4 Key Issues in Employee Benefits Compliance

Posted on: January 13, 2020 by iSure

Employers face no shortage of policy and compliance issues to consider with benefit offerings, contribution strategies, vendor terms, plan operations, and employee communications. The array of potential changes and the quickening pace of marketplace developments makes monitoring and planning for these issues more complex than ever.

Every business should have employee benefits solutions, but it’s also important to understand what can affect your organization’s compliance. Here are key issues in compliance developments to address or monitor in planning employee benefits. 

1. Congress

Stay aware of the current 2022 effective date of ACA’s “Cadillac” tax, while monitoring Congress—which has twice delayed the tax’s effective date—for further action. 

You likely seek measures to reduce healthcare costs, make health savings accounts more flexible, simplify ACA reporting duties and ensure that legislation curbing surprise medical bills doesn’t increase costs for employers or undermine their ability to design effective provider networks.

Keep supporting drug-pricing reforms and measures aimed at ending surprise medical bills to enactment this year. 

2. Agencies

If you offer mental health and substance use disorder (MH/SUD) benefits, it’s critical to confirm ongoing compliance with the Mental Health Parity and Addiction Equity Act, given heightened agency enforcement and increased private litigation. Parity compliance may require understanding not only federal law but also state or local mandates.

The rapid development of new information technologies that allow quick access to data protected by the Health Insurance Portability and Accountability Act (HIPAA) means plan sponsors must evaluate each new IT vendor relationship for compliance with evolving guidance. Even if HIPAA doesn’t apply, other data-protection and privacy laws—including state laws—may have implications for emerging health and wellness applications and software.

3. Courts

Court action also has the potential to reshape benefits and program administration, as it’s occurred with rulings on cross-plan offsetting and behavioral health claims administration.

Parties continue to seek broad repeal of the ACA through litigation. Other legal challenges seek changes to specific ACA regulations, such as the contraceptive coverage mandate’s religious and moral exemptions, and the association health plan. 

Legal wrangling is also expected to strike the ACA regulations that ban discrimination based on gender identity and termination of pregnancy in federally funded healthcare programs or activities.

4. States

States are intensifying their focus on healthcare policy, taking steps to reinforce or weaken the ACA and pursue their own reforms, cost controls, coverage mandates, and consumer protection measures. 

Many employers are currently reviewing how to integrate leave programs with a growing patchwork of compliance duties. In the absence of a federal solution, more states are expected to develop paid leave requirements for employers.

Group Benefit Planning

It is in your best interest to have employee benefits solution on your side to protect your business and take note of these compliance-related priorities for health and fringe benefit planning. These include:

  • Ongoing ACA concerns for large employers
  • State activity
  • Data privacy and security
  • Health savings accounts and health reimbursement arrangements
  • Mental health parity
  • Wellness programs
  • Paid leave
  • Prescription drug costs and coverage
  • Cross-plan offsetting by ERISA plan service providers
  • Preventive services. 

About iSure Insurance Brokers

After serving leaders in the Greater Miami market for more than three decades, iSure Insurance Brokers has become the provider of choice for discerning commercial clients and individuals alike. Because no two insurance programs are or should be alike, you can be sure that iSure will craft a comprehensive approach to protection that is as unique as you are. We welcome the opportunity to protect what you have worked so hard to build. Please contact us at (305) 223-2533 to learn more about what we can offer you.

Posted in: Blog Employee Benefits