can contact your State Medicaid or CHIP office (see the listing attached, with instructions about getting an updated list) to find out if assistance is available. 

If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or visit www.insurekidsnow.gov to find out how to apply.  If you qualify, you can ask the State if it has a program that might help you pay the costs associated with coverage under an employer-sponsored health plan, like our Fund. 

Once we confirm that you or your dependents are eligible for assistance under Medicaid or CHIP, the Fund is required to permit you and your dependents to enroll in the Fund – as long as you and your dependents are eligible, but not already enrolled.  This is called a “special enrollment” opportunity, and you must make a written request for Health Fund coverage within 60 days of being determined eligible for this assistance.  If you or your dependents lose coverage under a Medicaid or CHIP plan and you and your dependents are otherwise eligible for Fund coverage, you also have a special enrollment opportunity if you make a written request to enroll in the Fund within 60 days of losing that coverage.  Under both special enrollment opportunities, all applicable Health Fund rules must be met and any amounts due must be paid on a timely basis.

Please call the Fund Office (203) 281-5511 or 1-800-922-6026 extension 641 if you have questions about this Notice.

If you live in one of the following States, you may be eligible for assistance in securing Fund coverage if you cannot otherwise afford it.  The following list of States is current as of January 31, 2011. You should contact your State for further information on eligibility –

