What you are legally required to hand your employees.
An enrollment guide is the usual delivery vehicle for most of this — but not all of it, because several of these notices run on their own clock and a once-a-year booklet cannot satisfy them. Here is the whole set, and which part the guide can actually carry.
No size threshold. No exceptions for being small.
These apply to essentially every ERISA group health plan, at any headcount and under any funding arrangement.
Summary Plan Description
Within 90 days of a participant becoming covered. Refreshed every 5 years if the plan has been amended, every 10 if it has not.
The document an auditor asks for first, and the one most often missing.
Summary of Material Modification
Within 210 days after the plan year in which the change was adopted — but a material reduction in group health benefits drops that to 60 days from adoption.
The 60-day rule is the one that catches people: cutting a benefit starts a much faster clock than adding one.
Summary of Benefits and Coverage
With enrollment materials, on renewal, and within 7 business days of any request. A mid-year material change not already in the SBC needs 60 days notice beforehand.
Every group health plan, grandfathered included. Comes with the Uniform Glossary.
2026 — The template itself has not changed — the version for plan years beginning on or after 1 January 2021 is still current. What did change is the county data behind the language-access footer, so a carrier SBC built on the old county list can carry the wrong statement.
HIPAA special enrollment rights
At or before the moment an employee is first offered the chance to enroll.
Explains the mid-year enrollment rights that come with marriage, birth, adoption or loss of other coverage.
Medicare Part D creditable coverage
Annually before 15 October, plus at initial eligibility, at a new hire’s coverage start, on any change in creditable status, and on request.
Any employer offering prescription coverage to anyone Medicare-eligible. No size threshold at all — this one catches small employers who assume it does not apply.
2026 — CMS revised the simplified determination behind this notice. The old method asked whether the plan was expected to pay 60% of prescription drug costs; the revised one asks 72%. For 2026 a group plan that does not claim the retiree drug subsidy may use either. Re-test before the October notice goes out, because the creditable and non-creditable versions are different documents.
Marketplace / Exchange notice
To every new hire within 14 days of their start date.
Required of every FLSA-covered employer, whether or not you offer a plan, and to every employee whether or not they enroll.
2026 — Do not send DOL’s model as posted. It still carries the 2023 affordability figure of 9.12% and still describes a Medicaid and CHIP unwinding enrollment period that closed in July 2024. Replace the figure with 9.96% for plan years beginning in 2026, or 10.22% for 2027, and delete the unwinding passage.
WHCRA notice
Twice: on enrollment and annually thereafter.
Any plan covering mastectomy benefits. The annual repeat is the half that gets forgotten.
Newborns’ and Mothers’ Health Protection Act
Carried in the SPD.
Plans covering hospital stays for childbirth.
Claims, appeals and external review
At the point of any adverse benefit determination, with the process described in the plan documents.
Every plan. The denial letter itself is a regulated disclosure.
CHIP premium assistance notice
Annually, before the start of each plan year, to every employee — not only the ones enrolled.
Any employer with employees living in a state that runs a premium assistance program, whichever state the employer itself sits in. DOL publishes an official model with the full state table; paste it verbatim.
2026 — the model’s state list is current as of 31 July 2026. Replace the whole table rather than editing the one already in your booklet. States leave the list as well as join it, and an edit in place leaves the departed ones behind.
These switch on with a threshold or a plan feature.
COBRA notices
General notice within 90 days of coverage starting; election notice within 14 days of the administrator being told, or 44 where you are your own administrator.
Trigger: 20 or more employees on more than half your typical business days last year. Below that, and with no Michigan continuation law behind it, there is nothing to send.
Summary Annual Report
Within 9 months of the plan year closing, or two months after a Form 5500 extension ends.
Trigger: you have to file a Form 5500. No filing obligation means no SAR.
Forms 1095-C or 1095-B
Statements now satisfied by a website notice posted by the furnishing deadline, with a copy supplied within 30 days of a request.
Trigger: applicable large employer status, or a self-funded plan of any size for 1095-B. See the change note on the compliance page.
2026 — For 2025 forms: furnish by 2 March 2026, or post the on-request notice by that date and leave it up through 15 October 2026. File by 2 March on paper, 31 March electronically. Electronic filing is mandatory at ten or more information returns in aggregate.
