Open-Enrollment:

The Annual Open Enrollment period typically occurs 30 days prior to your health plan’s renewal.  If your plan renews on December 1st, then open enrollment would occur during the month of November.  The following forms should be distributed with other benefits information.  If your company does not hold an Annual Open-Enrollment meeting, the forms should still be distributed to employees.

Summary of Benefits & Coverage (SBC)HIPAA Special Enrollment Rights NoticePremium Only Plan (POP) Automatic Enrollment NoticeChildren’s Health Insurance Program NoticeWomen Health & Cancer Rights

The SBC is typically provided in one of 3 ways depending on the insurance carrier.  1.  Directly from the insurer  2.  From your agent  3.  Available to you through an online link provided by insurer.  It’s important to note that the insurer’s do not always provide the Uniform Glossary, however they are required to accompany the SBC.

This notice describes the health plan’s special enrollment rights and, if applicable, disclosure the plan requires a reason for declining coverage.  Special enrollment rights allow an employee who previously declined coverage to enroll mid-year due to marriage, birth, adoption, or loss of other group health coverage.  Notice should be provided at or before enrollment and annually.

This form is a sample that you can use to notify employees about the automatic enrollment feature of the plan.  We are including this form in Word format so that you can modify accordingly.  This should be distributed annually and to each employee at open enrollment and also to new employees upon initial enrollment into the plan throughout the year.

The Children’s Health Insurance Program Reauthorization Act of 2009 requires employers that maintain a group health plan in states that provided Medicaid or CHIP assistance to notify their employees about potential opportunities for premium assistance subsidies.  Notice must be provided annually.

This notice describes required mastectomy-related benefits requied to be provided under WHCRA.  For group plans that include mastectomy benefits, this notice should be distributed to employees at enrollment into the plan and annual thereafter.  Notice can be on enrollment documents instead of a stand-alone form.

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