Each year, employers and health plans are required to send certain notices to employees. Calendar-year health plans that are preparing for open enrollment may find it a good time to review the annual notice requirements. Some notices must be stand-alone notices and others can be distributed as part of other plan materials. Use the following checklist as a guide during open enrollment.
Required Notices:
- CHIPRA Notice. Employees who maintain group health plans are required to notify all employees of their potential right to receive medical assistance under a state's Medicaid or Childrens Health Insurance Plan (CHIP) program in states that provide premium assistance.
- HIPAA Notice of Privacy Practices. Notice must be provided at the time of enrollment in the group health plan. A reminder about the availability of the notice must be provided every 3 years.
- Medicare Part D Notice of Creditable Coverage. Group health plans that offer prescription drug coverage to individuals who are eligible for Medicare Part D must provide notice as to the creditability of the prescription coverage. This notice should have been distributed by October 15.
- WHCRA Notice. Group health plans that provide coverage for mastectomy benefits must provide annual notice of the coverage.
- NMHPA Notice. Group health plans that provide coverage for childbirth and hospital stays must provide notice of coverage upon initial enrollment. There is technically not an annual notice requirement, but many plans communicate coverage with the WHCRA Notice.
- Grandfathered Plan Notice. Group health plans that wish to maintain their status as a grandfathered plan under health care reform must provide notice each time plan materials are distributed.
- Patient Protection Notice. All non-grandfathered group health plans that require the designation of a primary care provider must provide notice whenever the plan provides a participant with a description of benefits.
- Wellness Program Disclosure. All group health plans that offer a wellness program that requires individuals to meet a standard related to a health factor in order to obtain a reward must provide notice in all materials that describe the wellness program.
- Summary of Benefits and Coverage. All group health plans that are not excepted under HIPAA must provide a summary of benefits in a format prescribed under health care reform.
BAS can assist with notice preparation and distribution. For more information, contact sales@BASusa.com.
