Model Notices Required By Employers

The first wave of health care reform became effective on or after 09/23/10 which means a new round of key reform compliance changes.  As your insurance broker, we are charged to keep you in compliance, keep your employees informed and to ultimately help you navigate through some turbulent waters.

Here  is a checklist of five notices you must arm your employees with as you renew your health care plans:

1. Dependent Coverage Notice– You’ve heard of this one.  At renewal health care plans are required to offer a one-time enrollment opportunity to eligible dependent children who are under age 26.
2. Lifetime Limit Notice – All health care plans are now required to have unlimited lifetime benefits.
3. OBGYN Designation – Employees will now have the right to obtain OBGYN care without a referral.  Most plans already have this provision unless you currently offer an HMO.
4. Grandfathered Status Notice – All participants must be notified as to whether their health plan will retain its grandfathered status.
5. Claims Appeals Notice – Must be given which outlines the new procedures for internal and external reviews of claim decisions. Your carrier will communicate this to you.

We can’t stress enough the importance of having annual Open Enrollment Meetings with your employees.  There is tremendous change , uncertainty and misinformation in the market.  Allowing us to conduct your enrollment meetings which we have done for many years is of utmost importance.  The employer who communicates health care reform change in a positive and objective way will be thanked later with stronger retention and a more educated workforce.  As always, we appreciate your business and hope you find the information in our weekly health care reform blasts informative.

Burman S. Clark

Burman S. Clark, RHU, CSA is the President of Muneris Benefits and a licensed insurance broker and consultant. His independent practice and focuses on employee benefits, individual life, disability, medical, and senior products. Burman has traveled extensively and provided guidance to large employer associations with regards to the Affordable Care Act.