Employee Benefit News for School, City and County Employers

2024 Open Enrollment Benefit Notices

Written by Steve Smith | Aug 18, 2023 11:45:00 AM

3.5 minute read

Employers should be providing certain benefit notices to their employees at open enrollment time. This includes the summary of benefits and coverage (SBC). Other notices must be distributed annually, and employers often choose to include them in their open enrollment materials for convenience.

Some benefit notices apply to all group health plans while other notices only apply to certain group health plans, based on plan design and coverage. Employers should review their materials to ensure that they are accurately reflecting the terms and cost of coverage. Any plan design changes for 2024 should be communicated to employees through a summary of material modifications (SMM) or an updated plan description (SPD).

Here's a compliance overview chart that summaries the benefit notices for open enrollment.

Benefit Notice

Applicability

Description

SBC

Group health plans and health insurance issuers

Group health plans and health insurance issuers are required to provide an SBC to applicants and enrollees each year at open enrollment or renewal time.

Medicare Part D notice of creditable or non-creditable coverage

Group health plans that provide prescription drug coverage

Employers must notify Medicare Part-D eligible individuals before October 15th each year about whether the drug coverage is “creditable” or “non-creditable”.

WHCRA notice

Group health plans that provide medical and surgical benefits for mastectomies

Notice must be provided at time of enrollment and on an annual basis after enrollment.

Children’s Health Insurance Program (CHIP) notice

Group health plans that provide a premium assistance subsidy under a Medicaid plan or CHIP

The employer must send an annual notice about the available assistance to all employees residing in that state. The annual CHIP notice can be provided at any time during the year.

SPD

Group health plans subject to ERISA

An SPD must be provided to new health plan participants with 90 days of the date their plan coverage begins. Notice can be included in open enrollment materials. An updated SPD must be provided to participants at least every five years if modifications have been made during that time.

COBRA General Notice

Group health plans subject to COBRA

A written General Notice of COBRA Rights to covered employees must be provided 90 days after their health plan coverage begins.

Grandfathered plan notice

Health plans with grandfathered status under the Affordable Care Act (ACA)

Notice must be provided in plan materials describing the plan’s grandfathered status.

Notice of patient protections

Group health plans that require designation of primary care provider

The plan or issuer must provide this notice whenever the SPD is provided to participants.

HIPAA privacy notice

Self-insured group health plans

Plans must send privacy notices at certain times including to new enrollees at the time of enrollment. At least once every three years, plans must either redistribute the notice or notify employees about its availability.

HIPAA special enrollment notice

All group health plans

Include notice in enrollment materials. Notice lets employee know about their special enrollment rights under HIPAA.

Wellness notice – HIPAA

Group health plans with health-contingent wellness programs

The notice informs employees about an alternative way to qualify for the program’s reward. Notice must be included in all plan materials that describe the terms of the wellness program.

Wellness notice – ADA

Wellness programs that collect health information or include medical exams

This notice complies with the Americans with Disabilities Act (ADA) and explains how the information will be used, collected, and kept confidential. Notice should be included in open enrollment materials.

Individual coverage HRA (ICHRA) notice

Employers that sponsor ICHRAs

Employers may implement an ICHRA to reimburse their eligible employees for insurance policies purchased on the individual market or Medicare premiums. Notice must be provided 90 days before the beginning of each plan year.

 

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