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Required Notices

What Do I Need to Know?

These notices are just for your information. No action needed.

The following information applies to all of your Veritas health care plans as indicated below and in the attached links to the required notices. If you have questions about any of these notices, please create an HR vHelp case.

  • California Paid Family Leave Notice (pdf)
  • California Time of Hire Pamphlet (pdf)
  • California Paid Sick Leave Notice (pdf)
  • California Notice to Employee (DLSE-NTE) (pdf)
  • San Francisco Paid Parental Leave (pdf)
  • San Francisco Paid Sick Leave (pdf)
  • Texas Workers Compensation New Employee Notice (pdf)
  • New Jersey Family Leave Insurance Notice (pdf)
  • New York Paid Family Leave Notice (pdf)
  • Victims of Domestic Violence Leave Notice (pdf)

Summaries of Benefits and Coverage

Under the Affordable Care Act, we are required to provide Summaries of Benefits & Coverage (SBC) that have simple and consistent information about health plan benefits and coverage. The SBCs will help employees better understand the coverage they have and allow them to easily compare different coverage options. It will summarize the key features of the plan or coverage, such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions.

  View Summaries of Benefits and Coverage

Summary Plan Documents

The complete text of each benefit plan is contained in the actual Summary Plan Document (SPD). If there is any conflict between the following on-line information and the provisions of the applicable document, the plan document and contract between the carrier and Veritas will always take precedence. The following on-line documents replace all descriptions of benefit plans included in prior printed material. Although Veritas expects to continue these benefits, the company does reserve the right to change or terminate any benefit for any reason without notice at any time.

  View Summary Plan Documents

COBRA Continuation Coverage

In accordance with COBRA regulations, you and/or your eligible dependents have a right to continue your health care coverage in the event you (or your dependents) are no longer eligible for coverage through Veritas Benefits. There are several instances in which COBRA continuation coverage will be available, such as:

  • You end your employment with Veritas or are no longer eligible for Veritas Benefits due to a reduction of work hours.
  • You and your spouse divorce, and therefore your spouse is no longer an eligible dependent.
  • Your dependent child reaches the maximum age for coverage.

COBRA coverage is generally available for 18 months (an additional 18 months is available in certain circumstances). To receive this coverage, you must pay the required premium, which is equal to the amount formerly paid by Veritas and your prior contribution amount, plus up to a 2 percent administration fee.

In the event a COBRA "qualifying event" occurs with regard to your and/or your dependents' coverage, you will receive additional information, including enrollment details.

Note that while Federal COBRA coverage provisions do not consider domestic partners or their children to be eligible dependents, Veritas extends the same continuation opportunities to these individuals.

COBRA Continuation Notice (pdf)

Health Care Reform

The Patient Protection and Affordable Care Act (PPACA), commonly called Obamacare or the Affordable Care Act (ACA), is a United States federal statute that aims to increase the quality and affordability of health insurance, lower the uninsured rate by expanding public and private insurance coverage, and reduce the costs of health care for individuals and the government. It provides a number of mechanisms -- including mandates, subsidies, and insurance exchanges to increase coverage and affordability.

  Health Care Reform notice (pdf)

HIPAA Privacy Rights

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) includes provisions that protect the privacy of health plan participants and their Protected Health Information (PHI). These provisions govern how entities such as health insurance companies, plan administrators, medical professionals, and plan sponsors (e.g., Veritas) must handle PHI.

HIPAA requires health plans to notify plan participants and beneficiaries about its policies and practices to protect the confidentiality of health information. Veritas Corporation is required by law to periodically provide you with information about the privacy regulations under HIPAA.

Veritas maintains a Notice of Privacy Practices applicable to its self-funded health plans. The Notice provides information to individuals whose PHI will be used or maintained by ERISA.

HIPAA Notice of Privacy Practices (pdf)

Important Notice from Veritas Technologies LLC About Your Prescription Drug Coverage and Medicare

Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with Veritas Technologies, LLC about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice.

There are a two important things you need to know about your current coverage and Medicare’s prescription drug coverage:

1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.

2. Veritas Technologies LLC has determined that the prescription drug coverage offered by WellDyne and Kaiser Permanente is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.

When Can You Join a Medicare Drug Plan?
You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15th to December 7th. However, if you lose your current prescription drug coverage with Veritas Technologies, LLC, through no fault of your own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan.

