Employment Law Blog

News, trends and analysis in employment law and HR

Jun 30, 2010

DOL issues health care reform model notices

Employee BenefitsHealth Care Reform 

The U.S. Department of Labor has released model notices to meet the following notice requirements imposed by recent federal health care reform guidance:

 

·         Notice of extension of coverage for adult children: This notice notifies employee enrollees of their right to enroll an adult child up to the age of 26. The notice (and the opportunity to enroll an adult child up to the age of 26) must be given no later than the first day of the first plan year beginning on or after September 23, 2010. For calendar year plans, the notice and right to enroll must be given by January 1, 2011. This notice applies to all plans.

 

·         Notice of Lifetime Limits: This notice contains information on the removal of any lifetime limits on the dollar value of coverage, and of the right to re-enroll in the plan after previously exceeding the plan’s lifetime limit. This notice (and the opportunity to re-enroll in the plan, if otherwise still eligible) must be given no later than the first day of the first plan year beginning on or after September 23, 2010. For calendar year plans, the notice and right to re-enroll must be given by January 1, 2011. This notice applies to all plans.

 

·         Notice of Patient Protections: This notice includes information about certain patient protections, including the right to select any participating provider as the individual’s primary care provider (or a participating pediatrician, in the case of a child’s care) and the right to seek OB-GYN care without needing a referral or preauthorization. This notice must be provided in the plan’s summary plan description (SPD) or other description of benefits given to participants. This notice applies only to plans that are not grandfathered.

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