COBRA NOTICES FMLA Designation Notice: Within five business days of COBRA General Notice: Provide a general notice of COBRA receiving sufficient information to grant or deny FMLA leave, rights to each covered employee and spouse (if any) within 90 inform the employee whether their FMLA leave request is days after their health plan coverage begins. Employers often approved. The DOL has a model designation notice (Form include this notice in their plan’s open enrollment materials. WH-382) that employers may use. The DOL has a model notice that employers may use. COBRA Election Notice: Notify qualified beneficiaries of their ERISA DISCLOSURES right to elect continuation coverage under COBRA following a SPD: Provide the SPD to new plan participants within 90 qualifying event. This notice must be provided no later than 14 days of when their coverage begins. An updated SPD must days after the plan’s receipt of the notice of a qualifying event. be provided to covered employees at least every five years if For qualifying events where the employee (or covered depen- material modifications have been made during that period. If dent) is not required to notify the employer of the qualifying no material modifications have been made, an updated SPD event, the election notice must be provided within 44 days of must be provided at least every 10 years. the qualifying event (or loss of coverage, if later). The DOL has a model notice that employers may use. Summary of Material Modification (SMM): An SMM must be provided when there is a material modification in the terms Notice of COBRA Unavailability: If you deny a request for of the plan or any change in the information required to be in COBRA continuation coverage (or for an extension of COBRA the SPD. As a general rule, the SMM must be provided within continuation coverage), provide the individual with a notice 210 days after the close of the plan year in which the change of unavailability of COBRA coverage. The notice must be was adopted. A shorter deadline may apply in some circum- provided within 14 days after the request for COBRA continu- stances, depending on the nature of the modification or ation coverage is received, and it must explain the reason for change. If the change is a material reduction in group health denying the request. plan benefits or services, the deadline for providing the SMM is 60 days after the change is adopted. Also, employers must Notice of COBRA Early Termination: If COBRA coverage provide 60 days advance notice of any material modification terminates early, give the qualified beneficiary a notice of to plan terms or coverage that takes effect mid-plan year and early termination. The notice must explain why the coverage affects the content of the plan’s SBC. The 60-day notice can will terminate earlier than the end of the maximum cover- be provided to participants through an updated SBC or by age period, provide the date the coverage will terminate and issuing an SMM. describe any rights the qualified beneficiary may have to elect other coverage. The notice must be provided as soon as prac- Plan Documents: Provide copies of certain plan documents ticable following the decision to terminate coverage early. within 30 days after a written request by a participant and beneficiary and have copies available for examination. These Notice of Insufficient Payment: If a qualified beneficiary documents include the latest SPD, SMMs, Form 5500, trust makes a timely premium payment, but the amount of the agreements and other instruments under which the plan is payment is short by an insignificant amount, notify the qual- established or operated. ified beneficiary of the shortfall and provide a reasonable period of time (e.g., 30 days) to pay the missing amount. WELLNESS PROGRAM NOTICES HIPAA Wellness Notice: HIPAA’s nondiscrimination rules apply FAMILY AND MEDICAL LEAVE ACT (FMLA) NOTICES to wellness programs offered in connection with group health General Notice of FMLA Rights: Post a general FMLA notice plans. To comply with HIPAA, health-contingent wellness where it can be readily seen by employees. Also, provide plans (i.e., those that require individuals to satisfy a standard this notice to employees by including it in the company’s related to a health factor to qualify for a reward) must provide employee handbook, if one exists, or distributing a copy to a notice informing employees that there is an alternative each new employee upon hiring. The DOL has a model poster way to qualify for the program’s reward. This notice must be for employers to use. included in all plan materials that describe the terms of the wellness program. FMLA Eligibility Notice: When an employee requests FMLA leave, or when you learn that an employee’s leave may be for Americans with Disabilities Act (ADA) Wellness Notice: The an FMLA-qualifying reason, notify the employee of their eligi- ADA imposes nondiscrimination requirements on certain well- bility to take FMLA leave within five business days, absent ness plan designs. To comply with the ADA, wellness plans extenuating circumstances. The DOL has a model eligibility that collect health information or involve medical exams must notice (Form WH-381) that employers may use. provide a notice to employees that explains how the informa- tion will be used, collected and kept confidential. Employees FMLA Rights and Responsibilities Notice: Each time the eligi- must receive this notice before providing any health informa- bility notice is provided, give a notice detailing the specific tion and with enough time to decide whether to participate in expectations and obligations of the employee and explain- the program. ing any consequences of a failure to meet these obligations. This notice may be accompanied by any required certification form. The DOL has a model rights and responsibilities notice, which is included in Form WH-381. 17