Legal Notices
The Department of Labor (DOL) and the Department of Health and Human Services (HHS) require employers to provide certain notices related to employer-sponsored health benefit plans. These notices provide important information regarding your rights, protections, and responsibilities under the health plan offered by your employer.
The information included in this packet is intended to provide general summaries of these required notices and is not intended to provide legal or tax advice. If you have questions regarding any notice or your benefits, please contact Human Resources or your plan administrator.
The following are summaries of key legal notices included in this packet:
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General FMLA Notice
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Uniformed Services Employment & Reemployment Rights Act (USERRA)
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HIPAA Notice of Privacy Practices
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Notice of Special Enrollment Rights
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General Notie of COBRA Continuation Coverage Rights
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Medicare Prescription (Part D) Creditable (Select One)
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New Health Insurance Marketplace Coverage Options
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Premium Assistance Under Medicaid & the CHIP
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Women’s Health & Cancer Rights Act (WHCRA)
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Genetic Information Non-Discrimination Act (GINA)
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Newborn’s & Mother’s Health Protection Act
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Mental Health Parity & Addiction Equity Act (MHPAEA)
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Notice of Patient Protections
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Your Rights & Protections Against Surprise Medical Bills
For more information regarding these notices, please contact the Plan Administrator identified below or your Human Resources Department.
PLAN SPONSOR:
Employer
Yellow Jacket Drilling
Employer Address:
3922 E University Drive Ste 1
Phoenix, AZ 85034
Employer Phone Number:
(602) 453-3252
PLAN ADMINISTRATOR:
Raina Hansen, HR Manager
Plan Admin Email Address:
Phone Number:
(480) 695-1369
