ACA Reporting
ACA Compliance Lessons Learned From Recent Reporting Seasons
Common themes emerge when reflecting on recent ACA reporting seasons that can help employers reduce administrative burdens and improve accuracy.
Employers
Required Notices for Employers with Calendar-Year Plans
As employers with calendar-year plans gear up for open enrollment, a critical part of preparation is gathering all required notices for annual distribution to plan participants.
As employers with calendar-year plans gear up for open enrollment, a critical part of preparation is gathering all required notices for annual distribution to plan participants. Each employer’s notice obligations vary based on factors like company size, types of plans offered, and plan funding. However, the following key notices should be reviewed and included in the open enrollment materials to ensure compliance:
| 1. | HIPAA Notice of Privacy Practices – This notice is required upon an employee’s initial enrollment and every three years afterward. Including it with open enrollment materials can simplify tracking its tri-annual distribution. |
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| 2. | Health Care Exchange Notice – Distributed upon hire, this notice is often included in open enrollment materials for ongoing awareness. |
| 3. | Summary of Benefits and Coverage (SBC) – This annual document, outlining health plan details, should be provided with open enrollment materials and also at initial enrollment and upon request. |
| 4. | Women’s Health and Cancer Rights Act Notice – Required at initial enrollment and annually thereafter, this notice is typically included with open enrollment materials. |
| 5. | CHIP Notice – Also required at initial enrollment and annually afterward, this notice informs participants about potential assistance under the Children’s Health Insurance Program. |
| 6. | Medicare Part D Notice of Creditable Coverage – This notice must reach Medicare-eligible participants by October 15 each year to clarify coverage options. |
| 7. | Special Enrollment Rights Notice – Provided at initial enrollment and annually, this notice is often included with open enrollment materials to clarify participants’ rights. |
| 8. | Summary Annual Report (SAR) – If applicable, this report should be distributed nine months after the end of the plan year, detailing the financial status of the benefit plan. |
| 9. | Wellness Program Notices (HIPAA and ADA) – If your health plan includes wellness programs, HIPAA and ADA require corresponding notices, which many employers include in open enrollment materials. |
| 10. | COBRA Initial Rights Notice – While typically provided upon enrollment or hire, including this notice during open enrollment can be a helpful reminder for employees about their COBRA rights if they lose coverage. |
Employers should carefully review the notification requirements associated with their benefit plans and ensure all relevant notices are distributed to employees and plan participants in a timely manner.
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This article is for informational purposes only and is not intended as legal, tax, or benefits advice. Readers should not rely on this information for taking (or not taking) any action relating to employment, compliance, or benefits. Always consult with a qualified professional before making decisions based on this content.
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