Great benefits are increasingly important to employees, particularly in this tight labor market, as well as to organizations that not only want to be able to recruit and retain talent, but that want to have a healthy and productive workforce that’s good for their bottom line.

But for employers, making sure they’re in compliance with what can seem like a bottomless barrel of laws and regulations at every governmental level is a monumental headache, at best, especially with a workforce that’s increasingly remote and diverse. But remain in compliance you must or else face heavy penalties and maybe a hit to your reputation.

With that, here’s what you need to know about ensuring that your health care benefits are complying with rules and legislation — plus any new laws and modifications that may be coming online.

What Needs Monitoring?

There are tons of laws and rules for the Affordable Care Act (ACA), for example, as well as the Consolidated Omnibus Budget Reconciliation Act (COBRA), the Health Insurance Portability and Accountability Act (HIPPA), and the Employment Retirement Income Security Act (ERISA).

And again, this isn’t counting new laws and changes, and those that are on the way.  

What are Penalties for Non-Compliance?

You don’t want to mess around here. Just for the ACA, employer penalties over the next 10 years are expected to reach a whopping $207 billion.

And for example, penalties for breaches of HIPPA, which seeks to safeguard employees’ protected health information, and ensures that people have access to their health records, are issued by the Department of Health and Human Services’ Office for Civil Rights (OCR), and state attorneys general. Depending on the level of harm, and any history of noncompliance, fines can reach up to $50,000 per violation.

How Can I Stay in Compliance?

Healthcare reform and increased scrutiny can turn managing and tracking all that you’re supposed to do, and not do, can be a full-time job – literally. There was a time when organizations were depended on to voluntarily comply, but those days are gone. Not only must companies have a healthcare compliance plan in place, but they must be able to demonstrate implementation.

What you need is outside assistance to help you fulfill your compliance requirements while improving internal work processes. This allows you to concentrate on your core business.

Often, employers do strive to comply but are unable to prove it because they lack documentation. A compliance manual is needed in addition to a database for deadlines and documents that you may need to show.

Once you have data in one place, you need a system for quickly addressing compliance concerns or issues. You must have the bandwidth to swiftly and thoroughly investigate potential misconduct so that remediation that ensures future compliance can occur.

You also need help with complex health benefits including retiree plans, domestic partnerships, and wellness plans, all which mandate compliance plus tax considerations.

Further, you could use a compliance review that can uncover where more action is necessary regarding certain requirements.

As you can see, ensuring that your healthcare benefits comply with various and sundry rules and regulations is serious business – for serious businesses – and requires deliberate action. You don’t want to fool around here or drag your feet. Why risk huge penalties that can set your organization back? Besides, don’t you want a culture of accountability at your workplace, and the ability to recruit and retain without fear of noncompliance?

To get and stay on track, consider enlisting the assistance of Mercer, which combines regulatory and legal expertise with vast benefits knowledge and strong risk management capability.


By admin