Posted: 10.05.2010
Affordable Care Act - Sept. 23rd

With the passage of the Affordable Care Act, employers must comply with new disclosure requirements in regards to their group health plan. The DOL has recently issued model notices to assist employers with these requirements.

There are currently 4 model notices that are available:

• Dependent Coverage - Group health plans are required to cover children to age 26. If a child was terminated from the health plan prior to age 26 due to previous plan regulations, employers must provide the child (or parent of the child) written notification of the opportunity to re-enroll. This enrollment opportunity must be at least 30 days long. The written notice must be provided no later than the first day of the first plan year beginning on or after September 23, 2010. The model notice can be accessed at: http://www.dol.gov/ebsa/dependentsmodelnotice.doc.
  
• Grandfathered Plan Status - To maintain status as a grandfathered health plan, a plan must include a statement in any plan materials provided to a participant or beneficiary describing the benefits provided under the plan, informing the participant or beneficiary that the plan believes it is a grandfathered health plan and providing contact information for questions and complaints. The model notice can be accessed at: http://www.dol.gov/ebsa/grandfatherregmodelnotice.doc.
  
• Lifetime Limits - A notice must be given to group health plan
  participants informing them that lifetime limits no longer apply and that an individual, if covered, is once again eligible for benefits under the plan. In addition, if the individuals are no longer enrolled in the plan, the plan must provide them a written notice of the opportunity to re-enroll. The notices must be provided beginning no later than the first day of the first plan year beginning on or after September 23, 2010. Notices may be included with other enrollment materials that a plan distributes to employees, provided the statement is prominent. The model notice can be accessed at: http://www.dol.gov/ebsa/lifetimelimitsmodelnotice.doc.
  
• Patient Protection - A group health plan must provide notice to participants of their rights, if applicable, to (1) choose a primary care provider or a pediatrician when a plan requires designation of a primary care physician; or (2) obtain obstetrical or gynecological care without prior authorization. The notice must be provided whenever the plan provides a participant with a summary plan description or other similar description of benefits under the plan. The notice must be provided no later than the first day of the first plan year beginning on or after September 23, 2010. The model notice can be accessed at: http://www.dol.gov/ebsa/patientprotectionmodelnotice.doc.

Brown & Brown is dedicated to helping its clients understand which notices they must provide to their employees. If you have any questions regarding these notices, please contact your Brown & Brown representative. It is our objective to assist you in making sure that the appropriate notices are provided to your employees.
 
This Brown & Brown Alert is not intended to be exhaustive and should not be construed as legal advice. Readers should contact legal counsel for legal advice.

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