Laws Pages
- ERISA: Electronic Distribution of Health Plan Notices
- ACA: Grandfathered Health Plans
- ACA: Reporting Health Coverage Cost on W-2s
- ACA: Reporting on Forms 1094-C and 1095-C
- ACA: Required Marketplace/Exchange Notice
- ACA: Summary of Benefits and Coverage (SBC)
- Employer Responsibilities with Medicare Notices
- ERISA: Form 5500 Introduction (SAR Notice)
- GHP: Benefit Notices for Group Health Plans
- GHP: COBRA Health Coverage Continuation
- GHP: Plan Documents and Summary Plan Descriptions
- FMLA: Maintenance of Healthcare Benefits
- HIPAA: Special Enrollment Rights
Guides
- ERISA Notices Distribution Guide and Sample Language
- Benefit Notices for Open Enrollment
- Benefit Notices for New Hires: Employers with Fewer Than 20 Employees
- Benefit Notices for New Hires: Employers with 20-49 Employees
- Benefit Notices for New Hires: Employers with 50+ Employees
Charts
- Timeline of Benefit Notices for Group Health Plans
- Benefit Notices for New Hires
- Benefit Notices for Open Enrollment
Customizable Notices and Forms
General Benefits
- Consent to Receive Electronic Health and Welfare Plan Documents
- Disclosure of Grandfathered Plan Status
- Health Insurance General Waiver Form
- Health Insurance Opt-Out Arrangement Form
- Michelle’s Law Sample Notice
- Medicare Part D Notice of Creditable Coverage
- Medicare Part D Notice of Non-Creditable Coverage
- Newborns’ and Mothers’ Health Protection Act Notice
- Notice of Patient Protections (PCPs)
- Notice of Rescission of Coverage in a Group Health Plan
- Special Enrollment Rights Notice
- Wellness Program Disclosure Notice (GINA)
- Wellness Program Notice
- Women’s Health and Cancer Rights Act Disclosure Notice
COBRA Continuation
- Acknowledgment of Receipt of COBRA Rights
- COBRA Qualifying Event Notice to Plan Administrator or TPA
- COBRA Second Qualifying Event Notice to Plan Administrator or TPA
- Voluntary COBRA Termination Request Form
Family and Medical Leave Act (FMLA)
Health Insurance Portability and Accountability Act (HIPAA)
- HIPAA Authorization to Disclose PHI
- HIPAA Breach Notification to Individuals
- HIPAA Business Associate Agreement
- Disclosure to Enrollees Regarding HIPAA Opt-Out
- HIPAA Notice of Privacy Practices
- HIPAA Reminder of Availability of Notice of Privacy Practices
- Wellness Program Disclosure Notice (HIPAA)
Customizable Letters
Affordable Care Act (ACA)
COBRA Continuation
- COBRA Premium Change Letter
- COBRA Premium Change Letter - Disability Extension
- Notice of Natural Expiration of COBRA Coverage
- Notice of Past Due COBRA Premium
- COBRA Notice of Premium Underpayment
- Notice of Early Termination of COBRA Coverage
- Notices of Unavailability of COBRA Coverage
