Employee notice of special enrollment rights

[Guest Liz Mikkelson]

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]

The EBSA website has guidance on this topic along

with model notices.

[oriecat]

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

© 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]

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...!

[Guest ptpnthr]

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