As the majority of employers head into open enrollment season, it’s important to look at a few year-end compliance reminders to try to stay ahead of the game. Even if you operate a non-calendar year plan, these items are important and should be addressed before the year is over.
While there are a vast number of year-end compliance items to remember each year, don't forget about the required annual compliance notices that you should be distributing to employees. Here’s a quick rundown of each notice:
Premium assistance under Medicare and the Children’s Health Insurance Program (CHIP)
The CHIP notice informs employees of a possible right to receive financial assistance through Medicaid and CHIP. It should be distributed to all employees annually and is often easiest to include with open enrollment materials. Click here for a sample CHIP notice.
Women's Health and Cancer Rights Act (WHCRA)
The WHCRA annual notice must be provided once a year. For a fully-insured plan, it’s provided by the insurance carrier; however, for a self-funded plan, you should check to see if the Third Party Administrator (TPA) has provided this service or not. If you determine you need to provide the notice, please feel free to use this copy of the model DOL notice. Click here for a WHCRA template.
Medicare Part D Notice
Employers with a group health plan that covers any employee or dependent who is also enrolled in Medicare (Parts A or B) must notify those people annually, whether drug coverage is Creditable or Non-Creditable. Those who are enrolled in both Medicare and the group health plan must be enrolled in creditable drug coverage, meaning the group health plan’s prescription drug coverage meets the standard level of coverage required by Medicare. If the group health plan coverage is non-creditable an individual either needs to enroll in a Medicare Part D plan or will incur a higher premium upon enrolling in a Part D plan at a later date. This notice allows enrolled employees and their dependents to make an informed decision on whether or not they need to enroll in a Part D plan.
The Medicare Part D Notice should be distributed by October 15 each year, although there is no penalty for a late notice. We believe it’s better for the notice to be late and correct than be on time but not accurately reflect the upcoming health plan.
You may not know if employees or their dependents are enrolled in Medicare, so it may make sense to distribute this notice to all employees to be safe. It’s valuable to have a partner who keeps you on track and sends you the appropriate template notice once your renewal decisions are finalized for the next medical plan year.
HIPAA Notice of Privacy Practices
It might also be time to distribute your HIPAA Notice of privacy practices. Though you are only required to provide the notice every three years, this might be the year for you to do so. Again, for fully insured plans, the carrier will send out the notice. Self-funded plans can check with their TPAs. To learn more about HIPAA and the notices, visit the US Department of Health and Human Sciences website.
While compliance is often thought of as keeping your plans and programs up to snuff, it also heavily relies on communication. As the end of the year approaches, make sure you’re sending employees the necessary notices and documentation. It’s just as important for them to be cognizant of compliance that may affect them as it is for your business.
Remember, compliance requires year-round focus. It can also be a confusing area, so click here to take a closer look at a few common requirements that might come up throughout the year.
Updated November 28, 2017