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By: Marissa Dalmata

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November 5th, 2019

Mandatory Health Enrollment Notices Employers Often Miss

Healthcare Compliance

There's never a shortage of compliance concerns when offering group benefits. While Summary Plan Descriptions and Plan Documents from insurance carriers cover much of the required notices to plan participants, there are a few outlying communications that fall on the shoulders of employers.

To keep in compliance, here are a few notices that should be a part of an employer’s onboarding or annual enrollment processes.

Initial COBRA Notice

The Consolidated Omnibus Budget Reconciliation Act (COBRA) applies to employers that sponsor group health plans with 20 or more employees.

This notice (click here for a model notice) must be provided to new participants within 90 days after plan coverage begins. The notice is often incorporated into a plans Summary Plan Description (SPD), and only must be presented once to the participant. Verify that your SPD has this notice, or contact your broker to confirm.

Annual CHIPRA Notice

For employers offering group health plans in states extending subsidies through Children’s Health Insurance Program (CHIP), they must furnish a notice (click here for 2019 model notice) communicating the available assistance to their employees.

The program assists low income families in paying for employer-sponsored health coverage.

This information must be provided when the employee first becomes eligible for the employer’s health plan, and each year during open enrollment.

Annual WHCRA Notice

The Women’s Health and Cancer Rights Act of 1998 requires employers to provide annual notices to participants regarding their plan’s coverage of certain mastectomy related services.

The DOL provides the following sample notice to meet this requirement:

Do you know that your plan, as required by the Women’s Health and Cancer Rights Act of 1998, provides benefits for mastectomy-related services including all stages of reconstruction and surgery to achieve symmetry between the breasts, prostheses, and complications resulting from a mastectomy, including lymphedema? Call your plan administrator at [insert phone number] for more information.

To download this, as well as a list of other model DOL notices, click here.

For more updates on keeping your health plan compliant, be sure to subscribe to our blog, or contact Benetech today to learn more about our services.

About Marissa Dalmata

Marissa is one of Benetech's long-standing client-service reps, with a passion for wellness and elite knowledge of benefits administration.

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