Page 30 - 2020 DAN Benefits Enrollment
P. 30
Legal Notices
If you have questions about the annual notices For these enrollment opportunities, you will have 60
available below or about the BeneitsPlus program, days – instead of 30 – from the date of the Medicaid/
contact the BeneitsPlus Solution Center at CHIP eligibility change to request enrollment in
1-855-326-7870. the BeneitsPlus group health plan. Note that this
new 60-day extension doesn’t apply to enrollment
State Provided Health Exchanges opportunities other than due to the Medicaid/CHIP
Individuals without health insurance may sign up eligibility change.
for standardized coverage through health insurance
marketplaces run either by their state, the federal WHCRA Annual Notice
government, or a combination of the two. Please see Do you know that your plan, as required by the
page 9 for the required health exchange notice. Women’s Health and Cancer Rights Act of 1998,
provides beneits for mastectomy-related services
Please note that in most cases you won’t be eligible for including all stages of reconstruc¬tion and surgery to
federal inancial assistance under a health exchange achieve symmetry between the breasts, prostheses,
plan because the company subsidizes a signiicant and complications resulting from a mastectomy,
portion of the cost of your medical coverage and our including lymphedema? Call the BeneitsPlus Solution
plans exceed minimum coverage standards. As a result, Center at (800) 765-6717 for more information.
in most cases it may be in your interest to keep your
coverage under the BeneitsPlus medical plan.
Statement of Rights under the Newborns’ and
Mothers’ Health Protection Act
Special Enrollment Notice Under federal law, group health plans and health
As you may know, if you have declined enrollment insurance issuers offering group health insurance
in the lexible BeneitsPlus Program for you or your coverage generally may not restrict beneits for any
dependents (including your spouse) because of other hospital length of stay in connection with childbirth
health insurance coverage, you or your dependents for the mother or newborn child to less than 48 hours
may be able to enroll in comparable coverage following a vaginal delivery, or fewer than 96 hours
under the program without waiting for the next following a delivery by cesarean section. However,
open enrollment period, provided that you request the plan or issuer may pay for a shorter stay if the
enrollment within 30 days after your other coverage attending provider (for example, your doctor, nurse
ends. In addition, if you have a new dependent as midwife, or physician assistant), after consultation with
a result of marriage, birth, adoption or placement the mother, discharges the mother or newborn earlier.
for adoption, you may be able to enroll yourself and Also, under federal law, plans and issuers may not set
your eligible dependents, provided that you request the level of beneits or out-of-pocket costs so that any
enrollment within 30 days after the marriage, birth, later portion of the 48-hour (or 96-hour) stay is treated
adoption or placement for adoption. in a manner less favorable to the mother or newborn
BeneitsPlus will also allow a special enrollment than any earlier portion of the stay.
opportunity if you or your eligible dependents either: In addition, a plan or issuer may not, under federal
• lose Medicaid or Children’s Health Insurance law, require that you, your physician, or other health
Program (CHIP) coverage because you are no longer care provider obtain authorization for prescribing a
eligible or length of stay of up to 48 hours (or 96 hours). However,
you may be required to obtain precer¬tiication for
• become eligible for a state’s premium assistance any days of coninement that exceeds 48 hours (or 96
program under Medicaid or CHIP. hours). For information on precertiication, contact your
plan administrator.
30 2020 Beneits Enrollment
If you have questions about the annual notices For these enrollment opportunities, you will have 60
available below or about the BeneitsPlus program, days – instead of 30 – from the date of the Medicaid/
contact the BeneitsPlus Solution Center at CHIP eligibility change to request enrollment in
1-855-326-7870. the BeneitsPlus group health plan. Note that this
new 60-day extension doesn’t apply to enrollment
State Provided Health Exchanges opportunities other than due to the Medicaid/CHIP
Individuals without health insurance may sign up eligibility change.
for standardized coverage through health insurance
marketplaces run either by their state, the federal WHCRA Annual Notice
government, or a combination of the two. Please see Do you know that your plan, as required by the
page 9 for the required health exchange notice. Women’s Health and Cancer Rights Act of 1998,
provides beneits for mastectomy-related services
Please note that in most cases you won’t be eligible for including all stages of reconstruc¬tion and surgery to
federal inancial assistance under a health exchange achieve symmetry between the breasts, prostheses,
plan because the company subsidizes a signiicant and complications resulting from a mastectomy,
portion of the cost of your medical coverage and our including lymphedema? Call the BeneitsPlus Solution
plans exceed minimum coverage standards. As a result, Center at (800) 765-6717 for more information.
in most cases it may be in your interest to keep your
coverage under the BeneitsPlus medical plan.
Statement of Rights under the Newborns’ and
Mothers’ Health Protection Act
Special Enrollment Notice Under federal law, group health plans and health
As you may know, if you have declined enrollment insurance issuers offering group health insurance
in the lexible BeneitsPlus Program for you or your coverage generally may not restrict beneits for any
dependents (including your spouse) because of other hospital length of stay in connection with childbirth
health insurance coverage, you or your dependents for the mother or newborn child to less than 48 hours
may be able to enroll in comparable coverage following a vaginal delivery, or fewer than 96 hours
under the program without waiting for the next following a delivery by cesarean section. However,
open enrollment period, provided that you request the plan or issuer may pay for a shorter stay if the
enrollment within 30 days after your other coverage attending provider (for example, your doctor, nurse
ends. In addition, if you have a new dependent as midwife, or physician assistant), after consultation with
a result of marriage, birth, adoption or placement the mother, discharges the mother or newborn earlier.
for adoption, you may be able to enroll yourself and Also, under federal law, plans and issuers may not set
your eligible dependents, provided that you request the level of beneits or out-of-pocket costs so that any
enrollment within 30 days after the marriage, birth, later portion of the 48-hour (or 96-hour) stay is treated
adoption or placement for adoption. in a manner less favorable to the mother or newborn
BeneitsPlus will also allow a special enrollment than any earlier portion of the stay.
opportunity if you or your eligible dependents either: In addition, a plan or issuer may not, under federal
• lose Medicaid or Children’s Health Insurance law, require that you, your physician, or other health
Program (CHIP) coverage because you are no longer care provider obtain authorization for prescribing a
eligible or length of stay of up to 48 hours (or 96 hours). However,
you may be required to obtain precer¬tiication for
• become eligible for a state’s premium assistance any days of coninement that exceeds 48 hours (or 96
program under Medicaid or CHIP. hours). For information on precertiication, contact your
plan administrator.
30 2020 Beneits Enrollment