What Happens to Your Current Coverage If You Decide to Join a Medicare Drug Plan?
If you decide to join a Medicare drug plan, your current Veritas Technologies, LLC coverage will not be affected.

If you do decide to join a Medicare drug plan and drop your current Veritas Technologies, LLC coverage, be aware that you and your dependents will not be able to get this coverage back.

When Will You Pay a Higher Premium (Penalty) To Join a Medicare Drug Plan?
You should also know that if you drop or lose your current coverage with Veritas Technologies, LLC and don’t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later.

If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join.

For More Information About This Notice or Your Current Prescription Drug Coverage…
Contact the person listed below for further information
NOTE: You’ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this coverage through Veritas Technologies LLC changes. You also may request a copy of this notice at any time.

 

For More Information About Your Options Under Medicare Prescription Drug Coverage…
More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans.

For more information about Medicare prescription drug coverage:
Visit www.medicare.gov
Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help.
Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at www.socialsecurity.gov, or call them at 1-800-772-1213 (TTY 1-800-325-0778).

Remember: Keep this coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable or non-creditable coverage and, therefore, whether or not you are required to pay a higher premium (a penalty).

For more information about this notice or your prescription drug coverage, contact:

Veritas Technologies LLC, HR
801 International Parkway, Suite 1053
Heathrow, FL 32746
Phone Number: 407-357-8112

Newborns' Health Protection Act (NMHPA)

NMHPA was signed into law on September 26, 1998 and includes important protections for mothers and their newborn children with regard to the length of the hospital stay following childbirth. Group health plans and health insurance issuers generally may not, under federal law, 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. 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). If you would like more information on maternity benefits, call your plan administrator.

Notice of Special Enrollment Rights for Medical/Health Coverage

If you decline enrollment in a Veritas medical or health plan for you or your dependents (including your spouse) because of other health insurance coverage, you or your dependents may be able to enroll in a Veritas health plan without waiting for the next open enrollment period if you:

  • Lose other coverage. You must request enrollment within 31 days after the loss of other coverage.
  • Gain a new dependent as a result of marriage, birth, adoption, or placement for adoption. You must request enrollment within 31 days after the marriage, birth, adoption, or placement for adoption.
  • Lose Medicaid or Children's Health Insurance Program (CHIP) coverage because you are no longer eligible. You must request enrollment within 60 days after the loss of such coverage.

If you request a change due to a special enrollment event within the 31 day timeframe, coverage will be effective the date of birth, adoption or placement for adoption. For all other events, coverage will be effective the first of the month following your request for enrollment. In addition, you may enroll in Veritas' medical plan if you become eligible for a state premium assistance program under Medicaid or CHIP. You must request enrollment within 60 days after you gain eligibility for medical plan coverage. If you request this change, coverage will be effective the first of the month following your request for enrollment. Specific restrictions may apply, depending on federal and state law.

Note: If your dependent becomes eligible for a special enrollment rights, you may add the dependent to your current coverage or change to another health plan.

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’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. 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 www.healthcare.gov.

If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State 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, contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan.

If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t 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, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272).

If you live in one of the following states, you may be eligible for assistance paying your employer health plan premiums. The following list of states is current as of July 31, 2018. Contact your State for more information on eligibility –

ALABAMA –Medicaid

FLORIDA – Medicaid

Website: http://myalhipp.com/

Phone: 1-855-692-5447

 

Website: http://flmedicaidtplrecovery.com/hipp/

Phone: 1-877-357-3268

ALASKA – Medicaid

GEORGIA – Medicaid

The AK Health Insurance Premium Payment Program

Website: http://myakhipp.com/

Phone: 1-866-251-4861

Email: CustomerService@MyAKHIPP.com

Medicaid Eligibility: http://dhss.alaska.gov/dpa/Pages/medicaid/default.aspx

 

Website: http://dch.georgia.gov/medicaid

- Click on Health Insurance Premium Payment (HIPP)

Phone: 404-656-4507

ARKANSAS – Medicaid

INDIANA – Medicaid

Website: http://myarhipp.com/

Phone: 1-855-MyARHIPP (855-692-7447)

Healthy Indiana Plan for low-income adults 19-64

Website: http://www.in.gov/fssa/hip/

Phone: 1-877-438-4479

All other Medicaid

Website: http://www.indianamedicaid.com

Phone 1-800-403-0864

 

