ComplyDIY · BenefitLab

At-a-Glance What this is, who it affects, when to send it, and the risk.−

What A single packet linking all plan materials and required notices for employees enrolling in group health coverage.

Who Benefits-eligible new hires and anyone newly eligible due to a status change.

When Before the end of the waiting period and no later than the coverage effective date; several notices have their own specific timing windows (see Deadlines).

Risk Missed or late required notices can result in DOL penalties, COBRA disputes, or enrollment rights claims.

Deadlines & Frequency Anchor everything to hire date, eligibility date, and plan effective date.+

14

Marketplace Notice

Within 14 days of hire, to all employees, not just enrolled ones.

90

COBRA & SPD

COBRA General Notice and SPD within 90 days of coverage start.

Start

Enrollment materials

Before the end of the waiting period so coverage starts on time.

Item	Typical Timing	Notes
Enrollment materials + elections	Before end of waiting period	So coverage and deductions can start on time.
SBCs (Summary of Benefits and Coverage)	At enrollment and upon request	Also required 60 days before any mid-year material plan change.
Marketplace (Exchange) Notice	Within 14 days of hire	Required for all employees, not just benefits-eligible or enrolled.
Medicaid/CHIP Premium Assistance Notice	At hire and annually	Include state-specific contact list from the DOL model notice.
HIPAA Special Enrollment Rights	With enrollment materials	Explains 30-day (or 60-day for CHIP/Medicaid) request windows.
COBRA General Notice	Within 90 days of coverage start	Plans subject to COBRA only (generally 20+ employees).
WHCRA / NMHPA notices	At enrollment; annually thereafter	Often bundled with open enrollment mailing.
SPD / Wrap SPD	Within 90 days of coverage start	Provide access info or physical copy; note timing if delivered post-enrollment.

Item: Enrollment materials + elections

Timing: Before end of waiting period

Notes: So coverage and deductions can start on time.

Item: SBCs

Timing: At enrollment and upon request

Notes: Also required 60 days before a mid-year material plan change.

Item: Marketplace (Exchange) Notice

Timing: Within 14 days of hire

Notes: Required for all employees, not just enrolled ones.

Item: Medicaid/CHIP Premium Assistance Notice

Timing: At hire and annually

Notes: Include the state-specific contact list from the DOL model notice.

Item: HIPAA Special Enrollment Rights

Timing: With enrollment materials

Notes: Explains 30-day (or 60-day CHIP/Medicaid) request windows.

Item: COBRA General Notice

Timing: Within 90 days of coverage start

Notes: COBRA-subject plans only (generally 20+ employees).

Item: WHCRA / NMHPA notices

Timing: At enrollment; annually thereafter

Notes: Often bundled with the open enrollment mailing.

Item: SPD / Wrap SPD

Timing: Within 90 days of coverage start

Notes: Provide access info or a physical copy.

What You Need: Docs & Data Start with these core items, then add your plan-specific docs.+

Plan summaries: SBCs for each medical option; dental/vision highlights; HSA, HRA, or FSA summaries if applicable.
Elections: Enrollment form or HRIS task; waiver/declination form; HSA payroll authorization if applicable. If your company offers a Section 125 Premium Only Plan (POP) or FSA, also include the Salary Reduction Agreement; employees must elect pre-tax treatment before their first deduction. See the POP and FSA pages for templates and compliance details.
Required notices (at hire/enrollment): HIPAA Special Enrollment Rights; Marketplace Notice; Medicaid/CHIP Premium Assistance (state list); WHCRA; NMHPA; Michelle's Law (if applicable); COBRA General Notice (if subject to COBRA); Grandfathered Status Notice (if applicable).
Plan documents: SPD or Wrap SPD, or written notice of how and when to access it.
"How to use your plan": ID cards timing, carrier portals and apps, care navigation contacts, prior authorization procedures.

How To Do It: Step-by-Step A practical assembly and delivery flow.+

1

List your plans and eligibility rulesNote waiting period, effective dates, and which employees qualify.

2

Pull current SBCs and plan highlightsFrom carriers or your TPA; confirm versions are current.

3

Compile required noticesUse DOL model language where available; check your state for any additional required notices.

4

Build a cover sheetWith a checklist of every item included and links or page references for each.

5

Set enrollment windowsProvide election, Salary Reduction Agreement (if POP/FSA), and waiver forms.

