Federal agencies have recently updated key model notices for group health plans to ensure compliance with disclosure requirements. Employers should take note of these changes and consider incorporating them into their plans.
Expiration Dates:
- Notices may have OMB control numbers and expiration dates.
- Expiration doesn’t mean the information is outdated; it’s part of the OMB approval process.
- Agencies periodically seek OMB approval extensions, often with no substantive changes.
Action Items:
- Federal model notices are optional but recommended for at least minimum information.
- Employers can prepare their own notices or modify models for comprehensive information.
Updates for 2023 and 2024:
- Health Insurance Exchange Notices:
- ACA mandates written notices about Health Insurance Exchanges for new hires.
- Recently updated to include affordability thresholds, COVID-19 impacts, and optional Marketplace Employer Coverage Tool information.
- CHIP Notice:
- Annual notice requirement for employers with group health plans in states offering CHIP premium assistance subsidies.
- The updated model notice reflects changes in states providing subsidies, current as of Jan. 31, 2024.
- No Surprise Billing Notice:
- Effective from Jan. 1, 2022, health plans must disclose restrictions against balance billing.
- Two versions released (“Version 1” and “Version 2”)—use of only “Version 2” after Jan. 1, 2023, is considered good faith compliance.
- Summary Annual Report (SAR) Forms:
- SAR provides a summary of Form 5500 information and must be provided annually.
- Model forms were released for plan years beginning in 2023 with no substantive changes from 2022 forms.
These updates ensure employers are informed about recent changes and can maintain compliance with federal laws related to health plan disclosures.