LEGAL NOTICES
Federal regulations require Versiti to provide benefit eligible employees with the following important annual notices. For a complete copy of each notice contact Human Resources.
A portion of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) addresses the protection of confidential health information. It applies to all health benefit plans. In short, the idea is to make sure that confidential health information that identifies (or could be used to identify) you is kept completely confidential. This individually identifiable health information is known as “protected health information” (PHI), and it will not be used or disclosed without your written authorization, except as described in the Plans HIPAA Privacy Notice or as otherwise permitted by federal and state health information privacy laws, A copy of the Plan’s Notice of Privacy Practices that describes the Plan’s policies, practices and your rights with respect to your PHI under HIPAA is available from your medical plan provider. For more information regarding this Notice, please contact Human Resources or the medical plan directly.
Effective for plan renewals after January 1, 2012, the Patient Protection and Affordable Care Act requires employers that offer health coverage to provide a uniform Summary of Benefits and Coverage (SBC) to people who apply for and enroll in the health plan. This document contains the following:
〉 Four-page overview of plan benefits, cost sharing and limitations
〉 Required set of examples of how the plan works
〉 Phone number and internet address for obtaining copies of plan documents
〉 A Standard glossary of medical and insurance terms must also be available
The SBC will be updated each plan renewal to reflect applicable plan changes.
Versiti’s medical plans, as required by the Women’s Health and Cancer Rights Act of 1998, provides benefits for mastectomy-related services.
These services include:
〉 All stages of reconstruction of the breast on which the mastectomy was performed
〉 Surgery and reconstruction of the other breast to produce a symmetrical appearance
〉 Prostheses and treatment of physical complications resulting from mastectomy (including lymphedema)
This coverage will be provided in consultation with the attending physician and the patient, and will be subject to the same annual deductibles and coinsurance provisions that apply to the mastectomy. For more information, contact your medical plan provider.
If your coverage ends under the Plan, you may be entitled to elect continuation coverage (coverage that continues on in some form) in accordance with federal law.
If you selected continuation coverage under a prior plan which was then replaced by coverage under this Plan, continuation coverage will end as scheduled under the prior plan or in accordance with the terminating events listed here, whichever is earlier.
The annual open enrollment plan choices are available only once a year. The choices you make will remain in effect until the next annual open enrollment, unless you experience a qualifying event or lose eligibility under another plan. If you decline enrollment for yourself or your dependents (spouse or children) because of other medical insurance or group health plan coverage, you may be able to enroll yourself and your dependents in this plan or switch to another plan option for which you are eligible if
〉 You or your dependents lose eligibility for that other coverage; or
〉 The employer stops contributing towards your or your dependents’ other coverage.
However, you must request enrollment within 30 days after your or your dependents’ other coverage ends (or after the employer stops contributing toward the other coverage). In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must request enrollment within 30 days after the marriage, birth, adoption, or placement for adoption. The plan will also allow a special enrollment opportunity if you or your eligible dependent(s) either:
〉 Lose Medicaid or Children’s Health Insurance Program (CHIP) coverage because you are no longer eligible; or
〉 Become eligible for a state’s premium assistance program under Medicaid or CHIP.
For these enrollment opportunities, you will have 60 days from the date of the Medicaid/CHIP eligibility change to request enrollment in the group medical plan. This new 60-day period does not apply to any other special enrollment situations. To request Special Enrollment, or obtain more information, contact the Human Resources Department.
If you are called to active duty in the uniformed services, you may elect to continue coverage for you and your eligible dependents under USERRA. This continuation right runs concurrently with your continuation right under COBRA, explained below, and allows you to extend an 18-month continuation period to 24 months. You and your eligible dependents qualify for this extension if you are called into active or reserve duty, whether voluntary or involuntary, in the Armed Forces, the Army National Guard, the Air National Guard, full-time National Guard duty (under a federal, not a state, call-up), the commissioned corps of the Public Health Services and any other category of persons designated by the President of the United States.
Versiti provides a “Notice of Prescription Drug Creditable Coverage” to all Medicare eligible participants on an annual basis. This notice states that under Versiti’s medical plan, you have prescription drug coverage that is, on average, as generous as the standard Medicare Prescription Drug Coverage.
Employee Rights Under the Family and Medical Leave Act (FMLA)
FMLA-Notice-of-Rights-and-Responsibilities
WI and Federal FMLA – Notice-of-Rights-and-Responsibilities
Wisconsin Medical and Family Leave Act
Michigan Paid Medical Leave – Notice of Rights and Responsibilities