6

QA the packetVerify dates, contact information, correct plan-year versions, and that all required notices are present.

7

Deliver electronically or on paperSee Delivery Rules, then log or obtain acknowledgment of receipt.

Delivery Rules Paper or electronic; just make it accessible and trackable.+

Electronic delivery: Use HRIS or portal; pair with a signed Electronic Delivery Consent and keep bounce/read logs. See the Electronic Delivery Consent page for consent requirements.
Paper delivery: Provide clean copies of every item and keep a distribution log or signed receipt.
Language and accessibility: Provide translations or accessible formats where a meaningful portion of your workforce requires them. SBCs must be provided in certain languages on request.
Mid-year updates: Re-issue affected items (e.g., a revised SBC) within the required timeframes: 60 days before a material plan change.

Proof & Recordkeeping If it isn't documented, it didn't happen.+

Packet versionVersion and date, with a list of every item included.
Distribution logWho received it, when, and how, or HRIS acknowledgment.
Signed electionsElections, Salary Reduction Agreements, and waivers with effective dates.
Carrier confirmationsConfirmations of enrollment and coverage effective dates if available.

Common Traps & FAQs Quick answers and the mistakes we see most.+

Common traps

Delivering notices after coverage starts: Several notices, including the Marketplace Notice (14 days from hire) and COBRA General Notice (90 days from coverage start), have deadlines that don't align with each other or with your enrollment window. Build a checklist and calendar both the employment start date and the coverage start date as separate triggers.

FAQs

Can we send one packet that covers everything?
Yes, one well-organized bundle is fine. Include a cover sheet that lists every item so there's no question about what was provided. Each required notice must be present or explicitly linked.

Is the new hire packet the same as the open enrollment packet?
Similar but not identical. Some notices (Marketplace Notice, COBRA General Notice) are triggered at hire or coverage start; others (WHCRA, NMHPA) repeat annually at open enrollment. Use the deadlines table to know what each timing requires.

What if we miss a required notice deadline?
Send it as soon as you identify the gap. Document when it was sent and why it was late. Some penalties are per-day (e.g., COBRA), so don't let it sit. A pattern of late delivery creates more exposure than a single corrected miss.

Do we need state-specific notices too?
Possibly. Several states have their own continuation coverage laws (mini-COBRA), state marketplace notices, or additional enrollment rights requirements. Check the Special Cases section and confirm requirements for each state where you have employees.

Official Guidance & Links Each required notice has its own DOL or IRS source.+

DOL EBSA: Summary of Benefits and Coverage (SBC). Rules, templates, and instructions for providing SBCs to employees at enrollment and upon request.
DOL EBSA: Notice of Coverage Options (Marketplace Notice). Model notices for employers who offer a health plan and for those who do not; required within 14 days of hire for all employees.
DOL EBSA: Medicaid and CHIP Premium Assistance Notice (CHIPRA). Model employer notice with state-by-state contact list; required annually for all employees.
DOL EBSA: HIPAA Special Enrollment Rights. Notice of special enrollment rights must be provided with enrollment materials; covers loss of other coverage, marriage, birth, adoption, and CHIP/Medicaid eligibility events.
DOL EBSA: COBRA Continuation Coverage. Model General Notice, employer guide, and timing rules; General Notice due within 90 days of coverage start for COBRA-subject plans.
DOL EBSA: Women's Health and Cancer Rights Act (WHCRA). Required notice at enrollment and annually describing mastectomy-related benefits coverage.
DOL EBSA: Reporting and Disclosure Guide for Employee Benefit Plans. Comprehensive reference covering all ERISA plan notice and disclosure requirements with timing.

Special Cases & State Variations Plan size, design, and employee location change which notices apply.+

Small Employers (Fewer Than 20 Employees): No Federal COBRA

Federal COBRA applies to group health plans with 20 or more employees. If you have fewer than 20, you are not required to provide the COBRA General Notice or administer COBRA continuation. However, most states have "mini-COBRA" laws that impose similar continuation requirements on smaller plans. Check your state's insurance department for applicable rules, and note that the 20-employee threshold counts on a prior-year average basis, so recently grown employers should monitor their count carefully.

