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DOL Releases Model Notices for Employers Implementing
Health Care Reform
The U.S. Department of Labor’s Employee Benefits Security Administration has released a number of Model Notices
for employer-sponsored health plans to comply with requirements of the Affordable Care Act. Model notice language
is now available from the Department of Labor for the following:
Opportunity to Enroll in Connection with Extension of Dependent Coverage to Age 26.
The interim final regulations extending dependent coverage to age 26 provide transitional relief for a child
whose coverage ended, or who was denied coverage (or was not eligible for coverage) under a group health
plan or health insurance coverage because, under the terms of the plan or coverage, the availability of
dependent coverage of children ended before the attainment of age 26. This enrollment opportunity
(including the written notice) must be provided not later than the first day of the first plan year
beginning on or after September 23, 2010. For more information and to view the Model Notice, please
click here.
Patient Protection Model Disclosure
Individuals enrolled in a plan or health insurance coverage must be notified of their rights
to (1) choose a primary care provider or a pediatrician when a plan or issuer requires
designation of a primary care physician; or (2) obtain obstetrical or gynecological care
without prior authorization. This notice must be provided no later than the first day of
the first plan year beginning on or after September 23, 2010. For more information and to
view the Model Notice, please
click here.
Model Language Notice Lifetime Limit No Longer Applies and Enrollment Opportunity
Plans and issuers are required to give written notice that the lifetime limit on the dollar value of all
benefits no longer applies and that an individual, if covered, is once again eligible for benefits under
the plan. Additionally, if the individual is not enrolled in the plan or health insurance coverage, or if
an enrolled individual is eligible for but not enrolled in any benefit package under the plan or health
insurance coverage, then the plan or issuer must also give such an individual an opportunity to enroll
that continues for at least 30 days (including written notice of the opportunity to enroll). The notices
and enrollment opportunity must be provided beginning not later than the first day of the first plan year
beginning on or after September 23, 2010. For more information and to view the Model Notice, please
click here.
To visit the Department of Labor’s webpage dedicated to
the Affordable Care Act, please
click
here.
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