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ALERTS, NEWS & EVENTS

2011 OPEN ENROLLMENT NOTICES FOR ERISA GROUP HEALTH PLANS1

 

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 enrollmenta“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.

 

 


1This chart provides general information and should not be relied on for legal advice. It does not address all aspects of open enrollment notices, such as content requirements or electronic distribution. You should consult with your legal counsel for assistance with open enrollment notices.

 

Contact Us

 

If you have questions about the content of this alert, please contact a member of Oppenheimer’s Employee Benefits Group.