Compliance Tip #1 – ERISA
All ERISA plan documents and summary plan descriptions should be reviewed annually. This is not the carrier provided certificate booklet or policy. Most health and welfare plans are required to have ERISA documentation.
Compliance Tip #2 – Employee Handbook
Review your handbook to be sure it is up to date based on how you implement and practice all policies; Policies such as FMLA or Unpaid leave, PTO, personal electronic device usage, benefits, wellness plans, determining eligibility for benefits, etc.
Compliance Tip #3 – ACA Reporting
Understand your ACA Reporting responsibility! Are you an applicable large employer (ALE)? What, when and to who is ACA reporting due? Does the plan have a defined counting tracking or eligibility policy in writing? Do you track employees monthly? If you are an ALE, the deadline for the 2018 ACA reporting to be mailed or delivered to employees is March 4, 2019. All forms should be sent to the IRS by February 28, 2019 (or if filing electronically April 1, 2019). A counting policy or eligibility policy defines the plan’s look-back period (measurement, administrative and stability periods) or monthly measurement period for all employees, especially variable hour and part-time. This policy defines when employees working less than 30 hours per week are eligible for benefits. By tracking employees each month (hours worked, wages, plan contribution), you can quickly determine ALE status, eligibility and prepare employer reporting!
Compliance Tip #4 – Track EVERYTHING!
Tracking! Did you know that you should maintain a log of the who, when, how and what the plan has provided to participants – this includes ERISA Summary Plan Descriptions, Annual Notices, Summary of Benefits and Coverage, etc… You should maintain a log that details what was distributed, when and how it was to distributed and to whom it was distributed. This could be as simple as a copy of the notice, with a payroll report attached and handwritten notes about the when and how; or an excel spreadsheet, a paper file, a binder, whatever works best for you! Just remember the key is to track and maintain! You never know when the DOL may show up…
Compliance Tip #5 – Medicare Creditable Coverage Disclosure CMS
For January renewals, this disclosure is due by the end of February (or no later than 60 days from the beginning of the plan year). This annual disclosure is completed online and notifies CMS if the employer group health plan is creditable or not (meaning the RX coverage is expected to pay on average as much as standard Medicare RX coverage pays).
Compliance Tip #6 – Onsite Clinics
Did you know if you have a worksite clinic that does more than treat minor workplace injuries and illnesses during work hours, it will be subject to ERISA, including the requirements of issuing a summary plan description and filing an annual Form 5500. For more information, check out this article.
Pursuant to CAA requirements, UnitedHealthcare creates and publishes the Machine-Readable Files on behalf of Bim Group
To link to the Machine-Readable Files, please click on the URL provided: transparency-in-coverage.uhc.com