Short answer: No. In Texas a child cannot be covered by CHIP and other health insurance at the same time, and a child with affordable employer coverage is not eligible for CHIP at all.
HHSC applies an affordability test when a child already has health insurance:
- If the premium for the child’s coverage is less than 5% of the household’s net income (or family coverage including the child is less than 9.5%), the child is not eligible for CHIP.
- If it is 5% or more (or 9.5% or more for family coverage), the child can qualify, but the family must drop the insurance before CHIP starts.
A child who stays on the private plan can be removed from CHIP. Separate dental or vision plans do not count as other health insurance for this test.
Before an employee drops the children from a group plan, confirm the CHIP start date with HHSC and check whether the cafeteria plan allows a midyear change, so the children are not left uninsured. Medicaid works differently: a child can have Medicaid and an employer plan together.