Legal Notices
Summary of Benefits and Coverage (SBC) & Uniform Glossary - As part of the Affordable Care Act (ACA), the federal government announced new rules regarding the disclosure of the Summary of Benefits and Coverage (SBC) and Uniform Glossary. These regulations require group health plans and health insurance issuers that offer coverage for groups and individuals to provide access to the SBC and Uniform Glossary.
Affordable Care Act | ACA - The Patient Protection and Affordable Care Act, known as the "Affordable Care Act" (ACA), has three stated objectives: to increase healthcare accessibility, affordability, and quality. The Affordable Care Act implemented and enforced the individual responsibility (also known as "Individual Mandate"), and the employer shared responsibility (also known as "Play-or-Pay") provisions to support these objectives.
Consolidated Omnibus Budget Reconciliation Act (COBRA) Coverage Notice - Notice of the Arizona Benefit Options Program COBRA Coverage. This notice has important information about your right to COBRA continuation coverage, which is a temporary extension of coverage under the Plan.
Health Insurance Marketplace Notice | ADOA - For State Employees - Key parts of the health care law (ACA) allow you to buy health insurance through the Health Insurance Marketplace. To assist you as you evaluate options for you and your family, a notice that provides some basic information about the new Marketplace and the Benefit Options health coverage is available.
Health Insurance Marketplace Notice | ASU - For ASU Employees - Key parts of the health care law (ACA) allow you to buy health insurance through the Health Insurance Marketplace. To assist you as you evaluate options for you and your family, a notice that provides some basic information about the new Marketplace and the Benefit Options health coverage is available.
Health Insurance Marketplace Notice | NAU - For NAU Employees - Key parts of the health care law (ACA) allow you to buy health insurance through the Health Insurance Marketplace. To assist you as you evaluate options for you and your family, a notice that provides some basic information about the new Marketplace and the Benefit Options health coverage is available.
Health Insurance Marketplace Notice | UArizona - For UA Employees - Key parts of the health care law (ACA) allow you to buy health insurance through the Health Insurance Marketplace. To assist you as you evaluate options for you and your family, a notice that provides some basic information about the new Marketplace and the Benefit Options health coverage is available.
Health Insurance Portability and Accountability Act (HIPAA) - This notice protects the privacy of individually identifiable health information and establishes who can use personal health information and how it can be used.
HIPAA | Special Enrollment Rights - The notice provides information regarding special enrollment. You may be able to enroll in the Benefit Options health plan without waiting for the next open enrollment period if you request a QLE change within 31 days of an event for loss of other coverage or birth, adoption or placement for adoption. In addition, you may enroll if you become eligible for a state premium assistance program under Medicaid or CHIP. You must request enrollment within 60 days after you gain eligibility for medical plan coverage.
IRS 1095-C Statement - The IRS 1095-C statement generated by the State of Arizona serves as documentation to the IRS about coverage offered to you. The information from the form will be used to determine whether you will pay a penalty for failing to have health care coverage as required by the ACA. Think of the form as your “proof of insurance” for the IRS.
Medicare Notice of Creditable Coverage - This notice has information about prescription drug coverage through the Benefit Options program for participants with Medicare. It explains the options you have under Medicare prescription drug coverage (Medicare Part D) and can help you decide whether or not you want to enroll.
Newborns’ and Mothers’ Health Protection Act of 1996 - This notice provides that health plans and issuers may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child for prescribing a length of stay not in excess of 48 hours (or 96 hours). The plan may not require that a provider obtain authorization from the Plan for prescribing the minimum length of stay.
No Surprises Act - This notice provides information regarding your rights and protections against surprise medical bills. You are protected from surprise billing or balance billing when you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center.
Notice of Non-Discrimination - Benefit Options complies with applicable Federal civil rights laws and does not discriminate, exclude or treat people differently based on their race, color, national origin, sex, age, or disability.
Patient Protection & Affordable Care Act (PPACA) - Notices of the Arizona Benefit Options Program in reference to PPACA.
Vision Insurance Privacy Notice—This notice informs members participating in the Avesis vision program how their health information will be collected, used, who will receive it, and what will be done to keep it confidential.
Wellness Program Privacy Notice - This notice requires employers that offer wellness programs that collect employee health information to inform employees what information will be collected, how it will be used, who will receive it, and what will be done to keep it confidential.
Women’s Health and Cancer Rights Act (WHCRA) - This notice describes mandated benefits for mastectomy-related services and informs individuals that services are available for such treatment and services, including reconstructive surgery, prosthesis, and lymphedema treatment, and explains how to obtain a detailed description of the mastectomy-related benefits under the Plan.