Last reviewed October 2026

Does the employer’s plan have to give benefit information to Texas Medicaid or CHIP when the state asks?

Short answer: Yes. When a plan participant or beneficiary is covered by Medicaid or CHIP, the plan administrator must give the state, on request, enough information about the plan’s benefits for the state to judge premium assistance.

This is the second half of the CHIPRA notice rules. The state uses the information to decide whether paying the employee’s premium is cost-effective and what extra benefits Medicaid or CHIP must wrap around the plan. Federal law calls for a model coverage coordination disclosure form for these requests.

In Texas the request usually comes from HHSC’s HIPP program. Expect questions about who is eligible, the employee’s premium share for each tier, and plan benefits. Answering promptly protects the family’s assistance; an employer that ignores it can stall the employee’s reimbursement.

Keeping a current rate sheet and benefit summary ready to send makes this easy.

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