Page 26 - QSC EE Guide 01-20 SLO

The Affordable Care Act (ACA) requires

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

QSC plans are partially arranged by QSC and governed by it’s the individual mandate is no longer effective
beginning January 1, 2019, it is important
plan rules and documents. ERISA and various other state
and federal laws require that employers provide disclosure that you understand your options for health
and annual notices to their plan participants. QSC has insurance coverage. You may consider these
posted all federally required annual notices on UltiPro for options below:
you to download and read at your convenience. • Enroll in a medical plan offered by QSC 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 are insurance marketplace
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 QSC’s medical plans are considered
• HIPAA Notice of Privacy Practices: This notice is intended affordable and meet minimum value under
to inform employees of the privacy practices followed by the Affordable Care Act, you will not
QSC’ group health plan. It also explains the federal generally see lower premiums or out-of-
privacy rights afforded to you and the members of your pocket costs through the marketplace. In
family as plan participants covered under a group plan. addition, employer contributions to your
• Women's Health and Cancer Rights Act (WHCRA): This medical benefits will be lost if you choose to
purchase coverage through the marketplace,
act contains important protections for breast cancer
patients who choose breast reconstruction with a and your portion of medical premiums will
mastectomy. The U.S. Departments of Labor and Health no longer be paid via payroll deductions on a
and Human Services are in charge of this act of law pre-tax basis.
which applies to group health plans if the plans or
coverage provide medical and surgical benefits for a
mastectomy.
• Newborns’ and Mothers’ Health Protection Act: This act For More Information
affects the amount of time a mother and her newborn Go to www.healthcare.gov.
child are covered for a hospital stay following childbirth.
• Special Enrollment Rights: Plan participants are entitled
to certain special enrollment rights outside of QSC’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.