compliance resources

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PARTNERSHIP FOR HEALTH AND WELFARE BENEFITS MANAGEMENT

COMPLIANCE RESOURCES

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Compliance Resources:

Compliance Review

§  USI compiles federal notices, disclosures and reporting requirements in a single comprehensive document.

§  Sample templates and explanations of safe harbor practices enable employers to improve adherence to requirements.

§  Training, timely webinars and how-to guides assist employers with a variety of reporting requirements.

§  The DOL conducted 3,900+ audits in 2014 and assessed over 2,500 employers (~64% of those audited) an average penalty of $236,000, plus attorney fees.

§  Health plan audits are expected to rise in the coming years.

USI’s compliance review assists employers in identifying and mitigating potential compliance issues.




Compliance Review: Anticipated 5500 Expansion

§  Proposed rule changes are complex and designed to be more strict and similar to pension reporting requirements.

§  “Enhanced Data Mining” will allow the DOL to target employers not meeting specific requirements.

§  ERISA compliance and increased fiduciary accountability are a major focus of the expansion.

The Department of Labor’s proposed changes to 5500 filings will drastically increase compliance requirements and exposure to penalties.




Compliance Review: Anticipated 5500 Expansion (cont.)

§  Very few employers will achieve 100% compliance. Understanding the gaps and appropriate remedies will drastically reduce exposure to DOL fines.

§  Unintentional misstatements require correction and may carry penalties. Intentional misstatements are considered a felony offense.

§  Small or voluntary offerings may be overlooked on the 5500 filling. USI helps employers understand the requirements to ensure proper filing.

§  The penalty for failure to file Form 5500 has increased to $2,063 per day.

Benefit plan questions are expected to model the 5500 pension format, with increased scrutiny of documented policies and procedures.




Compliance Review: 1095 Reporting

§  Failure to comply with 1095 filing regulations may result in fines of $250 per failure.

§  Marketplace notices serves as a “heads up” to potential employer penalty assessments for each notice. One of two penalties could apply: 1)$3,240 per ACA FTE/year for individual employees 2) Maximum liability of $2,160 x each ACA FTE in excess of 30 for the year.

§  A robust and defined process for determining and documenting eligibility is the best defense against unwarranted penalties.

2016 ‘A’ Penalty = $2,160 (coverage not offered to 95% of ACA FTE’s) 2016 ‘B’ Penalty = $3,240 (unaffordable or no offer of coverage)

USI’s compliance guides simplify complex reporting requirements and assists employers with Marketplace notice appeals.




Compliance Review: 1095 Reporting (cont.)

§  Reporting solutions vary from simplistic spreadsheets to in-depth database management tools.

§  USI assists employers in identifying their needs and matching to third party tools.

§  Employers with few hourly workers, low turnover and robust benefit offerings can minimize costs with a streamlined solution.

§  Employers with high turnover, variable and seasonal employees and/or less robust benefit plans need a more advanced solution to ensure accurate reporting.

USI account management teams and HR technology experts assist employers in choosing the appropriate method to complete forms.




USI’s Legal & Compliance Team

§  Health and welfare plan compliance education

§  Health Care Reform (ACA) impact analysis tools

§  Ongoing articles, workshops and seminars

§  Compliance guides, templates and sample documents

§  Assistance with notice and disclosure requirements

USI’s Legal and Compliance team of more than 12 locally based, nationally networked attorneys provide clients with a wide range of in-house services.

compliance resources

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