Legal Notices

This online benefits guide is for informational purposes only. The content in this guide provides only a brief description of the benefits and insurance plans and is not the Summary Plan Descriptions for the plans. For complete details of any benefit, refer to your member handbook or the plan’s benefit booklet. If there are any conflicts between this guide and the insurance contracts, the insurance contracts and plan agreements contain legal, binding provisions and will prevail.

Summary of Benefits and Coverage (SBC)

As required under the Affordable Care Act, Sonos must provide you with a Summary of Benefits and Coverage (SBC) for the medical plan in which you (and your family members) are currently enrolled. The SBC summarizes important information about your coverage in a standard format established under the Affordable Care Act. Visit Backstage for the SBCs for the Sonos medical plans.

Women’s Health and Cancer Rights Act of 1998

The Women’s Health and Cancer Rights Act (effective 1998) states that any health plan that provides medical benefits for a medically necessary mastectomy must also provide coverage for:

  • Reconstruction of the same breast.
  • Reconstruction of the other breast to achieve symmetry.
  • Prostheses.
  • Treatment of physical complications of all states of mastectomy, including lymphedema.
  • This coverage will be provided in consultation with the attending physician and the patient and will be subject to the same annual deductibles and coinsurance provisions that apply to the mastectomy.
  • This act does not change the benefit maximums, limits, or deductibles of your plan. The state in which you live or work, or in which your plan was underwritten, may have additional mandated rights regarding mastectomy.

Newborns’ and Mothers’ Health Protection Act

Group health plans and health insurance issuers generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under federal law, require that a provider obtain authorization from the plan or the issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours).

Special Enrollment Events

Special enrollment events allow you and your eligible dependents to enroll for health coverage outside the Open Enrollment period under certain circumstances if you lose eligibility for other coverage, become eligible for state premium assistance under Medicaid or the Children’s Health Insurance Program (CHIP), or acquire newly eligible dependents. This is required under the Health Insurance Portability and Accountability Act (HIPAA).

If you decline enrollment in a Sonos medical plan for you or your dependents (including your spouse/domestic partner) because of other health insurance coverage, you or your dependents may be able to enroll in a Sonos medical plan without waiting for the next Open Enrollment period if you:

  • Lose other coverage. You must request enrollment within 31 days after the loss of other coverage;
  • Gain a new dependent as a result of marriage, birth, adoption, or placement for adoption. You must request enrollment within 31 days after the marriage, birth, adoption, or placement for adoption; or
  • Lose Medicaid or Children’s Health Insurance Program (CHIP) coverage because you are no longer eligible. You must request enrollment within 60 days after the loss of such coverage.

In addition, you may enroll in a Sonos medical plan if you become eligible for a state premium assistance program under Medicaid or CHIP. You must request enrollment within 60 days after you gain such coverage.

Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)

If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs, but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare.gov.

If you or your dependents are already enrolled in Medicaid or CHIP and you live in a state listed below, you can contact your state Medicaid or CHIP office to find out if premium assistance is available.

If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your state Medicaid or CHIP office, dial 1-877-KIDS NOW, or visit www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan.

If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must permit you to enroll in your employer plan if you are not already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, you can contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272).

For a list of states with Medicaid and/or CHIP, click here. This list is current as of July 31, 2018. Contact your state for more information on eligibility or the Department of Health and Human Services at www.cms.hhs.gov or call 1-877-267-2323, Menu Option 4, Ext. 61565.

Important Notice From Sonos About Your Prescription Drug Coverage and Medicare

This notice explains that prescription drug coverage through Sonos is as good as, or better than, Medicare prescription drug coverage. Click here to review this notice.

Health Insurance Portability and Accountability Act (HIPAA)

HIPAA describes your rights to health privacy. Click here to review this notice.

Physician Designation Notice

The Aetna HMO and Tufts HMO plans generally require the designation of a primary care provider.  You have the right to designate any primary care provider who participates in the network and who is available to accept you or your family members.  Until you make this designation, the applicable plan designates one for you.  For information on how to select a primary care provider, and for a list of the participating primary care providers, contact the Sonos People Team at people-help@sonos.com.  For children, you may designate a pediatrician as the primary care provider.

You do not need prior authorization from the Aetna or Tufts HMO plans or from any other person (including a primary care provider) in order to obtain access to obstetrical or gynecological care from 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 carrier website or the Sonos People Team at people-help@sonos.com.