Page 19 - The Raymond Group Supplemental Benefit Guide

ANNUAL ACA

NOTICES

Even though the Affordable Care Act (ACA)’s
penalty for not having health coverage (known as
the individual mandate) has been reduced to zero,
if you are a taxpayer in California, you will still be
The Raymond Group plans are partially arranged by The Raymond required to have health coverage (unless you
Group and governed by it’s plan rules and documents. ERISA and qualify for an exemption) or pay a penalty for the
various other state and federal laws require that employers provide 2020 tax year. In addition, several other states,
disclosure and annual notices to their plan participants. The including Massachusetts, New Jersey, and Vermont,
Raymond Group distributes annual notices to new-hires, and each as well as the District of Columbia, have reinstated
year during open enrollment. You may also request a copy by an individual mandate requirement, and others are
contacting the Human Resources Department. considering doing so.

The following are a list of Annual Notices: You may consider these options below to satisfy
• Medicare Part D Notice of Creditable Coverage: Plans are this requirement:
required to provide each covered participant and dependent a • Enroll in a medical plan offered by The
Certificate of Creditable Coverage to qualify for enrollment in Raymond Group or another group medical plan
Medicare Part D prescription drug coverage when qualified meeting the requirements for minimum
without a penalty. essential coverage;
• HIPAA Notice of Privacy Practices: This notice is intended to • Purchase coverage through a health insurance
inform employees of the privacy practices followed by The marketplace;
Raymond Group’s group health plan. It also explains the federal • Enroll in coverage through a government-
privacy rights afforded to you and the members of your family as sponsored program if eligible.
plan participants covered under a group plan.
• Women's Health and Cancer Rights Act (WHCRA): This act However, if you choose to purchase coverage
contains important protections for breast cancer patients who through the marketplace, because The Raymond
choose breast reconstruction with a mastectomy. Group’s medical plans are considered affordable
• Newborns’ and Mothers’ Health Protection Act: This act affects and meet minimum value under the Affordable
the amount of time a mother and her newborn child are covered Care Act, you may not be eligible for a subsidy, and
for a hospital stay following childbirth. you may not see lower premiums or out-of-pocket
• Special Enrollment Rights: Plan participants are entitled to costs through the marketplace. In addition,
certain special enrollment rights outside of The Raymond employer contributions to your medical benefits
Group’s open enrollment period. This notice provides will be lost and your portion of medical premiums
information on special enrollment periods for loss of prior will no longer be paid via payroll deductions on a
coverage or the addition of a new dependent. pre-tax basis
• Medicaid & Children’s Health Insurance Program: Some states
offer premium assistance programs for those who are eligible for
health coverage from their employers, but are unable to afford
the premiums. This notice provides information on how to For More Information
determine if your state offers a premium assistance program. Go to healthcare.gov
• Summary of Benefits and Coverage (SBC): Health insurance
issuers and group health plans are required to provide you with
an easy-to-understand summary about your health plan’s
benefits and coverage.

Employee Benefits 19