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 MyMonteBenefits.com or request a print version of these notices, email the Benefits Office at [email protected] or call 718.430.2547. 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 Einstein, 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 Einstein'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 Notice – An 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.
Non-Discrimination Notice – Einstein 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.
New York DBL/PFL – Notice of Compliance (Form DL-120 and PFL -120)
Summary Annual Report (SAR) – an SAR is a summary of the annual report for Albert Einstein College of Medicine 403(b) Retirement Income Plan, the annual report has been filed with the Employee Benefits Security Administration, U.S.
Department of Labor, as required under the Employee Retirement Income Security Act of 1974 (ERISA).
Summary of Benefits and Coverage (SBC) – An SBC is a standardized summary describing the benefits and limitations of each medical option.
Summary Plan Description (SPD) – An SPD is a summary of the plans that make up your Montefiore Benefits Program. It is designed to meet your information needs of the plans in effect on January 1, 2020 and the disclosure requirements of the Employee Retirement Income Security Act of 1974 (ERISA). It explains when you become eligible, what benefits the plans pay, any benefit limitations that apply, how to file claims and where to obtain additional information.