Page 22 - Lucas Sample Guide

The Affordable Care Act (ACA) requires applicable
large employers to make affordable coverage
available to their employees or risk paying a
penalty. Although the individual mandate is no
Lucas Museum plans are partially arranged by Lucas Museum and longer effective beginning January 1, 2019, it is
governed by it’s plan rules and documents. ERISA and various other important that you understand your options for
state and federal laws require that employers provide disclosure and health insurance coverage. You may consider these
annual notices to their plan participants. Lucas Museum distributes options below:
annual notices to new-hires, and each year during open enrollment. • Enroll in a medical plan offered by Lucas
You may also request a copy by contacting the Human Resources Museum or another group plan
Department, or download a copy from Ease. • Purchase coverage through a health insurance
marketplace
The following are a list of Annual Notices: • Enroll in coverage through a government-
• Medicare Part D Notice of Creditable Coverage: Plans are sponsored program if eligible
required to provide each covered participant and dependent a
Certificate of Creditable Coverage to qualify for enrollment in Because Lucas Museum’s medical plans are
Medicare Part D prescription drug coverage when qualified considered affordable and meet minimum value
without a penalty. under the Affordable Care Act, you will not
• HIPAA Notice of Privacy Practices: This notice is intended to generally see lower premiums or out-of-pocket
inform employees of the privacy practices followed by Lucas costs through the marketplace. In addition,
Museum’s group health plan. It also explains the federal privacy employer contributions to your medical benefits
rights afforded to you and the members of your family as plan will be lost if you choose to purchase coverage
participants covered under a group plan. through the marketplace, and your portion of
• Women's Health and Cancer Rights Act (WHCRA): This act medical premiums will no longer be paid via payroll
contains important protections for breast cancer patients who deductions on a pre-tax basis.
choose breast reconstruction with a mastectomy.
• Newborns’ and Mothers’ Health Protection Act: This act affects
the amount of time a mother and her newborn child are covered
for a hospital stay following childbirth. For More Information
• Special Enrollment Rights: Plan participants are entitled to Go to www.healthcare.gov.
certain special enrollment rights outside of Lucas Museum’s
open enrollment period. This notice provides information on
special enrollment periods for loss of prior coverage or the
addition of a new dependent.
• 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
determine if your state offers a premium assistance program.
• 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.