• Pittsford Village Green
  • 71 Monroe Ave Ste A, Pittsford, NY 14534
  • (585) 248-5870

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Compliance Documents

Understand the rules and regulations of your benefits with Bond’s compliance documents.

New Hire Open Enrollment Compliance Notices

Included in this packet:

Section 1 -   Notice of HIPAA Special Enrollment Rights and Women's Health and Cancer Rights Act

Section 2 -   Initial COBRA Notice

Section 3 -   Creditable/Non-Creditable Coverage Letter (Medical Plan(s))

Section 4 -   Summary of Benefits and Coverage

Section 5 -   Premium Assistance under Medicaid and the Children’s Health Insurance Program (CHIP)

Section 6 -   Primary Care Provider Notice

Open Enrollment Compliance Document Notice

Please see the bottom of this web page for a full copy of SBCs.

 

Marketplace Model Notice

All employers providing benefits to their employees must provide a model notice. We have attached a copy for your reference. Please contact us with any questions.

Marketplace Model Notice


Non-discrimination Statement

Affordable Care Act (ACA) Section 1557 provides covered entities with mandatory public notice requirements.  Covered entities include health programs that receive federal funds from programs operated by HHS, such as Medicare and Medicaid, which means the rule applies to hospitals, clinics, physician practices, nursing homes, other healthcare entities, and insurers.  We’ve attached sample model language for use if you are a covered entity.

Sample Non- discrimination Statement


Summary of Benefits & Coverage (SBC)

Excellus Medical - With Pediatric Dental


Excellus Medical - Without Pediatric Dental


MVP Medical