Benefit Notices for New Hires
Employers sponsoring group health plans are required by federal law to provide certain notices and disclosures to persons when they first become eligible for enrollment. These materials often are referred to as “new hire benefit notices” or “initial enrollment benefit notices.”
To get started, see the list of notices linked below along with guidance about which notices to include for your plan.
Use the first two pages as a glossary notices included. Simply click on the notice listed in blue text and the page will jump to the desired notice. Then simply copy the notices you need and customize them with your plan’s information. For convenience, variables and fill-in items are highlighted in red.
Insured Health Plans: Plans provided through group insurance policies are subject to state insurance laws that may apply in addition to, or in place of, one or more of the federal notices in this package. In that case, the insurance carrier provides the applicable notice(s) which may be distributed with enrollment materials or included in the carrier’s evidence of coverage (EOC) booklet. Employers are advised to coordinate with the carrier to ensure that all requirements are met under both federal and state law.
HIPAA Privacy Notices: Employers who sponsor one or more group health plans that are subject to Privacy and Security Rules under the Health Insurance Portability and Accountability Act (HIPAA) may be responsible for their plan’s compliance with the rules, including the requirement to prepare and distribute a Notice of Privacy Practices (Privacy Notice) to plan participants. The requirements vary widely, depending on whether the plan is insured or self-funded, the extent to which the employer has access to personal health information (PHI), the use of electronic media, and other factors. Due to these variables, Privacy Notices are outside the scope of the information provided here and employers are advised to review their plan or plans with legal counsel offering expertise in HIPAA.
Multi-Employer Plans, Multiple Employer Welfare Arrangements, and Association Health Plans: This material is designed for use by single-employer plans only. Do not use for multi-employer plans (e.g., union trusts), multiple employer welfare arrangements (MEWAs), or association health plans.
Entities Subject to § 1557 of the Affordable Care Act (ACA): Certain health programs that receive federal financial assistance may be subject to additional notice requirements under § 1557 of the ACA which are outside the scope of these materials. Employers who may be affected are advised to review the matter with legal counsel.
The information contained here regarding required benefit plan notices is for informational purposes only and should not be considered tax or legal advice or a substitute for legal counsel.