At or before enrollment, in the new-hire benefits packet and/or SPD delivery.
The NMHPA statement must appear in the SPD itself or a separate document distributed with it.
Not strictly required, but commonly bundled with Open Enrollment materials.
| Trigger | Due Date / Window | Notes |
|---|---|---|
| Initial enrollment / eligibility | At or before enrollment | Include with the new-hire benefits packet and/or SPD delivery. |
| SPD distribution | Per ERISA SPD timing rules | The NMHPA statement must appear in the SPD itself or in a separate document distributed with it. |
| Annual reminder (best practice) | Once each plan year | Not strictly required by NMHPA, but commonly bundled with Open Enrollment materials. Helps participants understand their rights before a maternity claim arises. |
- Notice text: See the Model Notice section below, the DOL's standard one-paragraph NMHPA language with a field for your plan administrator contact.
- Plan documents: Your SPD or SMM language confirming NMHPA protections, the 48-/96-hour minimums, and that cost-sharing may not treat later portions of the stay less favorably than earlier portions.
- Administrator contact: Plan administrator phone number and claims contact; participants need to know who to call with questions.
- Languages: English plus any translations your workforce needs.
- Audience: All plan participants, and beneficiaries as applicable, covered under a group health plan that includes maternity care.
- Method: Paper or electronic delivery. If using email or a benefits portal, follow ERISA's e-disclosure safe harbor rules (employees must have consented or meet the electronic access criteria).
- Clarity: Use plain language. Keep the notice easy to locate in new-hire packets, SPD booklets, or portal PDFs; don't bury it in fine print.
- Notice copiesThe exact notice used each plan year, date-stamped, with a note of where it appeared (new-hire packet, SPD, OE guide, benefits portal).
- Distribution logsMailing list, date sent, and delivery method (paper or e-delivery). For paper mailings, retain a Certificate of Mailing (USPS Form 3817) as proof of dispatch; certified mail is not required.
- E-delivery recordsPortal access timestamps or email delivery confirmations.
- SPD/SMM pagesCurrent pages showing NMHPA protections and applicable cost-sharing terms.
Common traps
FAQs
What is the minimum hospital stay?
Generally at least 48 hours after vaginal delivery and 96 hours after cesarean section. The attending provider (physician, nurse midwife, or physician assistant) can authorize an earlier discharge after consultation with the mother. The plan cannot make later portions of the stay subject to more restrictive cost-sharing than earlier portions.
Who should receive the NMHPA Notice?
All participants in any group health plan that covers maternity care, and beneficiaries as applicable.
What's the penalty for not providing it?
Plan violations, including notice failures, can trigger a $100 per affected individual per day excise tax under IRC § 4980D (statutory rate, not adjusted for inflation). The DOL also enforces notice requirements under ERISA. The notice is one paragraph; there's no good reason to skip it.
- NMHPA, DOL EBSA. Employer and participant resources, model notice guidance, and regulatory background.
- NMHPA FAQs, DOL EBSA (PDF). Includes model SPD/notice language and answers to common coverage questions.
- NMHPA, CMS. Requirements for fully insured state-regulated plans and HMOs.
- Insured plans: Carriers typically include NMHPA language in their certificates; confirm it's also in your Open Enrollment packet and that you retain your own proof of delivery rather than relying solely on the carrier.
- Self-funded plans: You're fully responsible for the notice and the underlying coverage requirements. Coordinate with your TPA to ensure SPD language, claims procedures, and cost-sharing rules all reflect NMHPA.
- State mandates: Some states impose additional postpartum or maternity coverage requirements beyond the federal minimums. Check the rules for every state where you have covered participants, particularly states with longer minimum stay requirements.
The DOL provides standard one-paragraph NMHPA language you can paste directly into your SPD or new-hire packet. Customize the one bracketed field and you're done.
Model NMHPA notice (paste into your SPD or new-hire packet):
This plan generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section delivery. However, the plan may pay for a shorter stay if the attending provider (e.g., your physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier. Also, under federal law, plans and issuers may not set the level of benefits or out-of-pocket costs so that any later portion of the 48-hour (or 96-hour) stay is treated in a manner less favorable to the mother or newborn than any earlier portion of the stay. If you have questions about this notice, contact your plan administrator at [PHONE NUMBER / EMAIL].
What to customize: Replace [PHONE NUMBER / EMAIL] with your plan administrator's direct contact. Everything else is standard language; do not shorten or paraphrase it.
DOL NMHPA FAQs (PDF): source of the model language above, plus answers to common coverage and enforcement questions.