Search results for: “Compliance”

  • Compliance Q&A: Look-Back Measurement Method – Reduction of Hours

    Question Our company uses the look-back measurement method to identify full-time employees. I recently hired an employee who was expected to work full-time hours. We offered her medical insurance coverage and she accepted. Since then, however, she dropped to part-time hours. What should I do about her benefits? Summary If an employee who is initially…

  • Compliance Q&A: Common COBRA Compliance Pitfalls

    Question When is COBRA continuation coverage required, and what are some common missteps to avoid? Summary The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) grants individuals the right to continue employer-sponsored health insurance coverage for a limited period after experiencing qualifying events such as a job loss or reduction in work hours. Despite its…

  • Compliance Q&A: Reporting Prescription Drug and Health Care Spending

    Interested in the steps plan sponsors need to take to comply with the RxDC rules? Learn these steps and how they fit into the larger picture of healthcare transparency laws in this compliance QA.

  • Compliance Q&A: What is the “Excepted Benefit” status and why does it matter?

    Summary The determination of whether a particular benefit may be “excepted” is important when structuring a particular solution – such as an FSA, EAP, or a carve-out point solution – to ease a plan sponsor’s compliance with laws such as HIPAA, the ACA, and MHPAEA. Click below to read more on excepted benefit status, why…

  • Compliance Q&A: Health Flexible Spending Accounts – Unsubstantiated Expenses

    Question We switched to a new health Flexible Spending Account (FSA) third-party administrator (TPA). The new TPA deactivated one of our employee’s FSA debit card because of $20 in unsubstantiated expenses, stating this was an Internal Revenue Code requirement. Our prior TPA told us expenses under $25 did not need to be substantiated and that…

  • Compliance Q&A: Fiduciary Duties in Vendor Selection and Management

    Question My company hired a vendor to outsource the utilization management and appeals processes for our health plan. I have heard that we, as the plan sponsor, have a fiduciary duty to monitor the vendor’s activities. What does that mean, and, if this is really required, how can we comply? Summary The 1974 Employee Retirement…

  • Compliance Q&A: On-site Clinics

    Question We are considering starting an on-site medical clinic where our employees can receive medical care. Can you explain the main employee benefits compliance concerns for such a clinic? Summary Employers providing access to an on-site medical clinic for their employees have several potential compliance issues to consider, including ERISA, COBRA, HIPAA, the ACA, and…

  • Compliance Q&A: Group Term Life Insurance – Taxation

    Questions We provide a basic group term life insurance policy of $50,000 to employees. We understand that providing a group life insurance policy under $50,000 would not require an imputed income calculation, but what about supplemental life insurance? Can you provide a high-level overview of group term life insurance and when an employer might have…

  • Common Misconceptions ERISA ACA Compliance

    Rules I’ve always been a rule-follower … to the point that my own family makes fun of me for never even breaking the speed limit! So, naturally, I am attracted to the field of Human Resources where we are bombarded with over 50 categories of rules and regulations affecting virtually every aspect of the employment…

  • Compliance Q&A: How Long Should Benefits Be Continued During an Employee’s Leave of Absence?

    Question One of our employees has been on medical leave for the past four months. Do I have to continue offering our medical insurance benefits or can I go ahead and terminate the medical coverage? Summary Ideally, the question of how long to continue benefits during an employee’s leave of absence (LOA)1 has been proactively…