The Department of Labor (DOL) has released updated forms for CHIP Model Notices, Exchange Notices, and SAR

The Department of Labor (DOL) has recently updated several of its model notices and forms, including the following:

• The CHIP Model Notice used to satisfy the annual notice requirement of the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA). English and Spanish versions are available here and here, respectively.
• The Health Insurance Exchange Notice required to be provided to new hires under the Affordable Care Act (ACA). English and Spanish versions are available here and here.
• Summary Annual Report (SAR) Form, summarizing the information contained in the Form 5500 for plans subject to ERISA’s Form 5500 reporting requirement. The version for plan years beginning in 2023 and later to be used by welfare benefit plans is available here.

Employer Action Items

Employers should review the new versions of the model notices and update their notices accordingly to comply with the model language. Going forward, employers should use the updated model versions. With respect to the updated SAR form, employers should confirm that their Form 5500 preparer has updated its program to reflect the most recent version.

Please note that the use of the Federal model notices is optional for employers. They can choose to prepare their own notices or modify the model notices to provide more comprehensive information. However, they should include at least the minimum up-to-date information in the model notices.

Summary

CHIP Notice

CHIPRA imposes an annual notice requirement on employers that maintain group health plans in states that provide premium assistance subsidies under a Medicaid plan or a Children’s Health Insurance Plan (CHIP). An employer is subject to this annual notice requirement if its group health plan covers participants who reside in a state that provides a premium assistance subsidy, regardless of the employer’s location.

The Federal model CHIP Notice is updated periodically to reflect the most current contact information for those states that offer premium assistance subsidies. The latest notice includes information current as of January 31, 2024.

Health Insurance Exchange Notices

The ACA requires all employers (regardless of size) to provide new hires with a written notice about the health insurance Exchanges, or Marketplaces, within 14 days from their start date. This notice is also referred to as the “Notice of Coverage Options.” Two model notices are available, one can be used for employers who offer a health plan to some or all its employees, and the other, for employers who do not offer a health plan.

Both versions of the model notices were recently updated to include the affordability threshold for purposes of the ACA’s employer shared responsibility rules, information on Exchange special enrollment periods, how the COVID-19 public health emergency affected eligibility for Medicaid and CHIP coverage, and optional information corresponding to the Marketplace Employer Coverage Tool. This was the first update made to the notices in many years.

SAR Form

The SAR is a narrative summary of the information contained in the Form 5500 and must be provided annually by administrators of plans subject to Form 5500’s annual reporting requirements. The SAR must be provided within two months after the Form 5500 filing, which for plans that do not file an extension, is nine months after the close of the plan year. Federal agencies released model forms for plan years beginning in 2023 and later. Note there were no substantive changes to the forms to those of the previous plan year.

Planned Future Updates

According to Department FAQs issued on November 28, 2023, federal agencies intend to update the following documents in the future:

• Summary of Benefits and Coverage (SBC) template and sample completed SBCs in English (with updated taglines in applicable non-English languages).
• Additional translated versions of the SBC and Uniform Glossary.
• Model notices for internal claims and appeals and external review (with updated taglines in applicable non-English languages).

These updates are intended to reflect updated guidance pertaining to 2023 Culturally and Linguistically Appropriate Services County Data.

More Information

Please read here for further information regarding CHIPRA. See here for additional information regarding ACA’s Exchange Notice requirements, and here for the updated SAR form to be used by plan sponsors of retirement plans.

This Legislative Update was prepared by the Baldwin Regulatory Compliance Collaborative (the “BRCC”), a partnership of compliance professionals offering client support and compliance solutions for the benefit of the Baldwin Risk Partners organization, which includes: Jason Sheffield, BRP National Director of Compliance; Richard Asensio, Burnham Benefits Insurance Services; Nicole L. Fender, the Capital Group; Bill Freeman, AHT Insurance; Stephanie Hall, RBA/TBA; Caitlin Hillenbrand, AHT Insurance; Paul Van Brunt, Baldwin Krystyn Sherman Partners (BKS); and Natashia Wright, Insgroup.

Burnham Benefits and the BRCC do not engage in the practice of law and this publication should not be construed as the providing of legal advice or a legal opinion of any kind. The consulting advice we provide is intended solely to assist in assessing its compliance with applicable federal and state law requirements, and is based on our interpretation of federal guidance in effect as of the date of this publication. To the best of our knowledge, the information provided herein, and assumptions relied on, are reasonable and accurate as of the date of this publication. Furthermore, to ensure compliance with IRS Circular 230, any tax advice contained in this publication is not intended to be used, and cannot be used, for purposes of (i) avoiding penalties imposed under the United States Internal Revenue Code or (ii) promoting, marketing or recommending to another person any tax-related matter.