The countdown to this year’s open enrollment is in full swing, and we know many brokers are likely already heads down in helping employers get ready. Benefits compliance is a key part in preparing benefits for the upcoming year and beyond, though a number of factors make staying compliant incredibly difficult…especially for small to mid-size employers.
In this article, we’ll cover some sticking points when it comes to benefits compliance, so brokers can help their clients maintain a compliant environment as a new decade of health care navigation dawns upon us.
Regulations are confusing…and aren’t slowing down.
As employers move to finalize their benefit offerings for the upcoming year, mandates from federal agencies, Congress, the courts, and states are also on the move. And often times, when benefits-related legislation is passed, it doesn’t go into effect until months later.
Brokers can do their part to help ease employee concerns over changing legislation by staying abreast of state and federal mandates and helping their clients build benefits plans that will reflect potential legislative outcomes. Brokers should also be aware of potential penalties and educate their employers so they understand what’s at stake with noncompliance.
Employers have other worries besides benefit compliance.
It’s no secret that HR professionals have a lot on their mind, including many compliance regulations that aren’t related to benefits at all. Anti-discrimination, fair labor, and workplace safety laws are just a few, and let’s not forget the responsibilities associated with recruiting, hiring, payroll, and day-to-day HR administration.
When many HR hats are being worn in cases like this, benefits brokers can be the star of the show in helping clients balance their benefits routine. Providing timely compliance information on relevant topics, such as the Affordable Care Act (ACA) and Employee Retirement Income Security Act (ERISA), sets the stage for a smooth and successful open enrollment cycle, especially for smaller employers—when documentation is due to comply with this legislation.
Juggling multiple deadlines and lots of documentation can get very tricky, very quickly.
When it comes to open enrollment, the long list of documentation HR professionals must get out the door is staggering. Here’s a quick overview of some the documentation organized and submitted during open enrollment season:
Initial COBRA Notice
Grandfathered Plan Notice
Internal Claims and Appeals and External Reviews Notice
Women’s Health & Cancer Rights Act of 1998 Notice
Medicare Part D Notices
Wellness Program Notices (HIPAA and ADA)
Form 5500 (Summary Annual Report)
Section 125 testing (for HSAs and FSAs)
Summary of Benefits and Coverage (SBC) and Uniform Glossary
Summary of Benefits and Coverage (SBC) and Uniform Glossary
Summary of Material Modifications (SMM) and Notice of Modification
CHIPRA Notice
HIPAA Special Enrollment Rights Notice
HIPAA Privacy Notice
Availability of Health Insurance Marketplaces Notice
When it comes to helping clients manage these deadlines, brokers can serve as a trusted advisor to recommend innovative technology to help ease a client’s administrative workload. Some platforms also offer compliance calendars to make juggling multiple deadlines more seamless. Recommending integrated technology to clients is a great way to build additional value outside of the respective benefits role.
