Federal Court Strikes Down Association Health Plan Rules

compliance bulletin

On March 28, 2019, a federal judge ruled that certain parts of the Trump administration’s 2018 final rule on association health plans (AHPs) are invalid. The court directed the DOL to reconsider how the remaining provisions of the final rule are affected. This Compliance Bulletin provides an overview of the court’s ruling and its impact.

© 2019 Zywave, Inc. All rights reserved.

 

A Record $304 Million in Back Wages Recovered by DOL

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On Oct. 9, 2018, the Department of Labor (DOL) announced that its Wage and Hour Division (WHD) recovered a record $304 million in wages owed to workers in fiscal year (FY) 2018. In comparison, the WHD recovered $270 million in back wages in FY 2017.

Compliance Assistance
The DOL’s secretary, Alex Acosta, states that the recovered wages are a demonstration that the DOL and WHD are committed to ensuring workers receive the wages they deserve. Moreover, the WHD’s compliance assistance efforts demonstrate its commitment to helping employers meet compliance requirements. Specifically, in FY 2018, the WHD held 3,643 educational outreach events to help job creators understand their responsibilities under the law.

PAID Program Extension
On the same day, the WHD also announced a six-month extension of the voluntary Payroll Audit Independent Determination (PAID) program. This program is an initiative designed to help expedite back wage payments to workers. Without this program, workers may have to wait for investigations and court cases to be resolved or concluded.

What does this mean for my organization?
Complying with wage and hour regulations should be a priority for your organization. This is especially important as the DOL has demonstrated that it will focus on ensuring compliance, as seen by the record numbers it has collected recently.

With more employees working remotely, using their smartphones to access email or work at home, and looming overtime rule changes in 2019, now is the time to ensure your organization’s compliance.

Contact Ardent Solutions today for help complying with wage and hour regulations, or for additional resources.

© 2018 Zywave, Inc. All rights reserved.

 

ERISA Compliance Audit Considerations

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There is no standard procedure or format for a compliance audit, however, every plan sponsor should periodically perform an audit of its employee benefit plans for compliance with ERISA and other legal requirements.  Here are some resources to help identify & correct compliance failures before they are discovered by the DOL.

  • The DOL’s compliance assistance webpage will will assist employers and employee benefit plan officials in understanding and complying with the requirements of ERISA as it applies to the administration of employee retirement, health and other welfare benefit plans. Tools on this website include:
  • Health and Welfare Plan Compliance Checklist – a high level quick check. By answering 20 questions this checklist will provide you with a base line of what needs to be addressed in greater detail. Any question answered “No” equals an area where additional work is required.
  • Ardent Solutions Compliance Guide This Guide is designed to provide general information with respect to Health and Welfare Plan compliance. No representation is made that the information provided is comprehensive or anything more than an overview. The information contained in this Guide is not intended, and should not be viewed as, legal advice. Specific questions about the tax or legal  implications of your policy or related matters should be referred to a qualified ERISA and employee benefits attorney.

If problems are discovered during a compliance audit, they should be addressed promptly. Knowingly continuing the same practice or not correcting a violation, may be construed as “willful” leading to possible criminal penalties and considered a breach of fiduciary duty if later revealed during a DOL audit.

If you are looking for a partner to provide the advice, tools, and support to proactively keep your benefits plan up to speed with dynamic and fluctuating legislative regulations, and ensuring compliance is seamlessly integrated into your business — contact Ardent Solutions today 1-855-770-4118 or http://ardentsolutionsllc.com/contact/ to learn more.

 

 

DOL Audit—Are you ready?

DOL Audit guideThe Department of Labor (DOL) has broad authority to investigate or audit an employee benefit plan’s compliance with the Employee Retirement Income Security Act (ERISA). Audits are performed by the DOL’s Employee Benefits Security Administration (EBSA). To perform these audits, EBSA employs over 400 investigators working out of field offices, many of whom are lawyers or CPAs or have advanced degrees in business and finance.

This DOL Audit Guide is your manual for preparing for a DOL audit of your HEALTH PLAN. This Guide is designed to provide you with an overview of why certain health plans are selected for audit and what you can do to prepare for an audit and reduce your risk of being audited. It also describes what is typically required of an employer during a health plan audit. It includes:

Suggestions on how to prepare for a DOL audit;
Tips for responding to a DOL audit letter;
A list of documents that DOL investigators commonly request during an audit; and
A list of available resources and sample documents to help you prepare for an audit.

© 2015 Zywave, Inc.All rights reserved.

