Required Notices & Documents
HIPAA Notice of Privacy Rights
Medicaid and the Children's Health Insurance Program (CHIP)
If you are eligible for health coverage from your employer, but are unable to afford the premiums, some States have premiums assistance programs that can help pay for coverage. These States use funds from their Medicaid or CHIP programs to help people who are eligible for their employer-sponsored health coverage, but need assistance in paying their health premiums.
PPACA - Notice of Coverage Options
When key parts of the health care reform law take effect in 2014, there will be a new way to buy health insurance: the Health Insurance Marketplace. This notice provides basic information about the new Marketplace and employment-based health coverage offered by Wittenberg.
Medicare Creditable Coverage Notice
Plans offering prescription drug benefits are required to conduct an actuarial analysis to determine if the prescription drug coverage is creditable, or expected to pay out as much as the standard Medicare prescription drug coverage. Notice of creditable/non-creditable coverage must be furnished to all active and retired employees age 65+ and/or active and retired employees with spouses age 65+ who participate in Wittenberg's group health plan.
Summary Annual Reports (SAR's)
The Employee Retirement Income Security Act of 1974 (ERISA) requires employers to furnish summary Annual Reports (SAR's) for covered benefit plans. These summaries contain certain financial information of the benefit plans sponsored by employers in a given plan year. As required, these SAR's are being made available to all employees and will be distributed on an annual basis.
- Plan 001 - Defined Contribution Retirement Plan: 2014, 2015
- Plan 509 - Welfare Benefit Plan: 2014, 2015
Summary of Benefits and Coverage (SBC)
As of September 23, 2012, health insurance issuers and group health plans are required to provide participants with an easy-to-understand summary about a health plan’s benefits and coverage. The new form must include a short, plain language summary of benefits and coverage; a uniform glossary of terms commonly used in health insurance coverage, such as "deductible" and "co-payment"; and coverage examples allowing participants to compare between plans using two common medical situations. All insurance companies and group health plans must use the same standard SBC format to help participants compare between health plans.
2017 SBC for Anthem PPO medical
2017 SBC for Anthem HDHP with HSA medical
Summary Plan Descriptions (SPD's)
Health & Welfare Plans
- The H&W SPD is comprised of the Benefit Booklets for the self-insured benefits (Medical, Dental, Vision); the Insurance Certificates for the insured benefits (Life, AD&D, LTD, Business Travel) the Flexible Benefit Plan document (FSA & pre-tax premium pay option), and the Wittenberg Welfare Benefit Plans Wrap document.
- Summary Material Modification (SMM)10/29/2014 - PPACA eligibility updates
- TASC - Flexible Spending Account
- TIAA-CREF - 403(b) Plan
TIAA-CREF- Automatic Enrollment and Qualified Default Investment Alternative (QDIA) Notice
Notification of the TIAA-CREF automatic enrollment provision is required to be sent on an annual basis to participants in the plan. In addition, all new employees who are eligible to participate in the defined contribution plan account under the plan will also be notified of the automatic enrollment provision upon first becoming eligible.
TIAA-CREF - Fee Disclosure Notices
Under the Department of Labor (DOL) Section 404(a) regulation, qualified retirement plan sponsors must provide disclosures to participants on plan-related information and investment-related fees and information. Additionally, a quarterly report (statement) that includes fees deducted from participant accounts must be provided. These regulations require that participants be provided with sufficient information regarding the plan and the designated investment alternatives offered under it to make informed investment decisions.
TIAA-CREF - QDIA Notices
Notification of the TIAA-CREF Qualified Default Investment Alternative (QDIA) provision is required to be sent on an annual basis to terminated participants in the plan with the purpose of describing how 403(b) accounts are invested into the default investment funds if there are no direct investment options selected.
- 2016 Plan Year
- 2017 Plan Year