- Health Benefits Advisor interactive Website assists employers in understanding and complying with federal group health plan laws
- Health Benefits Laws Self Compliance Tools
- Reporting/Disclosure Guide For Employee Benefit Plans – A quick reference tool for certain basic reporting and disclosure requirements under ERISA
- Understanding Your Fiduciary Responsibilities Under A Group Health Plan provides an overview of the basic fiduciary responsibilities applicable to health plans under ERISA
- Compliance Assistance Guide – Health Benefits Coverage Under Federal Law includes general descriptions of the four health care laws and FAQs. It also includes a self-compliance tool that can help to determine compliance with HIPAA, MHPA, the Newborns' Act, and WHCRA with compliance tips that relate to common mistakes. This publication also includes a chart summarizing the laws' notice requirements and provides model language that can be used to comply | Single Document Version large file
- HIPAA FAQs – The Health Insurance Portability and Accountability Act of 1996 (HIPAA), amended the Employee Retirement Income Security Act to provide new rights and protections for participants and beneficiaries in group health plans
- Final Regulations for HIPAA Health Coverage Portability
- Request for Information on Benefits-Specific Waiting Periods Under HIPAA
- Notice of Proposed Rulemaking for Health Coverage Portability: Tolling Certain Time Periods and Interaction With the FMLA Under HIPAA
- Nondiscrimination & Wellness Programs in Health Coverage in the Group Market – Final rules governing the HIPAA provisions regarding nondiscrimination based on a health factor and wellness program provisions for group health plans
- Notice of Changes under HIPAA to COBRA Continuation Coverage under Group Health Plans provides information to employers and operators of private-sector health plans about new requirements to notify workers of new changes in their continuation health benefit coverage, as required by HIPAA
- Health Disclosure and Claims Issues: FY 2001 Compliance Project Report – A review of group health plans for compliance with Part 7 of ERISA
- Fact Sheet
- Children's Health Insurance Program Working Goup
- Model Notice for Employers Regarding Premium Assistance Opportunities MS Word Format | Printer Friendly Version. Also available in Spanish MS Word Format | Printer Friendly Version
- Federal Register Notice
- Multiple Employer Welfare Arrangements Under ERISA (MEWA) – A booklet addressing many questions concerning the effect of ERISA on federal and state regulation of MEWAs
- How to Protect Your Employees when Purchasing Health Insurance – Tips that employers can use to help ensure that employees have the health care coverage they need
- The Form M-1 Online Filing System is an electronic filing system for the Form M-1 annual report for multiple employer welfare arrangements. The system allows filers to complete the form and submit it at no cost. This system is an example of an E-Government initiative which uses improved technology to make it easier for citizens and businesses to interact with the government
- Form M-1 Annual Report – This form is required to be filed under section 101(g) and section 734 of the Employee Retirement Income Security Act of 1974, as amended (ERISA), and 29 CFR 2520.101-2
- MEWA regulations/guidance under the ACA
- Group Health and Disability Plans Benefit Claims Procedure Regulation – A booklet on the rules that apply to group health and disability benefit claims
- Claims Procedure Final Rule – Final regulations revising the minimum requirements for benefit claims procedures of employee benefit plans covered by Title I of the ERISA
- COBRA Model General Notice | en español
- COBRA Model Election Notice | en español
- Model Notice for Employers Regarding Premium Assistance Opportunities MS Word Format | Printer Friendly Version. Also available in Spanish MS Word Format | Printer Friendly Version
- Model HIPAA, Newborns', WHCRA Notices
- GINA Research Exception Form
- Extension of Coverage for Adult Children Model Notice | en español
- Grandfathered health plans Model Notice | en español
- Revised Model Notice of Adverse Benefit Determination
- Revised Model Notice of Final Internal Adverse Benefit Determination
- Revised Model Notice of Final External Review Decision | en español
- Coverage Options Model Notice for employers who offer a health plan to some or all employees | MS Word Format | Printer Friendly Version | en español MS Word Format | Printer Friendly Version
- Coverage Options Model Notice for employers who do not offer a health plan | MS Word Format | Printer Friendly Version | en español MS Word Format | Printer Friendly Format
- Patient Protection Model Notice | en español
- Lifetime Limits Model Notice | en español
- Mental Health Parity Act Model Forms
- National Medical Support Notice - Part B
Summary of Benefits and Coverage (SBC) Templates, Instructions, and Related Materials – Currently Applicable
- Summary of Benefits and Coverage (SBC) Template | MS Word Format
- Sample Completed SBC | MS Word Format
- Instructions for Completing the SBC – Group Health Plan Coverage and Consumer Assistance Programs
- Instructions for Completing the SBC – Individual Health Insurance Coverage
- Why This Matters language for "Yes" Answers
- Why This Matters language for "No" Answers
- HHS Information For Simulating Coverage Examples
- HHS Coverage Example Calculator and Related Information
- Uniform Glossary of Coverage and Medical Terms
Summary of Benefits and Coverage (SBC) Templates, Instructions, and Related Materials – for use on or after 04/01/17 (Final)
- Summary of Benefits and Coverage (SBC) Template | MS Word Format
- Sample Completed SBC | MS Word Format
- Instructions for Completing the SBC - Group Health Plan Coverage and Consumer Assistance Programs
- Instructions for Completing the SBC - Individual Health Insurance Coverage
- Why This Matters language for "Yes" Answers
- Why This Matters language for "No" Answers
- HHS Information For Simulating Coverage Examples
- HHS Coverage Example Calculator and Related Information
- List of anchors for SBC Uniform Glossary terms
- Uniform Glossary of Coverage and Medical Terms
- HHS News Release
- Compliance Assistance Guide – Health Benefits Coverage Under Federal Law includes general descriptions of the four health care laws and FAQs. It also includes a self-compliance tool that can help to determine compliance with HIPAA, MHPA, the Newborns' Act, and WHCRA with compliance tips that relate to common mistakes. This publication also includes a chart summarizing the laws' notice requirements and provides model language that can be used to comply | Single Document Version large file
- Reporting/Disclosure Guide For Employee Benefit Plans – A quick reference tool for certain basic reporting and disclosure requirements under ERISA
- Understanding Your Fiduciary Responsibilities Under A Group Health Plan provides an overview of the basic fiduciary responsibilities applicable to health plans under ERISA
- An Employer's Guide to Group Health Continuation Coverage Under COBRA – The Consolidated Omnibus Budget Reconciliation Act of 1986 | en español
- Multiple Employer Welfare Arrangements Under ERISA (MEWA) – A booklet addressing many questions concerning the effect of ERISA on federal and state regulation of MEWAs
- How to Protect Your Employees when Purchasing Health Insurance – Tips that employers can use to help ensure that employees have the health care coverage they need
- Group Health and Disability Plans Benefit Claims Procedure Regulation – A booklet on the rules that apply to group health and disability benefit claims