Type of Disclosure
Applicability
Content Summary
When Provided
HIPAA certificate of creditable coverage (ß 701(e); 29 CFR 2590.701-5)
All group health plans.
Each certificate must include:
General notice of preexisting condition exclusion (29 CFR 2590.701-3(c))
Any group health plan that contains a preexisting condition exclusion.
The plan must disclose the existence and terms of any preexisting condition exclusion under the individual plan and the rights of individuals to demonstrate creditable coverage. This includes a description of the right of the individual to request a certificate from a prior plan or issuer and a statement that the current plan will assist in obtaining a certificate from any prior plan or issuer, if necessary.
Must be provided before a preexisting condition exclusion may be applied
Individual notice of preexisting condition exclusion (29 CFR 2590.701-5(d))
Group health plans that contain a preexisting condition exclusion, but only after receiving creditable coverage information from an individual that is not enough to offset the preexisting condition exclusion period.
This notice must include:
Within a reasonable time of the presentation of creditable coverage by the individual.
Notice of special enrollment rights (29 CFR 2590.701- 6(c))
All group health plans.
A description of the plan's special enrollment rules.
On or before the time an employee is offered an opportunity to enroll in the plan.
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