Regulatory Notices

Regulatory Notices

Employers are required to provide regulatory notices regarding your rights and procedures to protect those rights. You may view, download or print a copy of these notices from or request a print version of these notices from the HR Benefits Office by email at [email protected] or by calling 914.349.8531. Here’s a summary of the notices.

Children’s Health Insurance Program (CHIP) Notice – If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from Montefiore, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs.

Claiming Healthcare Benefits − Federal law requires your healthcare coverage to provide a process for filing claims for services and supplies that are urgent in nature in addition to procedures for post service claims.

Consolidated Omnibus Budget Reconciliation Act (COBRA) − COBRA gives workers and their families who lose their health benefits under certain circumstances the right to choose to continue their group health benefits for limited periods of time.

Genetic Information Nondiscrimination Act (GINA) − GINA prohibits employers, employment agencies, and labor unions from discriminating against employees based on genetic information. It also prohibits insurers from charging higher premiums based on genetic information or from using genetic information in underwriting decisions.

HIPAA Special Enrollment Rights – You may request a special enrollment in Montefiore’s healthcare coverage under the following circumstances:

  • Within 30 days of the date:
    • You or a family member loses other group health plan coverage (such as a spouse’s plan)
    • You acquire a new family member through marriage, birth, adoption or legal guardianship
  • Within 60 days of the date you or a family member:
    • Is no longer eligible for coverage under the State’s Children’s Health Insurance Program (CHIP) or Medicaid
    • Becomes eligible for premium assistance under the State’s Children’s Health Insurance Program (CHIP) or Medicaid.

Health Insurance Marketplace NoticeAn important provision of The Patient Protection and Affordable Care Act (PPACA) is the establishment of health insurance marketplaces. This notice provides some basic information about the Marketplace and employment-based health coverage offered by Montefiore-sponsored group health plans.

Medicare Part D Notice – If you and/or your family members are Medicare-eligible, federal law offers more choices for prescription drug coverage.

Michelle's Law – This law extends health benefits eligibility for up to one year to a student dependent child who would otherwise lose coverage due to loss of student status as a result of a medically necessary leave of absence.

Non-Discrimination Notice – Montefiore complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, religion, sex, national origin, disability, sexual orientation, gender identity or expression, physical appearance, or age.

Notice of Privacy Practices − These privacy rules set limits on how health plans, pharmacies, hospitals, clinics, nursing homes and other direct-care providers use individually identifiable health information. It is important that you understand your rights to privacy and the protection of information related to your health. It is also important that you safeguard the privacy of our patients’ healthcare information.

Family and Medical Leave Act (FMLA) − FMLA provides up to 12 work weeks of unpaid leave for certain family and medical reasons. If you utilize FMLA leave, you can elect to continue your health coverage provided that you pay the required premium. At the end of the leave, you generally have the right to return to the same job or an equivalent position.

NY Paid Family Leave (PFL) – New York Paid Family Leave provides job security and paid time off from work for a specified period of time to care for a new child, a seriously ill family member or if a family member is called to active military service.

Summary of Benefits and Coverage (SBC) – An SBC is a standardized summary describing the benefits and limitations of each medical option.