Page 25 - TCM EE Guide 2019 v2 Non CA FINAL

Annual ACA

Notices The Affordable Care Act (ACA) requires

applicable large employers to make
affordable coverage available to their
employees or risk paying a penalty. Although

Teacher Created Materials plans are partially arranged by the individual mandate is no longer effective
beginning January 1, 2019, it is important
Teacher Created Materials and governed by it’s plan rules
and documents. ERISA and various other state and federal that you understand your options for health
laws require that employers provide disclosure and annual insurance coverage. You may consider these
notices to their plan participants. Teacher Created Materials options below:
has posted all federally required annual notices on Paycom  Enroll in a medical plan offered by
for you to download and read at your convenience. Teacher Created Materials or another
group plan
The following are a list of Annual Notices:  Purchase coverage through a health
 Medicare Part D Notice of Creditable Coverage: Plans insurance marketplace
are required to provide each covered participant and  Enroll in coverage through a government
dependent a Certificate of Creditable Coverage to qualify -sponsored program if eligible
for enrollment in Medicare Part D prescription drug
coverage when qualified without a penalty. Because Teacher Created Materials’ medical
 HIPAA Notice of Privacy Practices: This notice is plans are considered affordable and meet
intended to inform employees of the privacy practices minimum value under the Affordable Care
followed by Teacher Created Materials’ group health Act, you will not generally see lower
plan. It also explains the federal privacy rights afforded premiums or out-of-pocket costs through the
to you and the members of your family as plan marketplace. In addition, employer
participants covered under a group plan. contributions to your medical benefits will be
 Women's Health and Cancer Rights Act (WHCRA): This lost if you choose to purchase coverage
act contains important protections for breast cancer through the marketplace, and your portion of
patients who choose breast reconstruction with a medical premiums will no longer be paid via
payroll deductions on a pre-tax basis.
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 Go to www.healthcare.gov.
entitled to certain special enrollment rights outside of
Teacher Created Materials’ 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.

Employee Benefits 25