Benefits Updates
Winter is the season of preparation, and that makes it the perfect time to spotlight comprehensive health plan notices. These notices – covering areas like COBRA, CHIPRA, Medicare Part D, and HIPAA-are critical for employers and their employees, but the rules around timing and responsibility can be overwhelming.
This overview provides insight into the requirements, compliance notices and timing.
| Notice | Timing | Responsible Party |
|---|---|---|
| Summary of Benefits and Coverage (SBC) | At enrollment, renewal, and upon request | Employer (carrier may assist) |
| COBRA Initial Notice | Within 90 days of coverage start | Employer |
| COBRA Election Notice | Within 14 days of qualifying event | Employer or COBRA administrator |
| HIPAA Special Enrollment Rights | At initial eligibility and upon qualifying event | Employer |
| HIPAA Privacy Practices Notice | At enrollment and every 3 years | Employer (if self-insured or handling PHI) |
| Medicare Part D Creditable Coverage Notice | Annually by October 15 | Employer |
| CHIPRA Notice | Annually | Employer |
| Women’s Health and Cancer Rights Act (WHCRA) | At enrollment and annually | Employer |
| Newborns’ and Mothers’ Health Protection Act Notice | At enrollment | Employer |
| Mental Health Parity and Addiction Equity Act (MHPAEA) | Upon request | Employer |
| Grandfathered Plan Notice | In SPD and plan materials | Employer |
| Wellness Program Disclosure (EEOC) | Before medical inquiries | Employer |
| HIPAA Wellness Program Notice | Before medical inquiries | Employer |
| ADA Wellness Program Notice | Before medical inquiries | Employer |
| Notice of Exchange (Marketplace Notice) | Within 14 days of hire | Employer |
| FMLA General Notice | At hire (if applicable) | Employer |
| Internal Claims & Appeals / External Review Notice | In SPD and denial notices | Employer |
| Transparency in Coverage (TiC) Disclosure | Ongoing via public website | Carrier (or employer if self-insured) |
| Summary Plan Description (SPD) | Within 90 days of coverage or upon request | Employer |
| Notices of Patient Protections | At enrollment | Employer |
| Special Rules for Fully Insured Plans | As applicable | Employer |
| Individual Coverage HRA (ICHRA) Notice | At least 90 days before plan year | Employer |
| Surprise Billing Notice | At time of service or enrollment | Provider or Employer |
| Michelle’s Law Notice | At enrollment or qualifying event | Employer |
• Electronic delivery is allowed if employees have regular access to email or intranet.
• Model notices are available from the DOL, CMS, and IRS.
• Recordkeeping is essential — retain documentation for at least 8 years for ERISA plans.
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