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Notice to Enrollees Regarding Opt-Out Election

Notifies enrollees that the plan has opted out of certain federal mandates (self-funded non-federal governmental plans only). Customize the exempted requirements and coverage period.

Companies Eligible

Only self-funded non-federal governmental plans (state and local government employers) that have elected to opt out of certain federal mandates. Private employers: not applicable.

The election can cover mental health parity, the Newborns' Act, WHCRA and Michelle's Law. It cannot cover ACA market reforms. For every private-sector client, record N/A and why.

What it is

An annual notice telling enrollees which federal requirements the plan has opted out of for the plan year, and what that means for their coverage.

What needs to be done

  • When: The election is filed with CMS before the plan year starts and renewed each year; the notice goes to enrollees at enrollment and annually.
  • To whom: Enrollees.
  • Who performs: The governmental employer. AAB assists only where a client is a governmental plan.
  • Customize: The requirements opted out of, the plan year dates and the plan contact.
  • Deliver: With enrollment materials.
  • Keep: The CMS election confirmation for each plan year.

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