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Home»Employee Benefits Info (Open Enrollment)

Employee Benefits Info (Open Enrollment)

Providing a comprehensive benefits package is a powerful tool for attracting and retaining top talent — and it comes with numerous compliance requirements. When employees are eligible for insurance and/or retirement benefits, there are essential documents and legal notices you are required to provide. Comply DIY is here to guide you through what to include.

Employee Benefits Packet or Portal

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 an online Employee Benefits Portal.

Benefits Highlights and Cost Information

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.

Benefits Enrollment Forms

Each insurance company will have its own employee enrollment or waiver forms. Remember to include the required forms 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.

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.

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.

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.

Notice of Coverage Options

Under the ACA, employers are required to provide this notice to all new hires informing them about the health insurance marketplace. It’s also a good idea to include it in the Employee Benefits Packet.

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.

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.

Medicaid and CHIP Notice

A notice about premium assistance under Medicaid or the Children’s Health Insurance Program (CHIP) should be included.

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.

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.

Michelle’s Law Notice

This notice informs eligible students about their rights to extended health insurance coverage under Michelle’s Law.

Mental Health Parity and Addiction Equity Act (MHPAEA) Notice

This notice informs employees about parity in mental health and substance use disorder benefits.

Genetic Information Nondiscrimination Act (GINA) Notice

This notice informs employees about protections against discrimination based on genetic information.

Uniformed Services Employment and Reemployment Rights Act (USERRA) Notification

This notice informs all employees of their rights under USERRA. It is typically distributed by displaying the USERRA rights poster in common workplace areas or by including the information in employee handbooks.

Essential Benefits Documentation

Certain essential documents govern your benefits plans and must be made available to employees.

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.

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 not reflected in the most recent SPD, a summary of those modifications must be provided.

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.

Retirement Plans

If your organization provides a retirement plan to employees, there are additional compliance requirements beyond those for health and welfare benefits.

Summary Plan Description (SPD)

A document provided to employees detailing their rights and responsibilities under the retirement plan and describing its features. Note: this is a separate document from the health plan SPD.

Annual Reports (Form 5500 Series)

Most retirement plans must file an annual report about the plan’s financial conditions, investments, and operations.

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LEGAL DISCLAIMER

While we try our best to provide all of the information you need to stay in compliance, the compliance requirements vary from employer to employer, and ultimately compliance is an employer responsibility. In order to ensure that you are in compliance with the various applicable rules and regulations, you may want to work with a professional administrator.

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