                                 CODE OF VIRGINIA

ASSISTANCE WITH EMPLOYER-SPONSORED HEALTH INSURANCE (§ 32.1-351.1)

A. For purposes of this chapter, &#8220;employer-sponsored health
insurance&#8221; or &#8220;ESHI&#8221; means comprehensive health insurance
offered by the employer when the employer contributes to the cost of dependent
or family coverage as defined in the Virginia Plan for Title XXI of the Social
Security Act, or as otherwise approved by the Centers for Medicare &amp;
Medicaid Services in the U.S. Department of Health and Human Services.

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

C. If a family chooses to participate in ESHI and ESHI is deemed cost-effective,
the Department of Medical Assistance Services shall contribute to the cost of
ESHI for eligible dependent children for those program participants that have
access to ESHI. Participants receiving ESHI under the Family Access to Medical
Insurance Security Plan shall apply for the full premium contribution available
from the employer. Those eligible for Family Access to Medical Insurance
Security Plan with access to ESHI may enroll in their designated ESHI at the
first available opportunity and shall be covered under the Family Access to
Medical Insurance Security Plan until coverage under ESHI becomes available.

HISTORY: 2000, cc. 824, 848; 2003, c. 513; 2009, c. 578.