Puerto Rico Notice of Special Enrollment Rights

State:
Multi-State
Control #:
US-AHI-014
Format:
Word; 
Rich Text
Instant download

Description

This AHI form is a notice of special enrollment rights for the employee or their dependents under the group health plan.

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FAQ

Law 80 addresses unjust dismissals in the workplace, protecting employees from wrongful termination. This law establishes the conditions under which employees may seek compensation for being let go without just cause. Understanding Law 80 is crucial for Puerto Rico residents, especially when navigating their rights and resources like the Puerto Rico Notice of Special Enrollment Rights.

Act 379 is legislation that provides guidelines for the health insurance sector in Puerto Rico. This act aims to enhance consumer protections and improve access to healthcare services. Familiarity with Act 379 helps individuals understand their entitlements under the Puerto Rico Notice of Special Enrollment Rights.

If you get married, you're eligible to get coverage effective the first of the following month, regardless of how late in the month you enroll. If you have a baby, adopt a child, or receive a court order for medical child support, the coverage can be backdated to the date of the birth, adoption, or court order.

What is the contract called that is issued to an employer for a Group Medical Insurance plan? (An employer would be a possible applicant and contract policyholder of a single master contract or master policy for group health benefits.)

Puerto Rico is not an 'employment at will' jurisdiction. Thus, an indefinite-term employee discharged without just cause is entitled to receive a statutory discharge indemnity (or severance payment) based on the length of service and a statutory formula.

From an employment law perspective, this means federal statutes such as Title VII, FLSA, ADA, ADEA, FMLA, USERRA, OSHA, ERISA, COBRA, among others, apply to Puerto Rico.

In general, employers must allow all employees who had at least 1,000 hours of service in the preceding plan year to participate in a simple cafeteria plan. However, employers may exclude from the plan employees who meet one of the following criteria: Are under age 21 before the close of a plan year.

2022 HIPAA allows eligible individuals to enroll in health plan coverage outside of the regular enrollment periods. 2022 These special enrollment rights apply to employees and their dependents, depending on the circumstance.

4 of 26 January 2017 (the Labor Transformation and Flexibility Act (Law No. 4)), requires that termination be for 'just cause' (or the payment of a statutory severance). A termination is for 'just cause' if it is not motivated by legally prohibited reasons or the product of the employer's caprice.

The HIPAA certificate of creditable coverage is no longer a required notice. The certificate was eliminated at the end of 2014 because its primary function was to address pre-existing condition exclusions (PCEs). The ACA has since prohibited all PCEs, which is why the certificate is no longer required.

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Puerto Rico Notice of Special Enrollment Rights