COLORADO – Health First Colorado (Colorado’s Medicaid Program) &

Child Health Plan Plus (CHP+)

IOWA – Medicaid

Health First Colorado Website: https://www.healthfirstcolorado.com/

Health First Colorado Member Contact Center:

1-800-221-3943/ State Relay 711

CHP+: Colorado.gov/HCPF/Child-Health-Plan-Plus

CHP+ Customer Service: 1-800-359-1991/

State Relay 711

 

Website:

http://dhs.iowa.gov/hawk-i

Phone: 1-800-257-8563

 

KANSAS – Medicaid

NEW HAMPSHIRE – Medicaid

Website: http://www.kdheks.gov/hcf/

Phone: 1-785-296-3512

Website: https://www.dhhs.nh.gov/ombp/nhhpp/

Phone: 603-271-5218

Hotline: NH Medicaid Service Center at 1-888-901-4999

 

KENTUCKY – Medicaid

NEW JERSEY – Medicaid and CHIP

Website: https://chfs.ky.gov

Phone: 1-800-635-2570

 

Medicaid Website:

http://www.state.nj.us/humanservices/

dmahs/clients/medicaid/

Medicaid Phone: 609-631-2392

CHIP Website: http://www.njfamilycare.org/index.html

CHIP Phone: 1-800-701-0710

 

LOUISIANA – Medicaid

NEW YORK – Medicaid

Website: http://dhh.louisiana.gov/index.cfm/subhome/1/n/331

Phone: 1-888-695-2447

 

Website: https://www.health.ny.gov/health_care/medicaid

Phone: 1-800-541-2831

MAINE – Medicaid

NORTH CAROLINA – Medicaid

Website: http://www.maine.gov/dhhs/ofi/public-assistance/index.html

Phone: 1-800-442-6003

TTY: Maine relay 711

 

Website: https://dma.ncdhhs.gov/

Phone: 919-855-4100

MASSACHUSETTS – Medicaid and CHIP

NORTH DAKOTA –Medicaid

Website: http://www.mass.gov/eohhs/gov/departments/masshealth/

Phone: 1-800-862-4840

 

Website: http://www.nd.gov/dhs/services/medicalserv/medicaid/

Phone: 1-844-854-4825

MINNESOTA – Medicaid

OKLAHOMA –Medicaid and CHIP

Website:

https://mn.gov/dhs/people-we-serve/seniors/health-care/health-care-programs/programs-and-services/other-insurance.jsp

Phone: 1-800-657-3739

 

Website: http://www.insureoklahoma.org

Phone: 1-888-365-3742

MISSOURI – Medicaid

OREGON – Medicaid

Website: http://www.dss.mo.gov/mhd/participants/pages/hipp.htm

Phone: 573-751-2005

 

Website: http://healthcare.oregon.gov/Pages/index.aspx

http://www.oregonhealthcare.gov/index-es.html

Phone: 1-800-699-9075

 

MONTANA – Medicaid

PENNSYLVANIA – Medicaid

Website: http://dphhs.mt.gov/MontanaHealthcarePrograms/HIPP

Phone: 1-800-694-3084

Website: Health Insurance Premium Payment (HIPP) Program

Phone: 1-800-692-7462

 

NEBRASKA – Medicaid

RHODE ISLAND – Medicaid

Website: http://www.ACCESSNebraska.ne.gov

Phone: (855) 632-7633

Lincoln: (402) 473-7000

Omaha: (402) 595-1178

 

Website: http://www.eohhs.ri.gov/

Phone: 855-697-4347

NEVADA – Medicaid

SOUTH CAROLINA – Medicaid

Medicaid Website: http://dhcfp.nv.gov

Medicaid Phone: 1-800-992-0900

Website: https://www.scdhhs.gov

Phone: 1-888-549-0820

 

SOUTH DAKOTA - Medicaid

WASHINGTON – Medicaid

Website: http://dss.sd.gov

Phone: 1-888-828-0059

Website: Premium payment program

Phone: 1-800-562-3022 ext. 15473

 

TEXAS – Medicaid

WEST VIRGINIA – Medicaid

Website: http://gethipptexas.com/

Phone: 1-800-440-0493

Website: http://mywvhipp.com/

Toll-free phone: 1-855-MyWVHIPP (1-855-699-8447)