ALABAMA – Medicaid	CALIFORNIA – Medicaid
Website: http://www.medicaid.alabama.gov Phone: 1-800-362-1504	Website: http://www.dhcs.ca.gov/services/Pages/ TPLRD_CAU_cont.aspx Phone: 1-866-298-8443
ALASKA – Medicaid	COLORADO – Medicaid and CHIP
Website: http://health.hss.state.ak.us/dpa/programs/medicaid/ Phone (Outside of Anchorage): 1-888-318-8890 Phone (Anchorage): 907-269-6529	Medicaid Website: http://www.colorado.gov/ Medicaid Phone (In state): 1-800-866-3513 Medicaid Phone (Out of state):  1-800-221-3943 CHIP Website: http:// www.CHPplus.org CHIP Phone: 303-866-3243
ARIZONA – CHIP
Website: http://www.azahcccs.gov/applicants/default.aspx Phone (Outside of Maricopa County):  1-877-764-5437 Phone (Maricopa County): 602-417-5437
ARKANSAS – CHIP	FLORIDA – Medicaid
Website: http://www.arkidsfirst.com/ Phone: 1-888-474-8275	Website: http://www.fdhc.state.fl.us/Medicaid/index.shtml Phone: 1-877-357-3268
GEORGIA – Medicaid	MONTANA – Medicaid
Website: http://dch.georgia.gov/     Click on Programs, then Medicaid Phone: 1-800-869-1150	Website: http://medicaidprovider.hhs.mt.gov/clientpages/ clientindex.shtml Telephone: 1-877-357-3268
IDAHO – Medicaid and CHIP	NEBRASKA – Medicaid
Medicaid Website: www.accesstohealthinsurance.idaho.gov Medicaid Phone:  1-800-926-2588 CHIP Website: www.medicaid.idaho.gov CHIP Phone: 1-800-926-2588	Website: http://www.dhhs.ne.gov/med/medindex.htm Phone: 1-877-255-3092
INDIANA – Medicaid	NEVADA – Medicaid and CHIP
Website: http://www.in.gov/fssa Phone: 1-877-889-9948	Medicaid Website:  http://dwss.nv.gov/ Medicaid Phone:  1-800-992-0900 CHIP Website: http://www.nevadacheckup.nv.org/ CHIP Phone: 1-877-543-7669
IOWA – Medicaid
Website: www.dhs.state.ia.us/hipp/ Phone: 1-888-346-9562
KANSAS – Medicaid	NEW HAMPSHIRE – Medicaid
Website: https://www.khpa.ks.gov Phone:  1-800-792-4884	Website:  www.dhhs.nh.gov/ombp/index.htm Phone:  603-271-4238
KENTUCKY – Medicaid	NEW JERSEY – Medicaid and CHIP
Website: http://chfs.ky.gov/dms/default.htm Phone: 1-800-635-2570	Medicaid Website: http://www.state.nj.us/humanservices/ dmahs/clients/medicaid/ Medicaid Phone: 1-800-356-1561 CHIP Website: http://www.njfamilycare.org/index.html CHIP Phone: 1-800-701-0710
LOUISIANA – Medicaid
Website:  http://www.dhh.louisiana.gov/offices/?ID=92 Phone: 1-888-342-0555
MAINE – Medicaid	NEW MEXICO – Medicaid and CHIP
Website: http://www.maine.gov/dhhs/OIAS/public-assistance/index.html Phone: 1-800-321-5557	Medicaid Website: http://www.hsd.state.nm.us/mad/index.html Medicaid Phone: 1-888-997-2583 CHIP Website: http://www.hsd.state.nm.us/mad/index.html       Click on Insure New Mexico CHIP Phone: 1-888-997-2583
MASSACHUSETTS – Medicaid and CHIP
Medicaid & CHIP Website: http://www.mass.gov/MassHealth Medicaid & CHIP Phone: 1-800-462-1120
MINNESOTA – Medicaid	NEW YORK – Medicaid
Website: http://www.dhs.state.mn.us/     Click on Health Care, then Medical Assistance Phone (Outside of Twin City area):  800-657-3739 Phone (Twin City area):  651-431-2670	Website: http://www.nyhealth.gov/health_care/ medicaid/ Phone: 1-800-541-2831
MISSOURI – Medicaid	NORTH CAROLINA – Medicaid
Website: http://www.dss.mo.gov/mhd/participants/pages/hipp.htm Phone: 573-751-2005	Website:  http://www.nc.gov Phone:  919-855-4100
NORTH DAKOTA – Medicaid	UTAH – Medicaid
Website: http://www.nd.gov/dhs/services/medicalserv/medicaid/ Phone: 1-800-755-2604	Website: http://health.utah.gov/upp Phone: 1-866-435-7414
OKLAHOMA – Medicaid	VERMONT– Medicaid
Website: http://www.insureoklahoma.org Phone: 1-888-365-3742	Website: http://www.greenmountaincare.org/ Telephone: 1-800-250-8427
OREGON – Medicaid and CHIP	VIRGINIA – Medicaid and CHIP
Medicaid & CHIP Website: http://www.oregonhealthykids.gov Medicaid  & CHIP Phone: 1-877-314-5678	Medicaid Website:  http://www.dmas.virginia.gov/rcp-HIPP.htm Medicaid Phone:  1-800-432-5924 CHIP Website: http://www.famis.org/ CHIP Phone: 1-866-873-2647
PENNSYLVANIA – Medicaid	WASHINGTON – Medicaid
Website: http://www.dpw.state.pa.us/partnersproviders/medicalassistance/doingbusiness/003670053.htm Phone: 1-800-644-7730	Website:  http://hrsa.dsha.wa.gov/premiumpymt/Apply.shtm Phone:  1-800-562-3022  ext. 15473
RHODE ISLAND – Medicaid	WEST VIRGINIA – Medicaid
Website: www.dhs.ri.gov Phone: 401-462-5300	Website:  http://www.wvrecovery.com/hipp.htm Phone:  304-342-1604
SOUTH CAROLINA – Medicaid	WISCONSIN – Medicaid
Website: http://www.scdhhs.gov Phone: 1-888-549-0820	Website: http://www.badgercareplus.org/pubs /p-10095.htm Phone: 1-800-362-3002
TEXAS – Medicaid	WYOMING – Medicaid
Website: https://www.gethipptexas.com/ Phone: 1-800-440-0493	Website: http://www.health.wyo.gov/healthcarefin/index.html Telephone: 307-777-7531

To see if any more States have added a premium assistance program since January 31, 2011, or for more information on special enrollment rights, you can contact either:

U.S. Department of Labor                                    U.S. Department of Health and Human Services

Employee Benefits Security Administration        Centers for Medicare & Medicaid Services

www.dol.gov/ebsa www.cms.hhs.gov

1-866-444-EBSA (3272)                                      1-877-267-2323, Ext. 61565