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Kaiser Child Health Plan to be Revamped

The Kaiser Permanente Child Health Plan will be significantly altered in 2014 to comply with ACA provisions. The plan, which currently offers low-cost coverage to children who do not have access to other insurance, will shift to a separate plan and subsidy structure. Low-income children who enroll in a platinum-level plan outside of the Exchange can receive a subsidy from Kaiser that reduces their premiums and eliminates copays.

The Kaiser Child Health Plan presently serves as a program exclusively for children under 300% FPL who do not qualify for Medi-Cal and do not have access to insurance through their parents’ employers. The plan must be updated to comply with ACA rules including limiting applications to the standardized open enrollment period and accepting all applicants.

On March 1, the Child Health Plan will become the Child Health Program, which will provide subsidies to low-income children who enroll in the Kaiser Permanente Individuals and Families Platinum Plan sold outside of Covered California. The health plan and the subsidy program will be separately administered.

Although the qualification criteria for the subsidy has not yet been specified, we assume that only those ineligible for Medi-Cal and possibly Covered California can receive the subsidy. This opportunity is particularly important to children who cannot enroll in Medi-Cal or Covered California or receive premium subsidies from the federal government due to residency status.

The table below describes the differences between the two programs.


Additionally, the following updates will take place:

  • Applications for the old program, Child Health Plan, will only be accepted until January 15, 2014. Members who are actively enrolled by February 28 will be transitioned to the new Child Health Program as of March 1.
  • The suspension of applications for the old program has been lifted in Southern California. Enrollment is now open.
  • Children can apply to the new Child Health Program between January 16 and March 31. Those with qualifying life events can apply after this period.
  • Children in the new program will have dental coverage.

Organizations interested in enrolling children should contact Katherine D. Clark, Kaiser Permanente Charitable Health Coverage Operations, at Katherine.D.Clark@kp.org.

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