This article contains various disclosure notices related to our employee benefits program, along with a brief description of each disclosure.
Statement of ERISA Rights
As a participant in the Greenville University Health and Welfare Plan and/or the health flexible spending account under Greenville University’s Cafeteria Plan you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA). Plan Participants are entitled to:
- Receive Information About Your Plan and Benefits.
- Review all Plan Documents on Campus Services Solutions Summary Plan Description where they reside electronically for convenient downloading.
- Examine, without charge, at the Plan Administrator’s office, and at other specified locations, such as worksites, all documents governing the Plan including insurance contracts and a copy of the latest annual report (Form 5500 Series) filed by the Plan with the U.S. Department of Labor and available at the Public Disclosure Room of the Employee Benefits Security Administration.
- Obtain copies of all Plan documents governing the operation of the plan, including insurance contracts and copies of the latest annual report (Form 5500 Series) and an updated Summary Plan Description, upon written request to the Plan Administrator. The Plan Administrator may make a reasonable charge for the copies.
- Receive a summary of the Plan’s annual financial report. The Plan Administrator is required by law to furnish each Participant with a copy of this Summary Annual Report (attached 2022 SAR.pdf).
Summary of Benefits and Coverage (SBC)
Provide the current SBCs for all offered medical insurance plans. Please note: SBCs for the plan year beginning 1/2/2024 will be sent out at the time of open enrollment (usually mid-November). The current SBCs can be found attached to the Medical Insurance article.
Health Insurance Marketplace Coverage Options and Your Health Coverage
Under the Patient Protection and Affordable Care Act of 2010 (ACA for short), employers who maintain group health plans must send the attached notice to every employee to comply with the rules under the ACA. This notice provides you with instructions on accessing information about the Health Insurance Marketplace, which are health plans offered to you by either your state or the U.S. Department of Health and Human Services. See the attached Marketplace Notice.pdf for more information.
Medicare Modernization Act of 2003 (MMA)
Under the Medicare Modernization Act of 2003 (MMA), any plan that currently provides prescription drug coverage to Medicare-eligible participants must annually disclose whether the plan's coverage is "creditable prescription drug coverage." Attached is the notice from Greenville University about your prescription drug coverage and Medicare (see the attached 2023 Medicare Part D.pdf). This notice communicates that Greenville University has determined that the prescription drug coverage offered by the Greenville University Health Insurance Plan is, on average, for all plan participants, expected to pay out as much as the standard Medicare prescription drug coverage will pay.
Please read and keep the attached 2023 Medicare Part D.pdf notice. If you enroll in one of the plans approved by Medicare which offers prescription drug coverage, you may need to give a copy of this notice when you join to show you are not required to pay a higher premium.
Greenville University, in accordance with HIPAA, protects your Protected Health Information (PHI) that is created or received by its group health plan. Greenville University will only use and disclose your PHI as permitted or as mandated by law. A copy of the Notice of Privacy Practices, which describes the manner in which your PHI may be used or disclosed, is available upon request to firstname.lastname@example.org.
HIPAA Special Enrollment (Qualifying Life Events) Rights
If you have declined enrollment of benefits for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll yourself and your dependents in one of GU’s plans if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing toward 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. To request special enrollment or obtain more information, go to the Special Enrollments Article. If you have problems completing your Qualifying Life Event, contact Jo Branscome at (618) 664-7010.
Women’s Health Act
The Women’s Health and Cancer Rights Act of 1998 requires that all health insurance plans that cover mastectomy also cover the following medical care: Reconstruction of the breast on which the mastectomy was performed; Surgery and reconstruction of the other breast to produce a symmetrical appearance; Prosthesis and treatment of physical complications at all stages of the mastectomy, include lymphedemas; and mastectomy bras and external prostheses limited to the lowest cost alternative available that meets the patient’s physical needs. Find more information on the attached WHCRA Addl Info.pdf.
Premium Assistance Under Medicaid and the Children's Health Insurance Program (CHIP)
Under the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA, Pub. L. 111-3), employers who maintain group health plans are required to notify all employees of their potential CHIPRA special rights to receive premium assistance under a state's Medicaid and/or the Children's Health Insurance Program (CHIP). This notification requirement applies to the 38 states currently providing premium assistance programs. Currently, twelve states, including Illinois and Tennessee, DO NOT offer a premium assistance program.
Additional information is available by calling 1-877-KIDS NOW or (www.insurekidsnow.gov).
The following 12 states DO NOT provide a premium assistance program:
- Arizona - Connecticut - Delaware
- Hawaii - Idaho - Illinois
- Maryland - Michigan - Mississippi
- New Mexico - Ohio - Tennessee
See the attached 2023 Chip model-notice.pdf for more information.
Notice of Patient Protections or the No Surprises Act
The No Surprises Act protects people covered under group and individual health plans from receiving surprise medical bills when they receive most emergency services, non-emergency services from out-of-network providers at in-network facilities, and services from out-of-network air ambulance service providers. See the attached GU-No Surprises Act.pdf
Newborns’ and Mothers’ Health Protection Act
Federal law prohibits health plans from limiting a mother’s or newborn’s length of hospital stay to less than 48 hours for a vaginal delivery or 96 hours for a cesarean delivery or from requiring the provider to obtain preauthorization for a stay of 48 or 96 hours, as appropriate. However, federal law generally does not prohibit the mother’s or newborn’s attending provider, after consultation with the mother, from discharging the mother or her newborn earlier than 48 hours for vaginal delivery or 96 hours for cesarean delivery.
Continuation Coverage Rights Under COBRA
COBRA is a Federal law that provides rights to temporary continuation of group health plan coverage for certain employees, retirees, and family members at group rates when coverage is lost due to certain qualifying events. See the COBRA general-notice.pdf for more information.
Universal Availability Notice
The attached 2024 Universal Availability.pdf notice relates to the Greenville University Retirement Plan and advises you of your right to participate.
While the University intends to continue each benefit plan, the University reserves the right to cancel or change the benefit plans and programs it offers to its employees at any time and for any reason.
Receiving or reviewing these notices does not mean you are eligible for or participating in the College benefit plans. You must meet the eligibility requirements outlined for each benefit plan and be enrolled.
To obtain more information, contact the Risk Management & Insurance office at 618-664-7010.