123STA T .59PUBLIC LA W 111 – 3 —FE B. 4, 2 0 09 describ edi npa ra g rap h(1) ( C ) of s u bsec t ion (a) for pur - poses of m a k ing pa y ments under that subsection .‘ ‘( D ) AP P LICAT I ON O FSE CON D A RY PAYOR R U LES. —T he S tate sha l l be a secondary payor for any items or ser v ices provided under the q ualified employer-sponsored coverage for w hich the State provides child health assistance under the State child health plan. ‘‘( E ) R E Q UIRE M ENT TO PRO V IDE SUPPLEMENTAL COV- ERA G E FOR B ENEFITS AND COST-S H ARING PROTECTION PRO- VIDED UNDER THE STATE CHILD HEALTH PLAN.— ‘‘(i) I N GENERAL.— N otwithstanding section 2 11 0 (b)(1)(C) , the State shall provide for each targeted low-income child enrolled in qualified employer-spon- sored coverage, supplemental coverage consisting of— ‘‘(I) items or services that are not covered, or are only partially covered, under the qualified employer-sponsored coverage
and ‘‘(II) cost-sharing protection consistent with section 210 3 (e). ‘‘(ii) RECORD K EEPING REQUIREMENTS.— F or pur- poses of carrying out clause (i), a State may elect to directly pay out-of-pocket e x penditures for cost- sharing imposed under the qualified employer-spon- sored coverage and collect or not collect all or any portion of such expenditures from the parent of the child. ‘‘(F) APPLICATION OF W AITING PERIOD IMPOSED UNDER THE STATE.—Any waiting period imposed under the State child health plan prior to the provision of child health assistance to a targeted low-income child under the State plan shall apply to the same extent to the provision of a premium assistance subsidy for the child under this paragraph. ‘‘( G ) O PT-OUT PERMITTED FOR ANY MONTH.—A State shall establish a process for permitting the parent of a targeted low-income child receiving a premium assistance subsidy to disenroll the child from the qualified employer- sponsored coverage and enroll the child in, and receive child health assistance under, the State child health plan, effective on the first day of any month for which the child is eligible for such assistance and in a manner that ensures continuity of coverage for the child. ‘‘( H ) APPLICATION TO PARENTS.—If a State provides child health assistance or health benefits coverage to par- ents of a targeted low-income child in accordance with section 2111(b), the State may elect to offer a premium assistance subsidy to a parent of a targeted low-income child who is eligible for such a subsidy under this para- graph in the same manner as the State offers such a subsidy for the enrollment of the child in qualified employer-sponsored coverage, except that— ‘‘(i) the amount of the premium assistance subsidy shall be increased to take into account the cost of the enrollment of the parent in the qualified employer- sponsored coverage or, at the option of the State if the State determines it cost-effective, the cost of the enrollment of the child ’ s family in such coverage; and Procedu re s.
