Important Legal Notices

The following are summaries of legal notices regarding your rights and procedures to protect those rights. The actual notices are available in the Health and Welfare Plan Summary Plan Description

Diageo Creditable Coverage

Diageo Creditable Coverage

Health Insurance Portability and Accountability Act of 1996 (HIPAA)

These privacy rules set limits on how health plans, pharmacies, hospitals, clinics, nursing homes and other direct-care providers use individually identifiable health information. It is important that you understand your rights to privacy and the protection of information related to your health.

Health Insurance Portability and Accountability Act (HIPAA) Privacy Notice

Women’s Health and Cancer Rights Act (WHCRA)

The Women’s Health and Cancer Rights Act (WHCRA) requires group health plans and health insurance issuers which provide coverage for medical and surgical benefits with respect to mastectomies to cover all stages of reconstruction and surgery to achieve symmetry between the breasts, prostheses, and complications resulting from a mastectomy, including lymphedema. Please contact your medical plan vendor or benefit team member for more information.

Consolidated Omnibus Budget Reconciliation Act (COBRA)

The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances.

COBRA Coverage Rights

Newborns’ and Mothers’ Health Protection Act (Newborns’ Act)

The Newborns’ and Mothers’ Health Protection Act (Newborns’ Act) requires group health plans which offer maternity coverage to pay for at least a 48-hour hospital stay following childbirth (96-hour stay in the case of Cesarean section).

Claims Procedures and Appeals

Federal law requires your health care provider to offer a process for filing claims for services and supplies that are urgent in nature in addition to procedures for post service claims.

Initial Notice of Preexisting Condition Limitation

You have a right to know any existing preexisting condition limitations under the Plan.

Patient Protection Notices

If the Plan provides for or requires the designation of a primary care provider, you have the right to designate any primary care provider who participates in our network and who is available to accept you or your family members. For information on how to select a primary care provider, and for a list of the participating primary care providers, contact the medical plan vendor. For children, you may designate a pediatrician as the primary care provider.

You do not need prior authorization from the Plan or from any other person (including a primary care provider) in order to obtain access to a health care professional in our network who specializes in obstetrics or gynecology. The health care professional, however, may be required to comply with certain procedures, including obtaining prior authorization for certain services, following a pre-approved treatment plan, or procedures for making referrals.

For a list of participating health care professionals who specialize in obstetrics or gynecology, contact the medical plan vendor.

Special Enrollment Periods

Loss of Other Coverage

If you decline enrollment for yourself or your dependents (including your spouse) because of other health insurance 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 to the other coverage). However, you must request enrollment within 30 days after the other coverage ends (or after the employer stops contributing to the other coverage).

New Dependent

If you gain a new dependent as the result of marriage, birth, adoption or placement for adoption, you may be able to enroll yourself and your dependents, provided that enrollment is requested within 30 days after the marriage, birth, adoption or placement for adoption.

Children’s Health Insurance Program and Medicaid Eligibility Changes

If you or your dependents are eligible for medical coverage in this Plan but are not enrolled, you have 60 days to enroll in the Plan in the following two circumstances:

  • If you or your eligible dependents’ Medicaid coverage or coverage under the state Children’s Health Insurance Program (CHIP) is terminated due to loss of eligibility; or
  • If you or your dependents become eligible for a premium assistance program in the state in which you reside.

Additional Notices