Compliance Issues: What to Consider When Updating Benefit Plans

Benefits Compliance: What a company should consider when it decides to update its benefit plans?

The government annually checks whether companies and firms remain compliant with the law when it comes to how they implement their insurance policies. Agencies such as the IRS require employees and firms to submit forms that prove compliance with government guidelines. This is done not only to keep standards, but also to ensure that employee benefits are given proper attention and care.

With changes in guidelines every year, it can easily be assumed that your firm should reshape its benefit plan in order to meet those guidelines. Therefore, whether you are going to be designing a new benefit plan for a new plan year, or if you are simply going to be updating an existing plan you have, you need to know the factors that your firm must consider in order to make your benefits compliance easy. The Affordable Care Act includes specific requirements that must be met before the government deems your plan compliant with the law. Here are some of the things you need to keep in mind.

  • Fair Labor Standards Act overtime rules. The changes in the entitlement to overtime compensation can affect the benefits that an employee can receive. Therefore, as part of your benefits compliance agenda, you must ensure that your firm is ready to keep the staffing costs neutral in consideration of the changes you will make regarding the benefits your employees receive.
  • HIPAA security and electronic transactions. Double check whether you need to make any upgrades on how you safeguard the personal health information of your employees by checking the latest requirements set under the Health Insurance Portability and Accountability Act guidelines. Ensure that the vendors you coordinate with are also following the guidelines imposed by HIPAA and other related government agencies.
  • Mental health. As part of the benefits compliance process, the Department of Labor will also be checking if you comply with the requirements for mental health benefits. Your firm needs to confirm that the plan you offer meets the guidance on substance use disorders and mental health benefit coverage. When you are selecting vendors, ensure that you consider their compliance with the Addiction Equity Act and the Mental Health Parity.
  • Nondiscrimination rules and health benefits. The size of the benefits you provide your workers are monitored by government agencies such as the Department of Health and Human Services. Federal agencies continue to issue regulations which will greatly affect how you design your benefit programs. With the ACA in place, you need to make sure that your plan includes all the required health benefits prescribed by the ACA, and that it has nondiscrimination rules in place as well.
  • Strategy and reporting. You also need to double check the design of your health plan and the requirements you impose that your employees will need to comply to. Your firm must check whether the medical coverage and options you provide meet the minimum necessity. You should also check whether the price of your health benefits match standards for affordability. Make the necessary adjustments for your firm to be compliant with the ACA.
  • Wellness programs. To ensure benefits compliance, if your wellness program includes biometric screening, health risk assessment, or collects information from the employee’s spouse, you need to make sure that your program meets the regulations set up by the Equal Employment Opportunity Commission. Your program also needs to be compliant with the Genetic Information Nondiscrimination act and the Americans with Disabilities Act. You should speak to vendors to ensure that your wellness program meets the expectations of the law.

Read more about what benefits are subject to ERISA.

The earlier you start planning your benefit plan, the better it would be. Effective planning is key in passing checks and audits made by government agencies. Compliance will, aside from keeping your firm’s reputation, attract more employees and will generally improve business. Companies that offer good benefit packages are sought after by applicants due to the high costs of insurance policies, medical treatments, and medicines.


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