Mandatory Employer Notices

 In Insurance Updates

Disregard the notices that do not apply to your situation.  You should also review each notice you do need to give, modify it as needed to describe your plan, and fill in any blanks or highlighted areas.

  • Important Notice About Your CREDIBLE Prescription Drug Coverage and Medicare – Provide this notice by October 14 to all participants and dependents who are or may become eligible for Medicare Part D in the next 12 months if the prescription drug coverage provided by the plan is “creditable.”  (Providence Insurance Group can tell you if the coverage is creditable.)
  • Important Notice About Your NON-CREDIBLE Prescription Drug Coverage and Medicare – Provide this notice by October 14 to all participants and dependents who are or may become eligible for Medicare Part D in the next 12 months if the prescription drug coverage provided by the plan is not “creditable.”  (Providence Insurance Group can tell you if the coverage is not creditable.)
  • Women’s Health and Cancer Rights Act Notice – Provide this notice at least once a year to all participants
  • Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP) – Provide this notice before the start of the plan year if you have any employees in a state listed in the notice. (These states provide premium assistance for CHIP and/or Medicaid coverage.)  Caution:  This notice is updated regularly. Check at www.dol.gov/ebsa/chipmodelnotice.doc for the most current version if you do not promptly distribute this notice.
  • Wellness Program – Notice of Reasonable Alternatives – Provide this notice only if you have a wellness program that considers health status
  • Notice to Enrollees Regarding Opt-Out – Provide this notice only if the plan is a self-funded nonfederal governmental group health plan that has opted out of some or all of HIPAA; tailor as needed to describe what the plan has opted out of

ADDITIONAL NOTICES FOR NEW ENROLLEES

  • Notice of Special Enrollment Rights – Give this notice to all new enrollees
  • ** Continuation Coverage Rights Under COBRA** – Give this notice to all new enrollees – including new spouses – if you employ 20 or more people
  • New Health Insurance Marketplace Coverage – Provide this notice to all new employees (even if they are part-time/temporary/not eligible for the plan) within 14 days after their hire date if you offer coverage to any employee.  Note that completing questions 13 – 16 is optional.  At this time, providing information on minimum value and affordability is required.  
  • New Health Insurance Marketplace Coverage – Provide this notice to all new employees (even if they are part-time or temporary) within 14 days after their hire date if you do not offer coverage to any employee.

 

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