Reminder: Model Notices Available to Help Employers Satisfy ACA Requirement
Model Notices Provided by U.S. Department of Labor
The Affordable Care Act requires employers and group health plans to provide a number of informational notices to employees and other individuals eligible for benefits under the plan. Model notices that may be used to satisfy certain notice requirements are available from the U.S. Department of Labor (DOL). Some of the key notices include:
Notice Regarding Availability of Health Insurance Exchanges
Employers must provide a written notice with information about a Health Insurance Exchange (Marketplace) to each new employee at the time of hiring, within 14 days of the employee’s start date. There is one model notice for employers who offer a health plan to some or all employees, and another model notice for employers who do not offer a plan.
Summary of Benefits and Coverage (SBC)
For employers who offer a group health plan, employees and beneficiaries under the plan must be provided a standard summary of benefits and coverage (SBC) notice explaining what the plan covers and what it costs. If an employer-sponsored plan is fully insured, this requirement may be satisfied if the health insurance issuer furnishes recipients with a timely and complete SBC.
The SBC must be distributed at specific times during the enrollment processand upon request. Starting with plan years beginning in 2014, SBCs must include additional language indicating whether the plan provides “minimum essential coverage” (the type of coverage an individual needs to satisfy the ACA’s individual mandate), and whether the plan meets the ACA’s “minimum value” standard (meaning the plan pays for at least 60% of covered health care expenses). SBC templates and sample completed SBCs are available from the DOL.
Disclosure of Grandfathered Status
To maintain status as a grandfathered health plan, a group health plan must include a statement indicating the plan believes it is a grandfathered plan, along with contact information for questions and complaints, in any plan materials provided to a participant or beneficiary describing the benefits provided under the plan.