Employers that sponsor group health plans should provide certain benefit notices in connection with their plans’ open enrollment periods. Some of these notices must be provided at open enrollment time, such as the summary of benefits and coverage (SBC).
Other notices, such as the Women’s Health and Cancer Rights Act (WHCRA) notice, must be distributed annually. Although these annual notices may be provided at different times throughout the year, employers often choose to include them in their open enrollment materials for administrative convenience.
In addition, employers should review their open enrollment materials to confirm that they accurately reflect the terms and cost of coverage. In general, any plan design changes for 2021 should be communicated to plan participants either through an updated summary plan description (SPD) or a summary of material modifications (SMM).
This Compliance Overview includes a chart that summarizes the benefit notices employers should provide at open enrollment time.
Links and Resources
- Department of Labor’s (DOL) website on compliance assistance for health plans, which includes links to many model notices
- Center for Medicare and Medicaid Services’ (CMS) website on Medicare Part D disclosures
Open Enrollment Notices
- Employers should provide certain benefit notices to their employees at open enrollment time.
- Some benefit notices apply to all group health plans.
- Other benefit notices only apply to certain group health plans, based on plan design and coverage.
Specific Notices
- Medicare Part D Notice
- SBC
- HIPAA Privacy Notice
- WHCRA Notice
- CHIP Notice
- SPD (and SMM, if applicable)
- Notice of Patient Protections
- Wellness Program Notices
- Individual Coverage HRA (ICHRA) Notice
Download Open Enrollment 2021 Benefit Notices
This Compliance Overview is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice. Readers should contact legal counsel for legal advice. ©2020 Zywave, Inc. All rights reserved.