Group Health Plan Timeline of Notices

Whenever an employer offers a group health plan, it’s vitally important to provide all the notices required under DOL, PPACA, ERISA, COBRA, and HIPAA. Failing to provide these notices can result in costly fines and penalties. And not only for your business, but you can also be held personally liable for damages resulting in failure to comply with disclosure requirements.

So when it comes to employee benefits communication how confident are you that you are providing all the required notices to your employees (and their dependents) in the time and manner that the law requires.

Smart employers can reduce the administrative burden and cost by distributing these notices with the annual enrollment materials the distribute for their health plan annual open enrollment. While you are not required to distribute these federal notices early, you should consider including some of them in your enrollment material anyway. Doing so can help you show a good faith effort to educate the plan participants of their rights.

These are just a selection of the annual notices that must be provided to an employee based on your company’s size and type of coverage:

• Summary Plan Description (SPD);
• Summary of Benefits and Coverage (SBC) and Uniform Glossary;
• Summary of Material Modifications (SMM) and Notice of Modification; CHIPRA Notice;
• HIPAA Special Enrollment Rights Notice;
• HIPAA Privacy Notice; Availability of Health Insurance Marketplaces Notice;
• COBRA Notice;
• Medicare Part D Creditable (or Non-Creditable) Coverage Notice;
• Grandfathered Plan Status Notice;
• Internal Claims and Appeals and External Reviews Notice.
• Women’s Health & Cancer Rights Act of 1998 Notice

How can a business owner possibly hope to navigate all these required notices and the laws that govern how you can send them to employees? The first step is to look at when these notices should be given to employees and which notices can be combined or are already included in other notices. For example, the summary plan description can include several of these notices by itself, so you can meet several requirements at once by providing an annual SPD at each open enrollment.

It is also helpful to maintain a calendar of when certain notices need to be sent out, and which actions require a notice be sent to an employee, That way your HR staff can always reference the calendar or guide throughout the year and as employees are hired and terminated. In addition, using an online enrollment and onboarding system allows you to ensure that all employees see the required notices and gives you a record of which employees have viewed the required notices in case you ever get audited or an employee attempts to sue you. If you don’t use an online system, then you should make a note whenever you send out or hand employees notices and keep a copy in your files.

Here is a helpful Timeline of Benefit Notices that provides a comprehensive list of the notices that you, as an employer, are required to distribute to employees. This timeline includes information on what the notice consists of and the date(s) by which the notice must be distributed. In each section, if there is a model notice available online, there is a link to the model notice, for your review, completion (if necessary), and distribution to employees.

Some of these required notices may be included in the Certificate of Coverage that your covered employees receive from the insurance company (we’ve highlighted those), but as employer regulations require that you ensure these notices, as well as the applicable others listed,  are distributed per the required schedule.

If you need assistance with meeting your compliance needs or feel free to contact us at Hershenberg & Stone-Walsh Insurance services. We can help you get set up with an online enrollment and onboarding system at potentially no cost to you or your company.