With the approach of Open Enrollment for calendar year health plans, employers may want to review their employee communications to make sure all required notices are being provided to employees.
Each employer’s specific notice distribution obligations differs based on factors such as size, types of plans offered and funding. Some required notices may include:
- HIPAA Notice of Privacy Practices- Provide at initial enrollment in the health plan and every three years. Many employers will include with open enrollment materials.
- Health Care Exchange Notice- Distribute upon hire. Many employers will include with open enrollment materials.
- SBC, Summary of Benefits and Coverage- Distribute with open enrollment materials. Also provide at initial enrollment and upon request. Provides a standard summary of plan benefits.
- Women’s Health and Cancer Rights Act Notice- Provide annually and at initial enrollment. Many employers include with open enrollment materials. Describes the requirement for a health plan providing mastectomy benefits to provide coverage for breast reconstruction.
- CHIP Notice- Provide annually and upon initial eligibility. Many employers to include with open enrollment materials. Describes the rights to premium assistance.
- Medicare Part D Notice of Creditable Coverage- Send by October 15 each year.
- Special Enrollment Rights Notice- Distribute upon initial enrollment and at annual enrollment. Describes the rights of certain people to enroll in group health coverage upon certain events.
- Summary Annual Report (SAR)- Due 9 months after the end of the plan year.
- Wellness Program Notices (HIPAA and ADA)- May be required if health plan includes wellness initiatives.
- Summary Plan Description. Distribute within 90 days of enrollment. Informs participants of benefits rights and obligations under the plan and describes how the plan operates.
- General COBRA Notice. Distribute no more than 90 days after coverage begins. Describes the right to COBRA after a qualifying event.
- Notice of Creditable Coverage. Distribute by October 15 each year. Describes whether prescription drug coverage is creditable for Medicare Part D purposes.
- Notice of Grandfathered Plan Status. Include in communications such as the SPD. Identifies a “grandfathered” health plan.
Employers should get their benefit house in order and confirm that required notices are being distributed to employees.
