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).

Legal Update HeaderOn Oct. 29, 2020, the Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury (Departments) issued a final rule regarding transparency in coverage that imposes new transparency requirements on group health plans and health insurers in the individual and group markets. These provisions only apply to non-grandfathered coverage, including both insured and self-insured group health plan sponsors.

This final rule was issued in response to an executive order issued on June 24, 2019, aimed at improving price and quality transparency in health care.

The Affordable Care Act (ACA) has made a number of significant changes to group health plans since the law was enacted in 2010. Since that time, a number of changes have been made to various ACA requirements that employers and plan sponsors should be aware of. It is important for employers to periodically review their benefit plans in order to maintain compliance with these various requirements.

Changes to some ACA requirements take effect in 2021 for employers sponsoring group health plans, such as increased dollar limits. To prepare for 2021, employers should review these upcoming requirements and develop a compliance strategy. This ACA Overview provides an ACA compliance checklist for 2021. Please contact Reseco Group for assistance or if you have questions about changes that were required in previous years.

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The COVID-19 Pandemic Has Upturned Everything This Year. So, It’s Understandable If You Are A Little Less Prepared For Open Enrollment At This Point. However, There’s Still Time To Address Open Enrollment With Employees In Meaningful Ways. Doing So Will Help Them Get The Most From Their Benefits, Which Are Especially Valuable In These Uncertain Times.

This article outlines a few last-minute strategies for maximizing open enrollment for your employees.