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A brief summary of the various benefits-related notifications and filing obligations that employers sponsoring group health plans must ensure they are complying with on an ongoing basis.

  • Business Associate Agreements - For self-insured or fully insured "hands-on" employer; ongoing.
  • ERISA Plan Document - For employer-sponsored group health plans providing medical care, regardless of size; does not have to be filed with federal agency; must be in writing and maintained with other records; must be provided to participants and beneficiaries within 30 days of written request; ongoing.
  • FMLA - For employers with 50 or more employees or public employers regardless of size; involves various employee notices, poster requirements, time frames and interaction with employment policies and procedures; ongoing.
  • Form 5500, Related Schedules and Accountant's Report - For all group health and welfare plans except fully insured, unfunded, or combination fully insured and unfunded plans with fewer than 100 participants on first day of plan year; due within seven months of plan year end; annually.
  • Form W-2 Reporting Requirement - Employers must file Form W-2 reflecting the "aggregate cost" of applicable employer-sponsored coverage in box 12, code "DD" with the IRS; due by Jan. 31 annually.
  • GINA Poster Requirement - Employers are required to post a notice explaining the provisions of the Genetic Nondiscrimination Information Act (GINA) at the workplace; ongoing.
  • HIPAA Breach Notifications - Following a breach of protected health information; must notify affected individuals and U.S. Department of Health and Human Services; time frame and notification requirement varies based on number affected.
  • HIPAA Privacy/Security Policies and Procedures - Does not have to be filed with federal agency; must be in writing and maintained with other records; covered entity must distribute privacy policies every three years.
  • Medicare Part D Creditable/Non-creditable Disclosure to CMS - Disclosure to Centers for Medicare and Medicaid Services (CMS) within 60 days of beginning of plan year; annually.
  • Medicare Section 111 Reporting - For employers who self-insure and self-administer health plan, including HRAs with annual benefits of $5,000 or more; filed on a quarterly basis.
  • Qualified Medical Child Support Order - Within 20 days of receiving order, employer must forward to administrator or respond directly to state issuing authority.
  • Section 125 Cafeteria Plan Document - Must be adopted prior to allowing employee pretax premium deductions; does not have to be filed with federal agency; must be in writing and maintained with other records; ongoing.
  • USERRA - Employer must post a notice explaining the provisions of the Uniformed Services Employment and Reemployment Rights Act (USERRA) at the workplace; ongoing.

The information provided is for educational purposes only. It highlights major federal requirements regarding employer-sponsored health plans. It is not inclusive of all requirements. This document should not be relied upon for legal advice.

This material was created by National Financial Partners Corp. (NFP), its subsidiaries, or affiliates for distribution by their registered representatives, investment advisor representatives and/or agents.

The material was created to provide accurate and reliable information on the subjects covered. It is not intended to provide specific legal, tax or other professional advice. The services of an appropriate professional should be sought regarding your individual situation. Neither NFP nor its affiliates offer legal or tax services.