Included is a list of Model Notices and documents that may be required for your employees throughout the year. Please contact Summit Insurance Services if we can be of assistance in the delivery or explanation of this document library.
Notices listed below are categorized by the Grandfathered or Non-Grandfathered Status of your Health Plan.
If your Plan is Grandfathered, the following Health Plan Notices are required henceforth:
- Grandfathered Model Notice
- Dependent to Age 26 Notice (Coverage for Adult Children)
- Annual Limits on Essential Health Benefits Notice
- Lifetime Limits on Essential Health Benefits
- Pre-existing Conditions Exclusion for Children Under Age 19 Notice
- Patient Protections Notice-Prohibition on Rescissions
If your Plan is Non-Grandfathered, the following Health Plan Notices are required henceforth:
- 2-6 Notices listed above under “Grandfathered”
- Notice of Adverse Benefits Determination
- Notice of Final External Review
- Notice of Final Internal Adverse Benefits Determination
- External Review Model Notice
- Nondiscrimination Rules Extended to Insured Plans Notice
- First Dollar Coverage for Preventative Care Notice
Finally, all Plans—Grandfathered and Non-Grandfathered alike—must also provide the following ERISA Notices:
- WHCRA Notice (Women’s Health and Cancer Right ACT)
- CHIPRA Notice (Children’s Health Insurance Program Reauthorization Act)
- HIPAA Notice (for self-insured plans) (Contact your agent for assistance)
- Medicare Part D Notice
- MHPA Notice (Mental Health Parity Act)
Grandfathered Plans will have 11 total Notice requirements under PPACA and ERISA.
Non-Grandfathered Plans will have 16 total Notice requirements under PPACA and ERISA.
Healthcare Reform Notices
Other Helpful Documents:
- Women’s Health and Cancer Right ACT Payroll Stuffers
- Employer’s Tax Guide to Fringe Benefits
- Initial COBRA Model Notice (Updated for Healthcare Reform)
- Qualifying Event COBRA Model Notice (Updated for Healthcare Reform)