Are You Prepared For a DOL Audit of your company benefit plans? Has the Internal Revenue Service contacted you for a review?

DOL Audit Checklist

Benefit Plan Compliance Audits

We can help with your DOL audit and IRS examination or work with us to help keep your business from being the target of future audits.

The Department of Labor (DOL) has the responsibility for the administration and enforcement of Title 1 of the Employee Retirement Income Security Act of 1974 (ERISA).  Title 1 establishes guidelines and standards for governing the operation of employee benefit plans such as health, life, disability, dependent care, 401K and other such employee benefits.  Investigative authority is vested in the Secretary of Labor by Section 504 of ERISA, 29 U.S.C. 1134, which in part states:

“The Secretary of Labor shall have the power, in order to determine whether any person has violated or is about to violate any provision of this title or any regulation or order thereunder. make an investigation, and in connection therewith to require the submission of reports, books, and records, and the filing of data in support of any information required to be filed with the Secretary under this title….”

The DOL has significantly increased their resources and staffing for the sole purpose of performing additional investigations and audits.

Reasons you can be singled out for an audit:

  • A participant complained about possible ERISA violations.
  • The IRS or SEC referred a case to the DOL.
  • The DOL used its National Enforcement Project, which looks at different providers, to pick low-hanging fruit in terms of audits.
  • Form 5500 filings.  The DOL will look at plan sponsors to see if they are filing them correctly.

A typical DOL audit can take up to two years and usually begins with a letter requesting an enormous amount of information and supporting documentation related to the Plan(s), including, but not limited to:

  • Plan Document, Adoption Agreement and any amendments.
  • Summary Plan Description (SPD), including any changes in Plan benefits and entitlement to benefits.
  • Summary of Material Modifications (SMM)
  • All contracts with insurance companies for the provision of all health and welfare benefits.
  • All current records related to the Health Insurance Portability and Accountability Act of 1996.
  • A copy of the Plan’s rules for eligibility.
  • A sample of the certification provided to those employees who have just health care coverage or to be provided to those who may lose health care coverage under this plan in the future, which certifies creditable coverage earned under this plan.
  • A copy of the written procedure for individuals to request and receive certificates.
  • A copy of the Plan’s rules regarding coverage of medical/surgical and mental health benefits, including information as to any aggregate lifetime dollar limits and annual dollar limits.
  • The Plan’s Newborns’ Act notice, including lists or logs of notices an administrator may keep of issued notices.
  • A sample general notice of preexisting condition informing individuals of the exclusion period, the terms of the exclusion period, and the right of individuals to demonstrate creditable coverage (and any applicable waiting or affiliation periods) to reduce the preexisting condition exclusion period, or proof that the plan does not impose a preexisting condition exclusion.
  • A copy of the written appeal procedures established by the Plan(s).
  • Copies of the Plan’s three most recent health insurance billing invoices for each of the Plan’s service providers.
  • Current participant census data.
  • Information provided to any employees to comply with the Genetic Information Non Discrimination Act (GINA).
  • A multitude of other information depending upon the scope of the audit.

Having your own staff gather and present all of this information is a daunting task.  Let Benefits Compliance Consultants, Inc. assist you in preparing for your IRS or DOL audit and eliminate the work and worry associated with this unenviable task.  Our audit services offer a wide range of help that include:

  • Comprehensive compliance review and report.
  • Benefit plan compliance audits and reviews.
  • Review of your current plans filings.
  • Thorough analysis and explanation of the government’s data request letter.
  • Negotiation of the scope of the information requested.
  • Assistance in gathering all relevant information.
  • Preparation of the material for the audit.
  • Onsite interview preparation, if necessary.
  • Presentation of the material to the auditor.
  • Follow up and remediation of your case file.
  • Ongoing services, education and training.

ERISA compliance is the law and Benefits Compliance Consultants, Inc. is an ERISA expert.  You simply can’t know everything there is to know about ERISA services.  And, if you’re hesitant to work with a benefits consultant because of the cost, you need to realize that our benefits consultants group can actually save you money, resources and time.  The only way to keep up with all of the changes is with the assistance of a professional company like ours.  Let our highly skilled professionals help make certain that your Plan is in compliance with the law.

Contact us at (515)244-2424 or for your benefit plan compliance review today.