Women’s Health and Cancer Rights Act (WHCRA) The Women’s Health and Cancer Rights Act (WHCRA) provides protections for individuals who elect breast reconstruction after a mastectomy. Under WHCRA, group health plans offering mastectomy coverage must also provide coverage for certain services relating to the mastectomy, in a manner determined in consultation with the attending physician and the patient. Required coverage includes all stages of reconstruction of the other breast to produce a symmetrical appearance, prostheses and treatment of physical compilations of the mastectomy, including lymph edema. Click Here to View a Copy of the Notice.
Medicaid and the Child Health Insurance Program (CHIP) If you or your dependent(s) are not currently enrolled in Medicaid or CHIP and you think your dependents might be eligible, you can contact the Ohio Medicaid or CHIP office or dial 1-877-KIDS-NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, you can ask the State if it has a program that might help you pay the premiums for an employer-sponsored plan. Once it is determined that you or your dependent(s) are eligible for premium assistance under Medicaid or CHIP, your employer’s health plan is required to permit your dependent(s) to enroll in the plan – as long as you and your dependents are eligible, but not already enrolled in the employer’s plan. You have 60 days to request coverage after it is determined you are eligible for premium assistance. Click Here to View a Copy of the Notice.
Continuation Coverage under COBRA COBRA continuation coverage is a continuation of employee health benefits coverage when it would otherwise end because of a life event. This is also called a “qualifying event.” Specific qualifying events are listed HERE on this site. After a qualifying event, COBRA continuation coverage must be offered to each person who is a “qualified beneficiary.” You, your spouse, and your dependent children could become qualified beneficiaries if coverage under the Plan is lost because of the qualifying event. Qualified beneficiaries who elect COBRA continuation coverage must pay for COBRA continuation coverage.
Reporting Employer-Provided Health Coverage in Form W-2 The Affordable Care Act requires employers to report the cost of coverage under an employer-sponsored group health plan on an employee’s Form W-2, Wage and Tax Statement, in Box 12, using Code DD. Many employers are eligible for transition relief for tax-year 2012 and beyond, until the IRS issues final guidance for this reporting requirement. In general, the amount reported should include both the portion paid by the employer and the portion paid by the employee. This reporting is now required, not only to show employees the value of their health care benefits so they can be more informed consumers, but as of the 2014 tax year, for the purpose of reporting your health care enrollment compliance.
HIPAA Notice of Privacy Practices Our Commitment Regarding Your Personal Health Information The City of Akron is committed to maintaining and protecting the confidentiality of our employees’ personal health information. Each health plan entity is required by federal and state law to protect the privacy of your individually identifiable health information and other plan information, known as Protected Health Information (PHI). You’ll receive Privacy Notices from each responsible entity after your initial enrollment and periodically as may be necessary. Click Here to View a Copy of the Notice.
Medicare Part D Notice Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription-drug coverage. All Medicare prescription-drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium. The City of Akron has determined that the prescription-drug coverage offered by the City’s health plan is, on average for all plan participants, expected to pay out as much as standard Medicare prescription-drug coverage pays and is, therefore, considered Creditable Coverage. Because your existing coverage, is on average, at least as good as standard Medicare prescription drug coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan. Click Here to View a Copy of the Notice.
Patient Protection Disclosure The City of Akron Health Benefits plan will continue to not require employees to designate a primary-care provider for themselves or their dependents. All members are encouraged to use providers who participate in our network and who are available to accept you or your covered dependents as patients. As has been our practice, you do not need prior authorization from our plan or from any other person (including a primary-care provider) in order to obtain access to obstetrical or gynecological care from a healthcare professional in our network who specializes in obstetrics or gynecology. The same is true of other specialties such as orthopedics. The healthcare provider however, may be required to comply with certain procedures, such as obtaining prior authorization for certain services, following a pre-approved treatment plan, or procedures for making referrals.