ERISA NOTICES
Can I enroll in Medicare instead of COBRA continuation coverage after my group health plan coverage ends? In general, if you don’t enroll in Medicare Part A or B when you are first eligible because you are still employed, after the Medicare initial enrollment period, you have an 8-month special enrollment period 1 to sign up for Medicare Part A or B, beginning on the earlier of
SUMMARY OF BENEFITS & COVERAGE (SBC) NOTICE
The SBC is designed to help you better understand and evaluate your health insurance choices. The SBC contains the same standard language used by all insurance companies and group health plans to make it easier for you to compare health plans.
•
The month after your employment ends; or
• The month after group health plan coverage based on current employment ends.
The information contained in an SBC includes:
• A short plain language summary about benefits & coverage • A uniform glossary of health insurance terms
If you don’t enroll in Medicare and elect COBRA continuation coverage instead, you may have to pay a Part B late enrollment penalty and you may have a gap in coverage if you decide you want Part B later. If you elect COBRA continuation coverage and later enroll in Medicare Part A or B before the COBRA continuation coverage ends, the Plan may terminate your continuation coverage. However, if Medicare Part A or B is effective on or before the date of the COBRA election, COBRA coverage may not be discontinued on account of Medicare entitlement, even if you enroll in the other part of Medicare after the date of the election of COBRA coverage. If you are enrolled in both COBRA continuation coverage and Medicare, Medicare will generally pay first (primary payer) and COBRA continuation coverage will pay second. Certain plans may pay as if secondary to Medicare, even if you are not enrolled in Medicare. For more information visit https://www.medicare.gov/medicare- and-you. If you have questions Questions concerning your Plan or your COBRA continuation coverage rights should be addressed to the contact or contacts identified below. For more information about your rights under the Employee Retirement Income Security Act (ERISA), including COBRA, the Patient Protection and Affordable Care Act, and other laws affecting group health plans, contact the nearest Regional or District Office of the U.S. Department of Labor’s Employee Benefits Security Administration (EBSA) in your area or visit www.dol.gov/ebsa . (Addresses and phone numbers of Regional and District EBSA Offices are available through EBSA’s website.) For more information about the Marketplace, visit www.HealthCare.gov . Keep your Plan informed of address changes. To protect your family’s rights, let the Plan Administrator know about any changes in the addresses of family members. You should also keep a copy, for your records, of any notices you send to the Plan Administrator. Plan contact information Angela Harrison | Human Resource Manager HMMG, LLC 6262 Veterans Parkway Columbus, GA 31908 706-494-3447
The SBC also includes details, called ‘coverage examples’, which are comparison tools that allow you to see what the plan would generally cover in two common medical situations.
You may also request a copy of the glossary of terms from your health Insurance Company or group health plan.
Also, if you don’t speak English, you may be entitled to receive the SBC and uniform glossary in your native language upon request to your health Insurance Company or group health plan. In an effort to comply with Affordable Care Act (Healthcare Reform), a copy of the Summary of Benefits & Coverage (SBC) for the plan will be available in your ADP portal.
The SBC is always available by contacting the (Underlying contract) health plan, the Plan Administrator or Third-Party Administrator.
Angela Harrison | Human Resource Manager HMMG, LLC 6262 Veterans Parkway Columbus, GA 31908 706-494-3447
WOMEN’S HEALTH AND CANCER RIGHTS ACT (WHCRA) OF 1998
If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women’s Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient, for: • All stages of reconstruction of the breast on which the mastectomy was performed; • Surgery and reconstruction of the other breast to produce a symmetrical appearance; • Prostheses; and
1 https://www.medicare.gov/sign-up-change-plans/how-do-i-get- parts-a-b/part-a-part-b-sign-up-periods.
IMPORTANT NOTICE: This document contains general compliance information only and does not constitute legal advice. For advice specific to your situation, please consult your attorney or tax advisor.
Made with FlippingBook - professional solution for displaying marketing and sales documents online