This communication serves as a reminder of the annual notices that must be provided to plan participants and employees. For health plans with a calendar year plan year, plan sponsors typically include these notices with open enrollment materials. For health plans with a plan year other than a calendar year, the notices may be distributed during the next open enrollment period, unless otherwise noted below.
For your convenience, all of the notices more fully described below can be found here in a single document for easy distribution to plan participants. Most documents contain customizable fields that need to be tailored to your specific health plan. Please review and customize each notice carefully prior to distribution.
Creditable Prescription Drug Coverage
The Centers for Medicare and Medicaid Services (CMS) require that the appropriate Notice of Creditable Prescription Drug Coverage be issued annually to all Medicare-eligible plan participants prior to the Medicare Part D annual open enrollment period. (Learn more on the CMS website). The 2025 open enrollment period runs from October 15, 2025, through December 7, 2025. Therefore, for the calendar year 2026, the notice must be issued prior to October 15, 2025.
This notice permits some customization; highlighted sections can be completed with information about your plan and individual recipients.
Creditable Coverage Disclosure to CMS
Group health plans providing prescription drug coverage to Medicare-eligible participants must submit a Creditable Coverage Disclosure to CMS annually and upon any changes affecting creditable status. This disclosure is due within 60 days after the plan year begins. (Example: For a January 1 – December 31 plan year, the disclosure is due by March 1, 2026.)
Children’s Health Insurance Program Reauthorization Act
This act requires annual notice to all benefit-eligible employees. The notice may be included with other health plan materials but should be presented separately so employees understand its significance. We recommend providing this notice with annual enrollment materials or no later than the first day of your plan year.
Employer-Sponsored Wellness Programs
Under the Americans with Disabilities Act (ADA), employers offering wellness programs that collect employee health information must provide a notice informing employees about:
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What information will be collected,
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How it will be used,
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Who will receive it, and
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How confidentiality will be maintained.
The requirement applies to the health plan year used to calculate any incentives offered as part of the wellness program. Employees must receive the notice before providing any health information, and with enough time to decide whether to participate.
We recommend providing this notice along with open enrollment materials. This notice requires customization tailored to your wellness program. For assistance, please consult your MedCost Account Manager.
Health Insurance Marketplace Coverage Options
Employers subject to the Fair Labor Standards Act must provide a notice of coverage options to each employee, regardless of enrollment status or full-/part-time status. The notice must be provided to new employees upon hire and may be included with other materials but should be presented separately. We recommend including this notice with open enrollment materials annually.
Newborns’ and Mothers’ Health Protection Act
Under federal law, health plans and issuers may not restrict hospital stays after childbirth to less than 48 hours for a vaginal delivery or 96 hours for a cesarean delivery. We recommend including this notice with open enrollment materials annually.
No Surprises Act
MedCost integrated the member rights and protections notice under the No Surprises Act into our plan documents (SPDs). The notice is also available on MedCost.com. We recommend including this notice with open enrollment materials annually.
Nondiscrimination and Accessibility
The nondiscrimination rules under Section 1557 of the Affordable Care Act (ACA), issued in 2016, required covered entities to post a consumer civil rights notice. (Please consult your legal counsel to determine whether your organization is a covered entity under Section 1557.)
In June 2020, the U.S. Department of Health and Human Services (HHS) repealed and replaced significant portions of these rules. The 2020 regulations eliminated the requirement to include nondiscrimination notices, instead requiring "reasonable steps" to ensure meaningful access for individuals with limited English proficiency.
Covered entities should decide whether to include this notice going forward based on whether it is part of their "reasonable steps" to ensure meaningful access.
Notice of Privacy Practices
The Health Insurance Portability and Accountability Act (HIPAA) requires that each plan participant receive a Notice of Privacy Practices at least once every three years. The enclosed Notice of Privacy Practices is based on a model that meets HIPAA requirements. If your plan has a customized notice, you should issue that notice instead. To simplify recordkeeping, we recommend distributing this notice annually to all plan participants.
Women’s Health and Cancer Rights Act
Group health plans must provide written notice annually to each plan participant regarding coverage required by this federal mandate. A separate notice must be sent to each participant with a different last-known address from the covered employee. We recommend providing this annual notice no later than January 31, 2026, for the plan year January 1 – December 31.
If you have any questions regarding the contents or the requirements of these model notices, please contact your MedCost Account Manager.