 

UTAH – Medicaid and CHIP

WISCONSIN – Medicaid and CHIP

Medicaid Website: https://medicaid.utah.gov/

CHIP Website: http://health.utah.gov/chip

Phone: 1-877-543-7669

Website:

https://www.dhs.wisconsin.gov/publications/p1/p10095.pdf

Phone: 1-800-362-3002

 

VERMONT– Medicaid

WYOMING – Medicaid

Website: http://www.greenmountaincare.org/

Phone: 1-800-250-8427

 

Website: https://wyequalitycare.acs-inc.com/

Phone: 307-777-7531

 

VIRGINIA – Medicaid and CHIP

 

Medicaid Website: http://www.coverva.org/programs_premium_assistance.cfm

Medicaid Phone: 1-800-432-5924

CHIP Website: http://www.coverva.org/programs_premium_assistance.cfm

CHIP Phone: 1-855-242-8282

 

To see if any other states have added a premium assistance program since July 31, 2018, or for more information on special enrollment rights, contact either:

U.S. Department of Labor

Employee Benefits Security Administration

www.dol.gov/agencies/ebsa

1-866-444-EBSA (3272)

U.S. Department of Health and Human Services

Centers for Medicare & Medicaid Services

www.cms.hhs.gov

1-877-267-2323, Menu Option 4, Ext. 61565


Paperwork Reduction Act Statement

According to the Paperwork Reduction Act of 1995 (Pub.  L.  104-13) (PRA), no persons are required to respond to a collection of information unless such collection displays a valid Office of Management and Budget (OMB) control number.  The Department notes that a Federal agency cannot conduct or sponsor a collection of information unless it is approved by OMB under the PRA, and displays a currently valid OMB control number, and the public is not required to respond to a collection of information unless it displays a currently valid OMB control number.  See 44 U.S.C.  3507.  Also, notwithstanding any other provisions of law, no person shall be subject to penalty for failing to comply with a collection of information if the collection of information does not display a currently valid OMB control number.  See 44 U.S.C. 3512.

The public reporting burden for this collection of information is estimated to average approximately seven minutes per respondent.  Interested parties are encouraged to send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Labor, Employee Benefits Security Administration, Office of Policy and Research, Attention: PRA Clearance Officer, 200 Constitution Avenue, N.W., Room N-5718, Washington, DC 20210 or email ebsa.opr@dol.gov and reference the OMB Control Number 1210-0137.

The Uniformed Services Employment and Reemployment Rights Act of of 1994 ("USERRA")

A Participant who is absent from employment with his Employer on account of being in "uniformed service" as defined by the Uniformed Services Employment and Reemployment Rights Act of 1994 ("USERRA") may elect to continue participation in the Plan. The coverage period shall extend for the lesser of 24 months or until the Participant fails to apply for reinstatement or to return to employment with the Employer. The Participant shall be responsible for making the required contributions during the period in which he or she is in "uniformed service." The manner in which such payments are made shall be determined by the Plan Administrator, in a manner similar to that of FMLA Leave.

Women's Health and Cancer Rights Act (WHCRA)

As required by the Women's Health and Cancer Rights Act of 1998 our plan provides benefits for mastectomy-related services including all stages of reconstruction and surgery to achieve symmetry between the breasts, prostheses, and complications resulting from a mastectomy, including lymphedema.

If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women's Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient, for:

  • All stages of reconstruction of the breast on which the mastectomy was performed;
  • Surgery and reconstruction of the other breast to produce a symmetrical appearance;
  • Prostheses; and
  • Treatment of physical complications of the mastectomy, including lymphedema

These benefits will be provided subject to the same deductibles and coinsurance applicable to other medical and surgical benefits provided under this plan.

Mental Health Parity and Addiction Equity Act Notice

Veritas’ group medical plans provide and administer mental health and substance abuse benefits as required by the Mental Health Parity and Addiction Equity Act of 2008 (“MHPAEA”).  For more information about the Veritas’ group medical plans and their compliance under MHPAEA, please contact:

Veritas Technologies LLC, HR
801 International Parkway, Suite 1053
Heathrow, FL 32746
Phone Number: 407-357-8112

 
Copyright 2015 Veritas Technologies. All rights reserved.