Grandfathered Health Plans

If your plan has maintained grandfathered status under the ACA (by not making significant changes since March 23, 2010), you must include a Grandfathered Status Notice in every benefits packet and open enrollment communication. Grandfathered plans are exempt from certain ACA requirements, but the notice must explain this status and inform employees of the tradeoffs. If you are uncertain whether your plan is grandfathered, ask your carrier or TPA.

State-Based Marketplaces

California, Colorado, Connecticut, Idaho, Kentucky, Maine, Maryland, Massachusetts, Minnesota, Nevada, New Jersey, New Mexico, New York, Pennsylvania, Rhode Island, Vermont, Washington, and Washington D.C. operate their own state-based health insurance marketplaces. The Marketplace Notice model from the DOL is generally applicable, but some states have issued supplemental guidance or require additional state-specific information. Confirm with your state marketplace if you have employees in these states.

Multi-State Workforces

Required notices generally follow the employee's state of residence or work location. For multi-state employers, the Medicaid/CHIP model notice includes state-specific contact information; confirm that the version you're using includes contact information for every state where you have employees. Some states also have their own continuation coverage laws that must be added to packets for employees in those states.

Self-Insured and Level-Funded Plans

Self-insured plans are subject to ERISA directly (not state insurance law) and must comply with all federal notice requirements. Level-funded plans that qualify as self-insured have the same obligations. The SPD/Wrap SPD is particularly important for self-insured plans since there is no carrier-issued certificate of coverage that satisfies ERISA disclosure requirements.

Union and Collectively Bargained Plans

If benefits are provided under a collectively bargained agreement, plan document and notice requirements still apply, but the CBA may govern how and when materials are distributed and what changes can be made. Confirm notice delivery procedures with your labor counsel or benefits TPA before rolling out a new packet process for represented employees.

Templates & Resources Use this cover sheet to assemble and track your benefits packet for each new enrollee.+

Use the cover sheet below to assemble and track your benefits packet for each new enrollee. Customize the checklist to match your plans and the specific notices required for your workforce.

EMPLOYEE BENEFITS PACKET

[Company Name], Plan Year: _____________ | Prepared for: _________________________

Date Distributed: _____________ | Distributed By: _________________________

Delivery Method: ☐ HRIS/Portal ☐ Email ☐ Paper (in person) ☐ Paper (mailed)

PART 1: PLAN ENROLLMENT MATERIALS

☐ Enrollment form or HRIS task link, deadline: _____________
☐ SBC, Medical Plan Option 1: _________________________
☐ SBC, Medical Plan Option 2: _________________________ (if applicable)
☐ Dental plan highlights / SBC
☐ Vision plan highlights
☐ Life / AD&D coverage summary
☐ HSA / HRA / FSA summary and election form (if applicable)
☐ Salary Reduction Agreement, POP (if Section 125 plan offered)
☐ FSA Election Form (if FSA offered)
☐ Waiver / declination form (for employees declining coverage)
☐ Carrier ID card timing and portal/app information

PART 2: REQUIRED FEDERAL NOTICES

☐ Marketplace (Exchange) Notice, must deliver within 14 days of hire to ALL employees
☐ Medicaid / CHIP Premium Assistance Notice, at hire and annually
☐ HIPAA Special Enrollment Rights Notice, at or before initial enrollment opportunity
☐ COBRA General Notice, within 90 days of coverage effective date (COBRA plans only)
☐ WHCRA Notice (Women's Health and Cancer Rights Act), at enrollment and annually
☐ NMHPA Notice (Newborns' and Mothers' Health Protection Act), at enrollment and annually
☐ Grandfathered Status Notice, if your plan is grandfathered under the ACA
☐ Michelle's Law Notice, if applicable to your plan
☐ SPD / Wrap SPD, or written notice of how and when it will be provided

PART 3: STATE-SPECIFIC NOTICES (add as required for your state)

☐ State continuation/mini-COBRA notice (if applicable)
☐ State marketplace notice (if in a state-based marketplace state)
☐ Other state-required notice: _________________________

PART 4: COMPANY DOCUMENTS

☐ Benefits overview / highlights one-pager
☐ Contact list, HR, carriers, care navigation, EAP (if offered)
☐ Open enrollment window dates (for reference)
☐ Electronic Delivery Consent (if delivering benefits documents electronically going forward)

Employee signature confirming receipt: __________________________ Date: ______________

[HR Use Only] Packet version: _______ All items confirmed included: ☐ Yes Filed: _____________