October brings with it the approach of year-end notices and open enrollment for 2021 health & welfare benefits. While open enrollment for your organization may be a month or so away, October 15 is the deadline for distribution of the Medicare Part D Notice which certifies whether a group health plan’s prescription drug coverage pays out at least as much as the standard coverage under a Medicare prescription drug plan. Most employer sponsored group health plans that provide prescription drug benefits are subject to the notice requirement mandated by the Centers for Medicare and Medicaid Services (CMS). Rather than trying to identify the Medicare Part D eligible individuals who must receive the required notice, many employers choose to simply distribute the Medicare Part D Notice to all of its employees who are enrolled in or eligible for the employer’s prescription drug coverage. CMS has model notices on its website which have not changed substantially since inception of the notice requirement.

Other notices to put on your autumn radar include

• Summary of Benefits and Coverage (SBC) which must be distributed by the beginning of open enrollment for 2021 benefits. Notably, the model format for the SBC has been revised for 2021. Be sure to check that your vendor uses the new format to create the 2021 SBCs for your plans.
• Wellness programs encountered a new notice requirement that came with the 2016 regulations mandating disclosures if your wellness program requires a medical exam or makes disability-related inquiries into employees’ health status. The Equal Employment Opportunity Commission (EEOC) has a model notice format on its website to assist with compliance. This wellness notice should be provided prior to employees making any disclosures for the coming wellness program year. A good practice is to distribute the wellness notice every year at open enrollment.
• HIPAA Notice of Privacy Practices is required to be provided to new hires and generally to all eligible employees once every three years. Including this notice with open enrollment materials will ensure compliance without having to track the three-year cycle.
• Statement of rights under the Newborns’ and Mothers’ Health Protection Act
• Notice about Women’s Health and Cancer Rights Act
• Medicaid and Children’s Health Insurance Program (CHIP) Notice. The state by state chart of CHIP coverage is updated every year, most recently as of July 31, 2020, and any notices should include the latest chart. While it is easiest to comply by distributing to all eligible employees, this notice is not required for employees who reside in a state without CHIP financial assistance.

Your plans may have other notices and disclosures that you typically make during open enrollment or by year-end and now is the time to dust them off and update them for 2021.