ERISA and ACA (Affordable Care Act) mandates require employers to implement an increasing number of employee benefits regulations that are changing year-round and force employers 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, employees might struggle to understand the content. Therefore, it is important to develop a strategy to effectively communicate this information to your employees.
SBCs not in compliance put employers 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 employers because each SPD must include the plan provisions as well as 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 the employer intended. Plan sponsors may seek legal consultation to further review the SPD’s content prior to distribution.
Each year plan sponsors face a 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, plan sponsors must stay informed on notices for Medicare Part D, CHIPRA, WHCRA, etc. It is the responsibility of the plan sponsor 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 employers.
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 large employers that their benefit plan designs are in-compliance with all regulations.