Health Care Reform: Open Enrollment Communications


The Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (collectively the “Act”), includes a series of significant changes that are relevant to employer-provided group health plans. Some of these changes take effect for plan years beginning on and after September 23, 2010. As a result, plan sponsors will need to update enrollment materials and participant communications for the upcoming plan year. Several of the Act’s more notable provisions affecting employer-sponsored health plans are highlighted below.

Notice Regarding Grandfathered Status:

Plan sponsors that have decided to maintain grandfathered status must provide participants with a statement that the plan intends to preserve the basic health coverage that was in effect on March 23, 2010, and that some of the consumer protections of the Act may not apply. The Department of Health and Human Services (HHS) has issued a model notice to satisfy this requirement. In addition, to maintain status as a grandfathered plan, the plan sponsor must retain records of the plan terms in existence on March 23, 2010, including plan documents, insurance policies, summary plan descriptions (SPDs), and other cost-sharing documentation.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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