Legal Alerts

2011 Open Enrollment Notices for ERISA Group Health Plans

08.22.11
Notice Type GHP Benefits Required To Comply When Notice Must Be Provided (Distribution during Open Enrollment Generally Satisfies these Deadlines)  To Whom Must Notice
Be Provided?  
Notice of Material Change in Plan Provisions Medical,  Rx, HRA, Dental, Vision, EAP, Health FSA (After DOL issues four-page Summary of Benefits regulations): At least 60 days before effective date of any material change

Participants (employees, retirees, COBRA QBs and QMCSO alternate recipients)

Note:  For calendar year plans, notice of change for next plan year will satisfy 60-day requirement only if given by November 2.

General HIPAA Pre-Ex Condition Notice, including no pre-ex for children under 19 Medical, Rx, HRA With enrollment application materials

Participants (employees, COBRA QBs and QMCSO alternate recipients)

Note:  Retiree-only plans are exempt. 

HIPAA Special Enrollment Notice, including CHIPRA HIPAA special enrollment right Medical, Rx, HRA At initial enrollment

At initial enrollment “Employees eligible to enroll” (Employees, COBRA QBs and QMCSO alternative recipients)

Note:  Retiree-only plans are exempt.  

CHIPRA Notice of State Premium Subsidies Medical, Rx, HRA Annually

Employees who reside in a state that provides premium subsidies (at least 40 states do)

Note:  DOL issued an updated notice effective January 1, 2011 (updated state contact information).

Notice of Availability of HIPAA Notice of Privacy Practices Medical, Rx, Dental, Vision, EAP, Health FSA At least once every 3 years Participants (employees, retirees, COBRA QBs and QMCSO alternate recipients)
Women's Health and Cancer Rights Act (WHCRA) Notice Medical Upon enrollment in the plan and annually Participants (employees, retirees, COBRA QBs and QMCSO alternate recipients)
Medicare Part D Notice of Creditable Coverage to Participants Rx Annually by October 15

Participants (employees, retirees, COBRA QBs and QMCSO alternate recipients)

Note:  Health care reform law changed the open enrollment period for Medicare Part D (now Oct. 15 to Dec. 7), which changed the notice deadline.  HHS issued an updated model notice effective April 1, 2011.

 

Contact
LaFromboise, Antoine J.
Communications and Brand Manager
T 612.371.3269

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