ERISA Compliance FAQs: Enforcement

Legislative BriefThe Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that sets minimum standards for employee benefit plans maintained by private-sector employers. ERISA includes requirements for both retirement plans (for example, 401(k) plans) and welfare benefit plans (for example, group health plans). ERISA has been amended many times over the years, expanding the protections available to welfare benefit plan participants and beneficiaries.

The Department of Labor (DOL), through its Employee Benefits Security Administration (EBSA), enforces most of ERISA’s provisions. Violating ERISA can have serious and costly consequences for employers that sponsor welfare benefit plans, either through DOL enforcement actions and penalty assessments or through participant lawsuits.

This ERISA Compliance FAQs Enforcement  Legislative Brief includes a set of frequently asked questions (FAQs) to help employers understand how ERISA’s requirements for welfare benefit plans are enforced.

© 2015 Zywave, Inc. All rights reserved.

ERISA Compliance FAQs: Reporting and Disclosure Rules

Legislative BriefThe Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that sets minimum standards for employee benefit plans maintained by private-sector employers. ERISA includes requirements for both retirement plans (for example, 401(k) plans) and welfare benefit plans (for example, group health plans). ERISA has been amended many times over the years, expanding the protections available to welfare benefit plan participants and beneficiaries.

The Department of Labor (DOL), through its Employee Benefits Security Administration (EBSA), enforces most of ERISA’s provisions. Violating ERISA can have serious and costly consequences for employers that sponsor welfare benefit plans, either through DOL enforcement actions and penalty assessments or through participant lawsuits.

This legislative brief, ERISA Compliance FAQs Reporting and Disclosure Rules includes a set of frequently asked questions (FAQs) to help employers understand ERISA’s requirements for reporting and disclosure.

Certain employee assistance programs (EAPs) are excepted benefits

Health Care Reform bulletin

Under final regulations, applicable for plan years beginning on or after January 1, 2015, an EAP will constitute excepted benefits if the following four requirements are met:

1. The EAP does not provide significant benefits in the nature of medical care. For this purpose, the amount, scope and duration of covered services are taken into account.

2. The EAP’s benefits are not coordinated with benefits under another group health plan. This requirement has two elements:

  • Participants in the other group health plan must not be required to use and exhaust benefits under the EAP (making the EAP a “gatekeeper”) before they are eligible for benefits under the other group health plan; and
  • Eligibility for benefits under the EAP must not be dependent on participation in another group plan

3. No employee premiums or contributions are required to participate in the EAP.

4. The EAP does not impose any cost-sharing requirements.

Top Tips for Navigating Through a DOL Health Plan Audit

DOL AuditTop Tips for Navigating Through a DOL Health Plan Audit (download using link below), features do’s and don’ts that will help you make it through a DOL audit. With more audits happening to companies of every size, this is a must-have tool that can prevent problems and help facilitate the entire process.

Top Tips for Navigating Through a DOL Health Plan Audit

COBRA: Action needed now

COBRA_insurance_wbg_1On May 7, 2014, the U.S. Department of Labor (DOL) issued proposed rules with amendments to the notice requirements under the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). The proposed amendments are intended to align the COBRA notice requirements with the Affordable Care Act (ACA) so that individuals who lose coverage under their employer’s plan understand that they have the option to either (a) purchase COBRA coverage; or (b) purchase coverage through the new ACA Health Insurance Marketplace, which may be more affordable than COBRA coverage. The proposed rules were accompanied by a new model election notice and general notice that employers may use to satisfy their COBRA notice obligations. (A new model Children’s Health Insurance Program notice was also issued.)

A few days before the DOL issued its proposed rules, the Department of Health and Human Services (HHS) also issued a new bulletin regarding COBRA. HHS is concerned that former model COBRA notices did not sufficiently explain the Marketplace options to persons eligible for COBRA. Thus, HHS is giving current COBRA-eligible individuals a one-time special period — through July 1, 2014 — to enroll in a qualified health plan through the Marketplace.

Right now, employers should, at a minimum: (1) update their COBRA general and election notices to include the new model language regarding Marketplace coverage; (2) notify current COBRA eligible individuals regarding their special, one-time right to enroll in Marketplace coverage through July 1, 2014; (3) review and revise their health plan’s COBRA communications, policies and procedures to include the availability of coverage in the Marketplace; and (4) update current plan’s summary plan description to include the option of Marketplace coverage.

If you have questions or need help with these action steps, please feel free to contact me, bbrown@thenoblegroup.com.

Agencies Release New COBRA Guidance for Individuals and Employers

Health Care Reform Legislative BriefThe DOL and HHS recently issued clarifying guidance regarding COBRA to reflect the impact of the ACA’s Exchanges. This Agencies Release New COBRA Guidance for Individuals and Employers Health Care Reform Compliance Bulletin provides an overview of the agencies’ guidance.