Are You Providing The Required Health Insurance Notices To Your Employees?

When I meet potential clients, I ask if they provide the 12 required government health insurance notices or documents and I receive a blank stare or the owners say yes. When I review each notice with them, they are missing at least 80% of them. Business- es that do not provide the notices are risking major fines from governmental agencies that could reach $1.5 million from the Office of Civil Rights for HIPAA privacy violations. The Depart- ment of Labor’s (DOL) fines start at $5,000 and can reach over $250,000.

The following is a list of notices that must be provided to all benefits eligible employees who enroll on your health plans. In addition, notices 1 & 3 have to go to all employees that are not benefits eligible.

1. Health Insurance Exchange Notice

• With the passage of the Affordable Care Act 10 years ago, this is an annual required notice.

2. Notice of Special Enrollment Rights

• Employees that enroll on your health plans must receive this notice each year that states that employees cannot change plans until open enrollment unless they is an IRS qualifying event.

3. Notice of Privacy Practices

• Since employees provide confidential non-public private information (NPPI) and protected health, information (PHI) employers must outline their privacy practices with this notice annually.

4. Mental Health Parity and Addiction Equity Act (MHPAEA) Dis- closure (for companies with 50 or more employees)

• Since 2008, the MHPAEA must be given to employees that states mental health benefits cannot be more restrictive than all medical/surgical benefits.

5. Employer’s Children’s Health Insurance Program (CHIP) Notice

• The CHIP notice states that children may be eligible for Medicaid/Medi-Cal with links to websites and phone numbers in participating states

6. Newborns’ and Mothers’ Health Protection Act Notice

• Group health plans may not restrict benefits for childbirth or newborn childcare and this notice outlines timelines for hospitals for normal and C-section deliveries.

7. Medicare Part D Creditable Coverage Notice

• This notice that must be provided before October 15 each year states whether the drug coverage the employee has is equal to or better than Medicare Part D coverage.
• Employers also have to log into the CMS website and report the information.

8. Genetic Information Nondiscrimination Act (GINA) Disclosures (for companies with 15 or more employees)?

• This act protects employees against discrimination based on genetic information and employers may not request or require any genetic information from employees or family members.

9. General Notice of COBRA Rights (for companies with 20 or more employees)

• The COBRA Rights notice outlines continuation health coverage if the employee leaves an employer.
• If an employer uses a third party to administer COBRA those services may not include this notice that is required when an employee enrolls in a company’s health plan.

10. USERRA Notice

• USERRA protects the job rights of employees who leave for military service and governs employer provided health insurance

11. FMLA Notice (for companies with 50 or more employees)

• Provides employees with their family & medical leave rights

12. Summary Plan Description (SPD)

• If the DOL conducts a benefits audit, the first thing they ask for is your SPD.
• My experience is that 80% of companies do not provide SPDs to their employees.
• The SPD is not provided by insurance carriers and is the employer’s responsibility.

If you are not providing these notices you are with the wrong health insurance agent or broker.