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Health Net to Send Notice of Insurance Marketplace

Sep 17, 2013

Health Net is mailing an important reminder to employer groups about two notices they must provide their employees within the next month: 1) Notice of the health insurance marketplaces, and 2) Pharmacy plan creditable coverage.

Delivering timely and relevant information is priority at Health Net. There are two notices that employers have to send to their employees in the coming weeks, if they haven’t already.

Health Net is mailing a letter to let them know about both notice requirements. California employer groups also are receiving important information about gender nondiscrimination for plans regulated by the Department of Managed Healthcare (DMHC).

So you have the details you need when meeting with your clients, Health Net has recapped the two notice requirements here.  

Notice of Marketplaces

Under the Affordable Care Act, employer groups of all sizes are required to notify employees about the health insurance marketplaces that will open on October 1, 2013. The deadline set by the Department of Labor (DOL) is October 1, 2013, to coincide with the initial open enrollment period for the marketplace. The written notification has to do three things:

  1. Tell employees about the health insurance marketplaces;
  2. State whether the employer offers a health plan that meets the minimum value standard; and
  3. Explain that if the employee purchases a qualified health plan through the marketplace, the employee may lose the employer contribution (if any) to any health benefits plan offered by the employer. 

The DOL has released model notices that employer groups can use to meet the requirement. There are versions for:

Pharmacy Plan Creditable Coverage Notification

Employer groups who provide prescription drug coverage through a group-sponsored health plan have to notify Medicare-eligible employees of the creditability status of their pharmacy plan.

Health Net has assessed their 2013–2014 pharmacy plans for creditability. Most are creditable, but some do not meet the actuarial value of the standard Medicare Part D benefit. Health Net is sending their group customers a list of pharmacy plans that are not creditable so they know what to tell employees, along with details for filing the Medicare-required “Online Disclosure to CMS Form.” 


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