Page 11 - 2022 Fantasea Benefit Guide English_Spanish
P. 11
Important Plan Information
NOTICES NEWBORN AND MOTHERS HEALTH
Under Federal laws and regulations, you are required to PROTECTION ACT
receive certain health care notices to you upon joining the This notice provides information regarding
Plan(s) and/or on an annual basis. The following is a list overnight hospitals days for delivery and
of those notices and a brief description of each notice. newborn care.
WOMEN’S HEALTH AND CANCER RIGHTS ACT NOTICE OF PRIVACY PRACTICES
OF 1998 This notice provides information regarding the
This notice provides information regarding coverage Plan’s handling of your private health
available for Reconstructive Surgery following a information.
mastectomy.
WOMEN’S PREVENTIVE SERVICES
IMPORTANT NOTICE ABOUT YOUR UNDER THE AFFORDABLE CARE ACT
PRESCRIPTION DRUG COVERAGE AND This notice provides information regarding
MEDICARE preventive services that are covered in
This notice provides information regarding prescription accordance with the Affordable Care Act.
drug coverage available under the Plan and the impact to
enrolling in a Medicare Part D prescription drug plan.
SPECIAL ENROLLMENT / HIPAA
QUALIFIED EVENTS
CHILDREN’S HEALTH INSURANCE PROGRAM This notice provides information regarding
This notice provides information regarding States that special events in your life that allow you to
offer premium assistance to help pay for medical change your coverage elections with the Plan(s).
coverage for your children.
To obtain a full copy of the above notices,
COBRA GENERAL NOTICE please visit Paylocity and review the Summary
This notice provides information regarding your ability to of Benefits & Coverage or Full Plan
continue the Plan(s) coverage in the event that you cease Certificates.
to be covered by the Plan(s) as active employee or
dependent.
NEW HEALTH INSURANCE MARKETPLACE
COVERAGE OPTIONS AND YOUR HEALTH
COVERAGE
This notice provides information regarding available
coverage in the Health Insurance Marketplace.
To obtain a full copy of the above notices, please visit the
Paylocity.
