Page 18 - 2021 Marcolin Benefit Guide
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Important Notices
EMPLOYEE RETIREMENT INC.OME SECURITY ACT (ERISA)
The Employee Retirement Income Security Act (ERISA) requires plan administrators - the people who manage plans -
to give plan participants in writing the most important facts they need to know about their retirement and health
benefit plans including plan rules, financial information, and documents on the operation and management of the
plan. Some of these facts must be provided to participants regularly and automatically by the plan administrator.
Upon written request, others are available, free-of-charge for minimal copying fees.
CONSOLIDATED OMNIBUS BUDGET RECONCILIATION ACT (COBRA)
The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health
benefits the right to choose to continue group health benefits provided by their group health plan for limited periods
of time under certain circumstances such as voluntary or involuntary job loss, reduction the hours worked, transition
between jobs, death, divorce, and other life events. Qualified individuals may be required to pay the entire premium
for coverage up to 102 percent of the cost to the plan.
HEALTH INSURANCE PORTATIBLITY AND ACCOUNTABILITY ACT (HIPAA)
The Health Insurance Portability and Accountability Act (HIPAA) provide rights and protections for participants and
beneficiaries in group health plans. HIPAA prohibits discrimination against Associates and dependents based on their
health status; and allow a special opportunity to enroll in a new plan to individuals in certain circumstances. HIPAA
may also give participants a right to purchase individual coverage if no group health plan coverage is available and
have exhausted COBRA or other continuation coverage.
MENTAL HEALTH PARITY AND ADDICTION ACT EQUITY ACT OF 2008
This act expands the mental health parity requirements in the Employee Retirement Income Security Act, the
Internal Revenue Code and the Public Health Services Act by imposing new mandates on group health plans that
provide both medical and surgical benefits and mental health or substance abuse disorder benefits. Among the new
requirements, such plans (or the health insurance coverage offered in connection with such plans) must ensure that
the financial requirements applicable to mental health or substance abuse disorder benefits are no more restrictive
than the predominant financial requirements applied to substantially all medical and surgical benefits covered by the
plan (or coverage), and there are no separate cost sharing requirements that are applicable only with respect to
mental health or substance abuse disorder benefits.
NEWBORNS AND MOTHERS HEALTH PROTECTION ACT
The Newborns and Mothers Health Protection Act (Newborns Act) requires group health plans that offer maternity
hospital benefits for mothers and newborns to pay for at least a 48-hour hospital stay for the mother and newborn
following childbirth (or, in the case of a cesarean section, 96-hour hospital stay), unless the attending provider, in
consultation with the mother, decides to discharge earlier.
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