There are countless rules and regulations governing employee benefit plans, many of which are complex. Our resources will help you meet your compliance obligations and keep you up to date on laws and regulations that affect your employee benefits program.
Employers who offer health benefits to their employees must ensure compliance with various regulations under the Health Insurance Portability and Accountability Act (HIPAA). These compliance obligations include implementing policies, procedures, and notices as required under HIPAA privacy rules, security rules, and final discrimination rules. Failure to comply with HIPAA regulations can lead to penalties of $100 per violation per day up to a maximum of $25,000 in a calendar year.
HIPAA Nondiscrimination rules prohibit discrimination against individuals or beneficiaries based upon a health factor in group health coverage, plan eligibility, and rewards for wellness programs.
Health factors include: health status, medical condition, claims experience, receipt of health care, medical history, genetic information, evidence of insurability and existing disability.
Navigating these guidelines requires experience, contact an ENV professional for compliance assistance with these regulations.
The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as: voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events. Qualified individuals may be required to pay the entire premium for coverage up to 102 percent of the cost to the plan.
COBRA generally requires that group health plans sponsored by employers with 20 or more employees in the prior year offer employees and their families the opportunity for a temporary extension of health coverage (called continuation coverage) in certain instances where coverage under the plan would otherwise end.
ENV offers a HIPAA package to assist our clients in developing their HIPAA policy. Our COBRA software is updated monthly to keep our COBRA administration clients in compliance. ENV clients also have access to our human resource hotline to answer any and all of your compliance questions.
Benefits and regulations are always subject to change through legislation. This makes understanding benefits and regulations confusing and complex. Since our 1988 founding, our professionals have worked through decades of fluctuating benefits and regulations.
ENV can explain relevant benefits and regulations to you and your organization. You can obtain these education services via telephone or email. Our approachable, competent agents will answer any questions you have about benefits and regulations.
Contact an ENV agent today.
Our monthly newsletters provide concise, attorney-reviewed summaries of benefits rule changes to keep you up to date with the latest regulations.