ICHRA notice
At least 90 days before the start of each plan year.
Trigger: you offer an individual-coverage HRA.
Wellness program disclosure
In all materials describing the program, and again in any notice that someone failed to meet the standard.
Trigger: the program is health-contingent — a reward tied to an outcome, not just to participating.
2026 — New guidance on 26 August 2026: if an employee meets a reasonable alternative standard partway through the year, the reward may start from that point rather than being backdated. The same guidance confines the disclosure to materials that describe the program’s terms, not ones that merely mention it exists.
Patient protections notice
Whenever the SPD or a similar benefits description goes out.
Trigger: the plan designates or allows a primary care physician, or covers OB/GYN care, and is not grandfathered.
Mental health parity disclosures
Medical-necessity criteria and denial reasons on request, within 30 days, along with the non-quantitative treatment limitation analysis.
Trigger: the plan covers mental health or substance use benefits. Employers with 50 or fewer employees are exempt.
2026 — Enforcement of what was new in the 2024 parity rule is paused while the Departments reconsider it. The 2013 rule and the 2021 statutory duty to produce a comparative analysis on request are both untouched. Nothing here is suspended.
W-2 Box 12, code DD
On the annual W-2.
Trigger: you filed 250 or more W-2s last year. It reports the cost of coverage and is informational — it does not make the benefit taxable.
Grandfathered plan notice
In any plan material that describes benefits.
Trigger: you are still claiming grandfathered status.
HIPAA notice of privacy practices
Within 60 days of a material revision, with a reminder of its availability at least every three years.
Trigger: the plan is self-funded, or fully insured and the employer touches protected health information beyond enrollment and summary data. A fully insured employer that stays hands-off relies on the carrier’s notice.
Distribution follows the plan, not the payroll. Carry it in the booklet if you are self-funded — it is the notice auditors most often find missing from an otherwise complete guide.
Michelle’s Law notice
With any material that describes the plan’s student-status requirement.
Trigger: the plan conditions a dependent child’s coverage on certification of student status. Largely overtaken by coverage to age 26, but still on audit checklists.
There is no government model for this one, so it has to be drafted. Coverage continues up to a year through a medically necessary leave of absence, on the treating physician’s written certification.
The booklet does a lot of this. It cannot do all of it.
The distinction that matters is timing. A notice tied to enrollment travels perfectly well inside an annual guide. A notice tied to an event or a date that is not your enrollment window needs its own delivery, and bundling it into the guide does not satisfy the rule.
Safe to carry in the guide
SBC and Uniform Glossary, HIPAA special enrollment rights, WHCRA (the annual one), the Newborns’ Act statement, CHIP notice, wellness program terms, patient protections, grandfathered status, and the SPD itself if the guide incorporates or accompanies it.
These are all tied to enrollment or to an annual cadence, which is exactly what a guide is.
Needs its own delivery
Marketplace notice — 14 days from a hire date that will not line up with your enrollment window. Part D creditable coverage — 15 October, which is rarely your renewal. COBRA notices — triggered by events, not calendars. SMM for a benefit reduction — 60 days from adoption, not next year’s guide. SAR — nine months after the plan year. ICHRA notice — 90 days before the plan year starts.
Put these in the guide by all means. Just do not let the guide be the only time they go out.
These go to the government, not to your employees.
Worth separating, because mixing the two lists is how an employer ends up believing it is covered when it is not.
Filings
Form 5500 and the 1094 transmittals. The SAR is the participant-facing half of the 5500; the 5500 itself is not.
Attestations and data
The annual gag clause attestation, prescription drug data reporting, and the disclosure to CMS confirming whether your drug coverage is creditable.
Public postings
Machine-readable transparency files and the balance-billing disclosure that has to sit on a public website — published, but not delivered to anyone.
Sourced from the U.S. Department of Labor’s Reporting and Disclosure Guide, the Internal Revenue Service and CMS. General information, not legal advice — which notices apply depends on your plan’s size, funding and features. CFH Insurance Consultants are licensed insurance brokers; CPAs and ERISA attorneys are available through the firm.
Send us your renewal.
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The renewal letter
Your current plan summary
Contribution split by tier
Enrolled counts by tier
Four documents — two more if your group is 50 or more. Nothing else; every extra one is a reason to postpone.
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