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SCHIP lets states subsidize employer premiums for low-income children and, in some cases, their parents. Many states viewed the federal requirements for premium assistance programs to be administratively complex. Consequently, few states have implemented premium assistance programs under SCHIP. This study of Massachusetts, Mississippi, and Wisconsin examines the development and implementation of premium assistance programs under SCHIP. Findings suggest several limitations and challenges: States are faced with the new challenge of augmenting broader outreach campaigns with specific efforts to target employers and working families; the enrollment process is complex and time-consuming, particularly investigating employer benefit packages and comparing it to the SCHIP benchmark; and enrollment in these programs is relatively small, in part due to federal SCHIP eligibility criteria.