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