Client Compliance Tips

Created by the Affordable Care Act, this fee funds clinical effectiveness research studies overseen by the Patient Centered Outcomes Research Institute (PCORI). Learn more by reading a series of frequently asked questions.

Is your health plan prepared for a Department of Labor audit? The penalties of non-compliance can be very costly to your business. Learn about penalties associated with certain provisions of ERISA, ACA and other areas of law impacting employee benefit administration.

The regulatory environment continues to keep benefit professionals extremely busy each year updating plan designs and complying with continuous changes. With constant evolving, it can be difficult to stay prepared. In this tip, we take a look at the top 3 surprises that 2017 will bring for employer-sponsored health plans to help keep you informed.

On October 3, 2016, the IRS released the Final 2016 Instructions for Forms 1094-C and 1095-C, as well as the 2016 Forms 1094-C and 1095-C. These instructions and forms are relevant for Applicable Large Employers (ALEs) who must report information about offers of health coverage and enrollment in health coverage for their employees in order to comply with the Employer Shared Responsibility Reporting. Read about these new simplified instructions, due dates, available extensions and more in this tip.

Transitional reinsurance is an Affordable Care Act program established to help stabilize premiums in the individual market from 2014 through 2016. If you are an employer sponsoring a self-insured health plan, you will have obligations under this program. This tip covers the final year of the transitional reinsurance fees and answers FAQs about the program.

Group health plans and health insurance issuers must make certain accommodations when delivering certain notices, like the Summary of Benefits and Coverage, to counties where 10% or more of the population is only literate in a language other than English. See how to determine if you need to make these accommodations.

The Department of Labor amended regulations governing the delivery of information required to be furnished to participants and beneficiaries in employer-sponsored group health plans. Now able to disclosure electronically, employers must perform a step-by-step analysis to determine when electronic disclosure is appropriate. Follow the step-by-step analysis detailed in this tip.

To ease the paperwork burden on Affordable Care Act plan sponsors and administrators, the Department of Labor rules allow for certain documents to be disclosed electronically under certain conditions. Following the enactment of the ACA, employers sponsoring group health plans now have even more notice requirements to comply with in order to stay compliant. This tip covers the safe harbor regulations to help ensure employers are following the DOL’s guidelines.

Health plan sponsors are required to provide an annual disclosure notice to all Medicare Part D-eligible individuals who are covered under an employer group health plan providing prescription drug coverage by October 15th of each year. Learn more about this requirement and the employer action required to stay in compliance in this tip.

The controlled group rules of the Employment Retirement Income Security Act (ERISA) made a popular return with the signing of the Patient Protection and Affordable Care Act (ACA). Learn more about controlled groups and their categories, here.

On May 18, 2016, the U.S. Department of Labor released the final rule updating the Fair Labor and Standards Act (FLSA). The long awaited change revises the overtime exemption rules for the first time since 2004. Read about these new exemptions and their implementation, here.

The IRS released final versions of the 2015 forms, 1094-B and 1095-B, that providers of minimum essential coverage (MEC) will use to report certain coverage information. These forms will report whether individuals were covered by MEC for each month of the calendar year. This tip will cover who is required to report, the information that must be captured in these forms and more.

Applicable Large Employers will now have to report certain coverage information using recently released 2015 forms and instructions from the Internal Revenue Service. However, nothing about these reporting requirements is simple. See how to address the specific issues related to completing and submitting the 2015 Forms 1094-C and 1095-C, here.

Previously scheduled to be effective in year 2018, the U.S. Congress formally passed legislation that delays the Cadillac Tax to year 2020. This is good news for many employers who expected the tax to impact them in 2018. Read about this and other provisions, here.

Under the ACA’s employer mandate, applicable large employers must “pay or play” when it comes to healthcare coverage. In order to avoid unintended penalties, these employers should ensure that their health plan documents accurately reflect changes they have made or will make to their eligibility. See what you need to know.

Do you fully understand all your obligations under federal wellness rules? This tip focuses on ensuring that a wellness program complies with non-discriminatory rules and that design and terms are properly documented.