Page 12 - Nortek Legal Notices
P. 12
Are There Other Coverage Keep Your Plan Informed of Address Changes
Options Besides Cobra
Continuation Coverage? To protect your family’s rights, let the Plan Administrator know about any changes in the
addresses s of family members . You should also keep a copy, for your records, of any
Yes . Instead of enrolling in COBRA notices you send to the Plan Administrator .
continuation coverage, there may Nortek Welfare Benefit Plan
be other coverage options for you
and your family through the Health Contact your local Human Resource representative for more details regarding the Plan
Insurance Marketplace, Medicaid, and COBRA continuation coverage .
or other group health plan coverage OMB Control Number 1210-0123 (expires 10/31/2016)
options (such as a spouse’s plan)
through what is called a “special
enrollment period .” Some of these Women’s Health and Cancer Rights Notice
options may cost less than COBRA Nortek Employee Health Care Plan is required by law to provide you with the following
continuation coverage . You can learn notice:
more about many of these options at
www .healthcare .gov . The Women’s Health and Cancer Rights Act of 1998 (“WHCRA”) provides certain
protections for individuals receiving mastectomy-related beneits. Coverage will be
If You Have Questions provided in a manner determined in consultation with the attending physician and the
Questions concerning your Plan or your patient for:
COBRA continuation coverage rights X All stages of reconstruction of the breast on which the mastectomy was performed
should be addressed to the contact X Surgery and reconstruction of the other breast to produce a symmetrical
or contacts identiied below. For more appearance
information about your rights under
the Employee Retirement Income X Prostheses
Security Act (ERISA), including COBRA, X Treatment of physical complications of the mastectomy, including lymphedemas
the Patient Protection and Affordable
Care Act, and other laws affecting The Nortek Employee Health Care Plan provide(s) medical coverage for mastectomies
group health plans, contact the nearest and the related procedures listed above, subject to the same deductibles and
Regional or District Ofice of the U.S. coinsurance applicable to other medical and surgical beneits provided under this plan.
Department of Labor’s Employee If you would like more information on WHCRA beneits, please refer to your Summary
Beneits Security Administration (EBSA) Plan Description or contact your Plan Administrator .
in your area or visit www .dol .gov/
ebsa . (addresses and phone numbers Revised October 19, 2010
of Regional and District EBSA Ofices
are available through EBSA’s website .)
For more information about the
Marketplace, visit www .HealthCare .gov .
This Employee Beneits Newsletter is only intended to highlight some
of the major beneit provisions of the Company plan and should not be
relied upon as a complete detailed representation of the plan. Please
refer to the plan’s Summary Plan Descriptions for further detail. Should
this newsletter differ from the Summary Plan Descriptions, the Summary
Plan Descriptions prevail.
© 2014 Lockton, Inc . All rights reserved .
Images © 2014 Thinkstock . All rights reserved .
[Rev 08/22/14] EB\NORTE08\Nortek Consolidated Group\EE Communications\Legal Notices\2015\Notices .pdf
Options Besides Cobra
Continuation Coverage? To protect your family’s rights, let the Plan Administrator know about any changes in the
addresses s of family members . You should also keep a copy, for your records, of any
Yes . Instead of enrolling in COBRA notices you send to the Plan Administrator .
continuation coverage, there may Nortek Welfare Benefit Plan
be other coverage options for you
and your family through the Health Contact your local Human Resource representative for more details regarding the Plan
Insurance Marketplace, Medicaid, and COBRA continuation coverage .
or other group health plan coverage OMB Control Number 1210-0123 (expires 10/31/2016)
options (such as a spouse’s plan)
through what is called a “special
enrollment period .” Some of these Women’s Health and Cancer Rights Notice
options may cost less than COBRA Nortek Employee Health Care Plan is required by law to provide you with the following
continuation coverage . You can learn notice:
more about many of these options at
www .healthcare .gov . The Women’s Health and Cancer Rights Act of 1998 (“WHCRA”) provides certain
protections for individuals receiving mastectomy-related beneits. Coverage will be
If You Have Questions provided in a manner determined in consultation with the attending physician and the
Questions concerning your Plan or your patient for:
COBRA continuation coverage rights X All stages of reconstruction of the breast on which the mastectomy was performed
should be addressed to the contact X Surgery and reconstruction of the other breast to produce a symmetrical
or contacts identiied below. For more appearance
information about your rights under
the Employee Retirement Income X Prostheses
Security Act (ERISA), including COBRA, X Treatment of physical complications of the mastectomy, including lymphedemas
the Patient Protection and Affordable
Care Act, and other laws affecting The Nortek Employee Health Care Plan provide(s) medical coverage for mastectomies
group health plans, contact the nearest and the related procedures listed above, subject to the same deductibles and
Regional or District Ofice of the U.S. coinsurance applicable to other medical and surgical beneits provided under this plan.
Department of Labor’s Employee If you would like more information on WHCRA beneits, please refer to your Summary
Beneits Security Administration (EBSA) Plan Description or contact your Plan Administrator .
in your area or visit www .dol .gov/
ebsa . (addresses and phone numbers Revised October 19, 2010
of Regional and District EBSA Ofices
are available through EBSA’s website .)
For more information about the
Marketplace, visit www .HealthCare .gov .
This Employee Beneits Newsletter is only intended to highlight some
of the major beneit provisions of the Company plan and should not be
relied upon as a complete detailed representation of the plan. Please
refer to the plan’s Summary Plan Descriptions for further detail. Should
this newsletter differ from the Summary Plan Descriptions, the Summary
Plan Descriptions prevail.
© 2014 Lockton, Inc . All rights reserved .
Images © 2014 Thinkstock . All rights reserved .
[Rev 08/22/14] EB\NORTE08\Nortek Consolidated Group\EE Communications\Legal Notices\2015\Notices .pdf
