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Liz Mikkelson

Jan 27 2004, 09:13 PM

What are the requirements for giving participants notice of special enrollment rights under HIPAA? Is the SPD posted on an employer website sufficient or is some other form of notice necessary? Also, what are the timing requirements for the notice? And, finally, is there a cite I can review?

mal

Jan 28 2004, 10:04 AM

The EBSA website has guidance on this topic along
with model notices.

oriecat

Jan 28 2004, 01:14 PM

The notice requirement is found in 29 CFR2590.701-6©

QUOTE

© Notice of enrollment rights. On or before the time an employee
is offered the opportunity to enroll in a group health plan, the plan is
required to provide the employee with a description of the plan's
special enrollment rules under this section. For this purpose, the plan
may use the following model description of the special enrollment rules
under this section:

If you are declining enrollment for yourself or your dependents
(including your spouse) because of other health insurance coverage, you
may in the future be able to enroll yourself or your dependents in this
plan, provided that you request enrollment within 30 days after your
other coverage ends. In addition, if you have a new dependent as a
result of marriage, birth, adoption, or placement for adoption, you may
be able to enroll yourself and your dependents, provided that you
request enrollment within 30 days after the marriage, birth, adoption,
or placement for adoption.

Christine Roberts

Jan 29 2004, 05:31 PM

Hi, Liz -
My EBIA manual on HIPAA compliance says this about the notice requirement for special enrollment rights:

"The Interim Regulations require that plans provide notice of special enrollment rights on or before the time an employee is offered the opportunity to enroll. The regulations provide the following model description of the special enrollment rules:
[text omitted]
Employers should include the text of this model description on their plan enrollment forms or on a separate form included with enrollment materials. Merely including the statement in the SPD would be insufficient, because employees who decline coverage are not given an SPD and therefore would not receive notice of their special enrollment rights. Note that the sample DOL audit document request letters request [sic] copies of this notice and a distribution log."

I hope this helps somewhat...!

ptpnthr

Jan 29 2004, 05:38 PM

Merely posting an SPD on a website is never sufficient for purposes of ERISA's disclosure rules.

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