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Aug21

HIPAA Notification Periods

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We are coming up on the 10-year point of our HIPAA plan. I understand that we have to take special action at the 10-year mark. Can you give me more information?

Sure. Every employer is required to submit is Summary Plan Description (SPD) every ten years as long as there are no plan changes to an employee policy or to the company policy. If there are plan changes, then you need to submit those SPDs every five years. If there are changes to the plan in between the five and ten-year marks, then you should submit what is called an SMM, which will then be included as an SPD appendix. The SMM and SPD are given to the new employees of your company when they are hired and become eligible for benefits. However, if an employer prefers, it can update the SPD instead of issuing the SMM.

Employers are required to improve their SPD and SMMs regularly so that employees will know what the terms of the plan are and so that the information is accurate when they need it. When the plans are updated, the goal is to convey some key pieces of information, including:

Participants and beneficiaries need to be notified regarding reductions in covered expenses, benefits, and increases in deductibles and co-payments. This notification needs to be made within 60 days of the change.

Participants and beneficiaries need to be told about the role of the HMO and the group health plan.  The participants should always know how to go through administrative steps, payment of claims and so forth.

Finally, the employer is required to provide information about where the employees can find assistance or further information about the plan or policy. This information can be obtained from the Department of Labor.

As such, you will need to regularly update your particular information and tell your employees about and changes that affect them. However, unless there has been a major change, you only need to update this information every five or 10 years.

This entry was posted on Tuesday, August 21st, 2007 at 11:34 pm and is filed under
Benefits, Compensation, Human Resources Management, Labor Laws.
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