Health Care Reform Compliance Checklist
Health Care Reform Compliance Checklist
In an effort to inform and review information that has been disseminated over the past year; Bedrosian & Associates is providing a snapshot of the most important Health Care Reform compliance requirements. Please never hesitate to contact us for additional information as needed for your business.
The Model Exchange Notices below that must be distributed to all employees prior to October 1, 2013:
- Model Exchange Notices for companies with a medical plan please use this Model Exchange Notice. If you offer medical insurance and need a Model Notice in Spanish please use Model Exchange Notice. If you do not offer medical insurance to any employees please use Model Exchange Notice.
Below are notices that should be distributed (where applicable) to new hires or at your next renewal or medical policy anniversary date:
- ERISA – General Requirements – Bedrosian & Associates recommends you consider enrolling in ERISAEdge services with TASC. We can offer all of our clients a significant discount for any ERISAEdge services needed. We can offer all of our clients a significant discount for any ERISAEdge services based on the standard rates of: employers with 1-49 employees the set up cost is $200 and annual cost is $700, 50-99 employees the set up cost is $300 and annual cost is $1,500 and 100+ employees the set up cost is $500 and annual cost is $1,750. Please review ERISAEdge Flyer. Please call us directly for discounted rates prior to applying. With more Health Care Reform regulations approaching it is important that you get in compliance soon. If not, you will have 10 days to resolve the non-compliance for ERISA if you are audited at a later time.
- Children’s Health Insurance Program Reauthorization Act (CHIPRA) should be distributed at each renewal CHIP Model Notice.
- HIPAA Portability and HIPAA Privacy and Security Certificate of Creditable Coverage – Plans and issuers must provide a Notice of Privacy Practices when a participant enrolls, upon request and within 60 days of a material revision. At least once every three years, participants must be notified about the notice’s availability. These documents are usually included with the medical evidence of coverage document mailed to each employee.
- Women’s Health and Cancer Rights Act (WHCRA) – Model WHCRA Notice should be given to all employees at each renewal.
- COBRA – For a list of Cobra Notices please visit the Department of Labor (DOL) for COBRA Notices. However, since most employers with 20 or more employees use a Third-Party Cobra Administrator there are usually no additional notices the HR Administrator needs to distribute to employees.
- Medicare Part D – There is a notice that should go to those employees age 65 or older who are eligible for Medicare. General information is available from CMS for Medicare and can be found at Creditable Coverage. Usually the Medicare notice is included with the Evidence of Coverage for a group medical plan. Therefore, there is no additional distribution required by the HR Administrator.
(FOR THOSE GROUPS WITH 50 OR MORE EMPLOYEES)
- Family and Medical Leave Act (FMLA) FMLA applies to private sector employers with 50 or more employees with employees that work 20 or more workweeks in the current or preceding calendar year. Information from the DOL is available at FMLA.
- ERISA – Form 5500 Requirements – Small health plans (those with fewer than 100 participants) that are fully insured, unfunded, or a combination of fully insured and unfunded, are exempt from the Form 5500 filing requirement. If you have over 100 employees please contact Bedrosian & Associates directly and we can assist you with the 5500 filing with one of our partners.
Does your company need assistance to get back in compliance?
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- Inflation-Adjusted ERISA Penalties – DOL February 27, 2017
- Blue Shield and Sutter Health sign 3 year contract January 5, 2017
- Eliminating Dependent Coverage? COBRA Rules, and the Employer Shared Responsibility Provision October 26, 2016
- Wrap SPD Requirements – Are you ERISA Compliant? October 14, 2016
- California Choice HSA Options – Q4 2016 October 5, 2016