With the open enrollment season fast approaching, it’s imperative that employers who sponsor group health plans ensure they are compliant with all necessary benefit notices associated with their offerings. This not only keeps organizations aligned with the law but also aids employees in making informed decisions regarding their health and well-being. Let’s dive into what is expected for Open Enrollment 2024.
Content Overview Employers have a responsibility to provide specific benefit notices to their employees during open enrollment periods. Notices such as the summary of benefits and coverage (SBC) must be given at this time. While other notices, like the Women’s Health and Cancer Rights Act (WHCRA) notice, should be distributed annually. To simplify the process, many employers opt to include these annual notices with their open enrollment materials.
It’s crucial for employers to ensure their open enrollment materials accurately depict the terms and costs of coverage. Any modifications to the 2024 plan design should be transparently communicated to plan participants.
Here’s a summarized chart for the benefit notices required at open enrollment:
Benefit Notices for Open Enrollment 2024
| Benefit Notice | Applicability | Description |
|---|---|---|
| SBC | Group health plans and health insurance issuers | Required to provide an SBC outlining benefits and coverage details annually.Federal agencies have provided a template for the SBC, which health plans and issuers are required to use. |
| Medicare Part D notice | Employers with group health plans that provide prescription drug coverage | Notify about the prescription drug coverage quality compared to Medicare Part D annually before Oct. 15.
CMS has provided model notices for employers to use. |
| WHCRA notice | Group health plans providing medical and surgical benefits for mastectomies | Inform about WHCRA’s coverage requirements annually.
Model language is available in the DOL’s model notice guide |
| CHIP notice | Group health plans covering residents in states offering a premium assistance subsidy under Medicaid or CHIP | Annual information regarding the premium assistance subsidy.
The DOL has a model notice that employers may use. |
| SPD | Group health plans subject to ERISA | Details provided to new health plan participants within 90 days of coverage start. |
| COBRA General Notice | Group health plans subject to COBRA | Inform new enrollees about their COBRA rights within 90 days of starting coverage.
The DOL has a COBRA Model General Notice that can be used by group health plans to meet their notice obligations. |
| Grandfathered plan notice | Health plans with grandfathered status under ACA | Confirm plan’s grandfathered status.
The DOL has provided a model notice for grandfathered plans. |
| Notice of patient protections | Group health plans requiring a designated primary care provider | Required for plans that mandate a designated primary care provider.
The DOL has provided a model notice of patient protections for plans and issuers to use. |
| HIPAA privacy notice | Self-insured group health plans | Detailing privacy rights for self-insured plans.
The Department of Health and Human Services has model privacy notices for health plans to choose from. |
| HIPAA special enrollment notice | All group health plans | Information about special enrollment rights. |
| Wellness notice – HIPAA | Group health plans with health-contingent wellness programs | Details of wellness programs, including alternatives to qualify for the program’s reward.
Sample language is available in the DOL’s model notice guide |
| Wellness notice – ADA | Wellness programs collecting health information or including medical exams | Compliance with ADA, explaining how health information will be used and kept confidential.
The Equal Employment Opportunity Commission has provided a sample notice for employers to use. |
| ICHRA notice | Employers sponsoring ICHRAs for specific employee classes | Details about ICHRAs and its interaction with the ACA’s premium tax credit.
A model notice is available for employers to use to satisfy this notice requirement. |
Open Enrollment 2024 brings with it a myriad of notices that employers must distribute to their employees. Staying compliant is not just a legal obligation but also a way for employers to foster trust with their workforce, ensuring they have the necessary knowledge to make empowered health decisions. From an organizational perspective, ensuring this information is communicated clearly can prevent future legal and administrative headaches. As we embrace this open enrollment season, it’s crucial for businesses to prioritize thorough, transparent communication for the well-being and security of their employees.
