Page 3 - CA Benefit Guide Shepard Bros 8-17

ENROLLMENT INFORMATION

Changes To Enrollment
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Our benefit plans are effective August 1 , 2017 through July 31, 2018 this year. There is an annual open enrollment period each
year, during which you can make new benefit elections for the following effective date. Once you make your benefit elections, you
cannot change them during the year unless you experience a qualified change in family status as defined by the IRS. Examples
include, but are not limited to the following:
• Marriage, divorce, legal separation or annulment • Change in your residence or workplace (if your benefit
• Birth or adoption of a child options change)
• A qualified medical child support order • Loss of coverage through Medicaid or Children’s Health
• Death of a spouse or child Insurance Program (CHIP)
• A change in your dependent’s eligibility status • Becoming eligible for a state’s premium assistance
• Loss of coverage from another health plan program under Medicaid or CHIP

Please note that coverage for a new dependent is not automatic. If you experience a change in family status, you have 30 days to
update your coverage. Please contact the Human Resources Department immediately to complete the appropriate election forms
as needed. If you do not update your coverage within 30 days from the family status change, you must wait until the annual open
enrollment period to update your coverage.

THE AFFORDABLE CARE ACT AND YOU

The Affordable Care Act (ACA) has created new options for purchasing health insurance coverage through a Fed-
eral Health Insurance Marketplace.

Because Shepard Bros’ medical plans are considered affordable and meet minimum value under Health Care
Reform, eligible employees will not generally see lower premiums or out-of-pocket costs through the market-
place. In addition, employer contributions to your medical benefits will be lost if you choose to purchase cover-
age through the marketplace, and your portion of medical premiums will no longer be paid via payroll deduc-
tions on a pre-tax basis.

For more information, please visit www.healthcare.gov.

ANNUAL NOTICES

ERISA and various other state and federal laws require that employers provide disclosure and annual notices to their plan
participants. To view the Shepard Bros. annual notice packet, please refer to our company intranet or you may contact the Human
Resources Department.

The following is a brief description of these notices.

• Medicare Part D Notice of Creditable Coverage
• HIPAA Notice of Privacy Practices
• Women's Health and Cancer Rights Act (WHCRA)
• Newborns’ and Mothers’ Health Protection Act
• Special Enrollment Rights
• Medicaid & Children’s Health Insurance Program

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