With open enrollment approaching for many employers, we thought it might be helpful to provide a list of the various notices and disclosures generally required to be provided to participants around this time of year.
Health Plans – Open Enrollment Notices
- Medicare Part D Notice of Creditable Coverage – Describes whether the prescription drug benefit offered under an employer's plan is at least as generous as the Medicare Part D drug benefit (must be provided by October 15th).
- Summary of Benefits and Coverages (SBC) – A summary of medical benefits for each medical plan design option.
- Notice of HIPAA Special Enrollment Rights (included in the plan's SPD as well) – Describes events that trigger mid-year enrollment rights in medical benefits. Must be provided prior to enrollment for employees who become eligible to participate in a group health plan.
- Women’s Health and Cancer Rights (WHCRA) Notice – Describes the right to reconstructive surgery after a mastectomy.
- Notice of Availability of HIPAA Privacy Practices – Describes the group health plan's HIPAA Privacy Practices. Must be provided every 3 years, but is often included in open enrollment materials each year to satisfy requirement.
- Notice of Coverage Options (or Exchange Notice) – Describes the Affordable Care Act insurance marketplace.
The following will need to be provided at open enrollment, if applicable:
- CHIPRA Notice — Notifies individuals of availability of premium assistance for dependent children's health coverage under a state's CHIP or Medicaid program and provides contact information for each state.
- Grandfathered Plan Disclosure – Required if the group health plan maintains its grandfathered status under the Affordable Care Act. Must be included in any materials describing the health benefits or coverage.
- Notice Regarding Designation of a Primary Care Provider – Notifies participants if a group health plan requires participants to designate a primary care provider.
- Wellness Program Disclosure(s) – Notifies participants in health-contingent wellness programs of the availability of reasonable alternative standards for obtaining a reward. Notice also needed if wellness program requires medical exam or makes disability-related inquiries.
Retirement Plan Annual Notices and Disclosures
- Participant Directed Investment Disclosure – Notice required under ERISA §404(c) providing investment and other information necessary for participants to direct the investment of their retirement plan account(s). Must be furnished annually, if applicable.
- Qualified Default Investment Alternative (QDIA) Notice – Notice regarding the default investment options under the retirement plan. Must be provided 30-90 days before the start of the plan year, if applicable.
- Automatic Contributions Notice – Notice regarding participants' rights and obligations under the automatic contribution arrangement and how automatic contributions will be invested. Must be provided 30-90 days before the start of the plan year.
- Participant-Level Fee Disclosure – Fee disclosure required under ERISA §404(a)(5) describing all retirement plan fees. Must be furnished annually, at least once in any 14 month period.
- Notice of effective opportunity to make or change cash or deferred election – notice must be provided 60 days before plan year for SIMPLE plans; must provide participants with an effective opportunity to make or change 401(k) deferral elections.
- 401(k) safe harbor notice, if applicable – Annual notice describing participants' rights and obligations under a safe harbor plan. Must be provided 30-90 days before the start of the plan year.
- SAR (for defined contribution plans) – Summary of information in plan's annual report. Must be furnished by September 30th or, if extension filed for Form 5500, by December 15th, for calendar year plans.
- Annual Funding Notice (for defined benefit plans) – Summary of the plan's funding status. Must be provided no later than 120 days after the end of the plan year.