COMPLIANCE AND REGULATORY
FOR BROKERS
Our extensive knowledge of employee benefit plans and the corresponding regulations, allow us to produce comprehensive and compliant employee benefit materials. These documents include: Summary Plan Descriptions (SPDs), Summaries of Benefits and Coverage (SBCs), Notices of Exchanges and 204(h) materials. Your clients can face financial, civil, and possible criminal penalties for any of these documents that are not in-compliance. Therefore, it is essential that these documents are produced with expert oversight and understanding.
The careful creation and distribution of employee benefit documents and materials can be challenging with no guarantee your clients’ employees will read or even understand the information they have been given. RT Consulting offers extensive support your clients through full content development using innovative regulatory and language templates that is verified for readability and compliance, plus the automated management of benefit plans. he automated management of benefit plans.
Working with RT Consulting
ERISA and ACA (Affordable Care Act) mandates require your clients to implement an increasing number of employee benefits regulations that are changing year-round and force your clients to stay up-to-date with new requirements to ensure they remain in compliance.
Even after ensuring that benefit plans are in-compliance with current regulations, your clients’ employees might struggle to understand the content. Therefore, it is important to develop a strategy to effectively communicate this information to their employees.
SBCs not in compliance put your clients at risk of costly penalties. It is required that SBCs must be distributed at initial enrollment, by the first date an individual can enroll in coverage, and at open enrollment (no later than 30 days before the beginning of the next plan year), during HIPAA special enrollment (no later than 90 days after enrollment) and on request (no more than seven business days after a request).
Since SBCs can be requested at any point during the year beyond the open enrollment period, regular changes to regulations add an extra challenge to the already complex task of developing and maintaining compliant benefits documents and materials.
Summary Plan Descriptions are developed to summarize benefits so that they can be read and understood by the average plan participant. Creation and maintenance of SPDs demands considerable time, effort, and resources from your clients because each SPD must include the plan provisions as well as your clients’ employee and employer rights and responsibilities. In addition to verifying that the benefit plans are current and in compliance, their administration is reviewed to confirm they are being carried out as your client intended. Your clients may seek legal consultation to further review the SPD’s content prior to distribution.
Each year your clients face an extensive and expanding list of disclosure requirements for welfare plans.
Some notices are tied to health care reform. Other notices are tied to Title 1 of ERISA which protects the interests of participants and their beneficiaries in employee benefit plans. Furthermore, your clients must stay informed on notices for Medicare Part D, CHIPRA, WHCRA, etc. It is your clients’ responsibility to comply with these disclosure requirements and determine who is providing what notice for both insured and self-insured plans.
Non-compliance with Affordable Care Act (ACA) regulations can result in heavy fines and possible legal repercussions. The stakes are high and so are compliance requirements which are highly-complicated and demand a significant amount of time and resources for your clients.
We use our extensive experience to address ERISA and ACA compliance issues faced by large organizations with complex benefit plan designs. Our ACA Reporting Solutions help through every step of the process to assure your large clients that their benefit plan designs are in-compliance with all regulations.