Open enrollment season is upon us. Employers are required to provide employees with certain benefit notices during this time of year. It is important to know which notices your group is required to provide.

For example, the summary of benefits and coverage (SBC) must be provided at open enrollment time. Other notices must be distributed annually, such as the Women’s Health and Cancer Rights Act (WHCRA) notice and the Children’s Health Insurance Program (CHIP) notice. Insurance Trust includes these notices in employee packets to help our clients satisfy this requirement.

However, there are some notices that will vary by group. For example, Employers with Medicare Part D eligible individuals must notify them about whether the drug coverage is creditable or non-creditable before October 15 each year. Employers may not easily be able to identify those who are eligible for Medicare Part D, so many employers choose to satisfy this requirement by providing the notice to all plan participants.

Groups that are subject to ERISA must provide new health participants with a Summary Plan Description (SPD) for each benefit offered within 90 days of when coverage begins. In lieu of a SPD, a “wrap” document can satisfy this SPD requirement in one document for all plans offered. The(se) documents needs to be maintained annually and if any material modifications have been made, updated notices must be provided to participants at least every 5 years. (If no material modifications have been made, every 10 years.)

Groups’ health plans that are subject to COBRA must provide a written General Notice of COBRA rights to covered employees within 90 days after their health plan coverage begins. This is often added to open enrollment materials as it will satisfy the requirement for new enrollees added at open enrollment. It is advisable to include this in any new hire packets as well.

The Notice of Patient Protections is required when plan participants are required to designate an in-network primary care provider. This is often included in the insurance certificate provided by the issuer or Summary Plan Description.

Insurance Trust works closely with clients to assist in complying with State and Federal laws. If you have questions about your responsibilities as an employer or would like assistance, feel free to contact us. Thank you and here’s to a successful season!

Contact Form