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Notices

The City of Tacoma is required by law to share and post benefits related notices.  Please take a minute to review the notices below.

Women's Health and Cancer Rights Act of 1998

Did you know that your medical plan, as required by the Women's Health and Cancer Rights Act of 1998, provides benefits for mastectomy related services?  These services include:

  • Reconstruction and surgery to achieve symmetry between the breasts
  • Prostheses
  • Complications resulting from a mastectomy (including lymphedema)

Please refer to your medical plan Summary Plan Description for details or contact your Plan Administrator for more information.


Newborn Act

Did you know that your medical plan, as required by the Newborns' and Mothers' Health Protection Act, generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child? Length of stay may be up to 48 hours following a vaginal delivery or up to 96 hours following a delivery by cesarean section as subject to the attending providers' discharge.

 

However, Federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under Federal law, require that a provider obtain authorization from the plan or the insurance issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours).

 

Please refer to your medical plan Summary Plan Description for details, or contact your Plan Administrator for more information. Please be aware that in order to add a newborn dependent to the plan, you need to submit your enrollment change application to Human Resources in a timely manner.  This is usually within 31 days of the event.

Special Enrollment Rights

Did you know that if your family experiences a qualified change in family status, that you and/or your dependents can enroll in the group insurance plans? Qualified changes include:
  • Marriage, birth, adoption of a child, or placement for adoption
  • A loss of coverage under another group plan (i.e., your spouse's employer medical plan)
Please refer to your medical plan Summary Plan Description for details, or contact your Plan Administrator for more information. Please be aware that in the event of a qualified change in family status, you need to submit your enrollment change application to Human Resources in a timely manner. This is usually within 31 days of the event.

 

If you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing toward your or your dependents’ other coverage). However, you must request enrollment within 30 days after your or your dependents’ other coverage ends (or after the employer stops contributing toward the other coverage).

 

Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)

If you or your children are eligible for Medicaid or CHIP and you are eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage. These states use funds from their Medicaid or CHIP programs to help people who are eligible for these programs, but also have access to health insurance through their employer. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace.  For more information, visit healthcare.gov.

If you or your dependents are already enrolled in Medicaid or CHIP and you live in a state listed here, you can contact your state's Medicaid or CHIP office to find out if premium assistance is available.

 

If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your State Medicaid or CHIP office or call (877) 543-7669 or visit the Insure Kids Now website to find out how to apply.  If you qualify, you can ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan.

 

Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligibility under your employer plan, your employer must permit you to enroll in your employer plan if you are not already enrolled. This is called a special enrollment opportunity and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, you can visit the Department of Labor website or call them toll-free at (866) 444-3272.

 

Contact the State for further information on eligibility.

 

Washington - Medicaid

(800) 562-3022 extension 15473
Apply for Medicaid at the Washington Medicaid website


Additional Information on Special Enrollment Rights 

U.S. Department of Labor Services
Employee Benefits Security
Administration Centers for Medicare and Medicaid Services
(866) 444-3272
Website

U.S. Department of Health and Human Services
(877) 267-2323, Extension 61565
Website

Medicare Prescription Drug Coverage (Medicare Part D)

Did you know that your prescription drug coverage offered under the Regence and Group Health plans is, on average for all participants, expected to pay out as much as the Standard Medicare drug plan. This is known as creditable coverage.

            Medicare Part D and your Prescription Drug Coverage

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(253) 573-2345
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