Employee Benefits Information

For ease of distribution and to ensure comprehensive communication of benefit offerings and legal requirements, consider compiling the following documents into an Employee Benefits Packet or online Employee Benefits Portal:

1. Benefits Highlights and Cost Information: While this is not a compliance requirement, you will want to include information about the health (and dental, vision, etc.) plan options available to your employees, any employer contribution toward the cost of coverage, and the employees’ costs on a monthly and per-pay-period basis.
2. Benefits Enrollment Forms: Each insurance company will have its own employee enrollment or waiver forms. Remember to include the required forms for employees to sign up for any tax-advantaged accounts you offer as well as a salary-reduction agreement if you allow employees to pay their portion of the premium through a Section 125 Premium Only Plan.
3. Summary of Benefits and Coverage (SBC): The SBC provides information about health plan coverage and costs. This needs to be provided to employees at initial enrollment and annually at renewal time.
4. Notice of Grandfathered Status (if applicable): If your health plan maintains grandfathered status under the ACA, you must provide a notice informing your employees of this status.
5. HIPAA Special Enrollment Rights Notice: Employees need to be aware of their rights to enroll in the group health plan upon certain life events or loss of other health coverage.
6. Notice of Coverage Options: Under the Affordable Care Act (ACA), employers are required to provide this notice to all new hires, informing them about the existence of the health insurance marketplace. While you will have already provided this notice to new employees, it’s also a good idea to include it in the Employee Benefits Packet.
7. COBRA General Notice: Employers with 20 or more employees who offer a group health plan must provide an initial COBRA notice to new participants and their spouses.
8. State Continuation General Notice: Many states offer a continuation option similar to COBRA for companies with fewer than 20 employees (and sometimes for larger fully-insured groups after COBRA ends). These “mini COBRA” plans often have notice requirements similar to COBRA.
9. Medicaid and CHIP Notice: A notice about premium assistance under Medicaid or the Children’s Health Insurance Program (CHIP) should be included.
10. Women’s Health and Cancer Rights Act Notice: Employers that provide medical and surgical benefits for mastectomy must also provide benefits for reconstructive surgery and prostheses following a mastectomy.
11. Newborns’ and Mothers’ Health Protection Act (NMHPA) Notice: Employers are required to provide notice to employees of their rights for hospital lengths of stay related to childbirth.
12. Michelle’s Law Notice: This notice informs eligible students about their rights to extended health insurance coverage under Michelle’s Law.
13. Mental Health Parity and Addiction Equity Act (MHPAEA) Notice: This notice informs employees about parity in mental health and substance use disorder benefits.
14. Genetic Information Nondiscrimination Act (GINA) Notice: This notice informs employees about protections against discrimination based on genetic information.
15. Uniformed Services Employment and Reemployment Rights Act (USERRA) Notification: This notice informs all employees of their rights under USERRA. This is typically done by displaying the USERRA rights poster in common workplace areas or including the information in employee handbooks.

NOTE: We’ve all heard the phrase “out of sight, out of mind.” Remember to provide the employee benefits packet and all other required forms to any former employees or dependents who are currently on COBRA or State Continuation.

Certain essential documents govern your benefits plans. These include:

1. Plan Document: This is the foundational document outlining the specifics of your company’s benefits offerings. If your plan document does not meet ERISA standards, you may need an ERISA Wrap document.
2. Summary Plan Description (SPD): This document provides employees with a comprehensive description of the benefits plans and how they operate. If there are any material modifications to your plan that are not reflected in the most recent SPD, a summary of such modifications must be provided.
3. ERISA Wrap Plan Document and Wrap SPD: This document is a “wrapper” that makes your benefits an ERISA-compliant plan, adds any missing ERISA items, and incorporates carrier/TPA booklets—plus a plain-language wrap SPD for participants.

If your organization provides a retirement plan to employees, there are additional compliance requirements:

1. Summary Plan Description (SPD): A document provided to employees detailing their rights and responsibilities under the retirement plan and describing the features of the plan. Note: this is different from the health plan SPD.
2. Annual Reports (Form 5500 Series): Most retirement plans must file an annual report about the plan’s financial conditions, investments, and operations.

Remember, it’s crucial to understand the specific compliance requirements for your situation and how to distribute these documents properly. Always consult with a legal expert or HR compliance consultant to ensure you’re meeting all necessary requirements. Laws vary by state and by country, and the requirements can change over time. Comply DIY is here to help, but we are not a substitute for professional legal or HR advice.