To prepare for open enrollment, group health plan sponsors should be aware of the legal changes affecting the design and administration of their plans for plan years beginning on or after Jan. 1, 2021. Employers should review their plan documents to confirm that they include these required changes.
In addition, any changes to a health plan’s benefits for the 2021 plan year should be communicated to plan participants through an updated summary plan description (SPD) or a summary of material modifications (SMM).
In this guide:
- Confirm that your plan’s out-of-pocket maximum complies with the ACA’s 2021 limits.
- For HDHPs, confirm that the plan’s deductible and out-of-pocket maximum comply with the 2021 limits.
- Communicate any plan design changes to employees as part of the open enrollment process.
- Notices to include – Annual CHIP notice, Medicare Part D creditable coverage notice, notice of grandfathered status and annual notice regarding coverage requirements for mastectomyrelated benefits (WHCRA notice).