Summary of Benefits & Coverage (SBC): An essential tool for plan comparison. The SBC provides an “at-a-glance” overview of each medical plan’s benefits, making it easy for employees to compare options side-by-side.
Plan sponsors must provide a Summary of Benefits and Coverage (SBC) to all eligible individuals—including employees, former employees, and their spouses and dependents during open enrollment.
Additional Documents
Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) Annual Notice
Overview: Employers offering group health plans must provide written notice annually to employees about potential Medicaid or CHIP premium assistance if the employee lives in a state that offers such assistance. The obligation to give notice is based on the employee’s state of residence, not the employer’s location. Even if only one employee lives in a state that provides premium assistance, the employer must comply—but only employees in those states need to receive the notice. Many employers find it easier to simply distribute the notice to all eligible employees along with other open enrollment materials.
The notice must be provided automatically, on an annual basis, and free of charge.
Medicare Part D Creditable Coverage Notice. This notice informs individuals whether a health plan’s prescription drug coverage is considered Creditable (meaning it is expected to pay, on average, as much as Medicare’s standard drug coverage) or Non-Creditable.
Linked below is a list of your available plans and their Creditable Coverage status. Employers are responsible for ensuring eligible individuals receive the appropriate notice based on the plans they are eligible to choose.
Important: If your plan’s creditable status changes (e.g., from creditable to non-creditable), you must promptly notify all eligible individuals by distributing an updated Creditable Coverage Notice. This is essential, as a change in creditable status triggers a limited Medicare Part D Special Enrollment Period (SEP), and timely notice ensures members have the information they need to make informed Medicare decisions.
HIPAA Notice of Privacy Practices: This important notice details how the plan protects, uses, and discloses an individual’s Protected Health Information (PHI). It also outlines individuals’ rights regarding their PHI. Plan sponsors must tailor this notice by completing the highlighted sections and make it available to eligible individuals during Open Enrollment.
Other Key Compliance Notices: A compilation of additional required open enrollment notices (e.g., CHIPRA, WHCRA, etc.) that must be distributed annually during open enrollment.