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Legal, Regulatory & Financial Compliance Solutions
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Employers must ensure all employees are aware of COBRA and its limitations. Businesses who fail to comply with all aspects of COBRA can face legal issues and financial penalties. IRS penalties include fines of $100 a day, per beneficiary, for noncompliance.
Providing plan participants with important information such as the major features of the plan and how the plan is financed. (Plan documents & SPDs.) Fiduciary duties for those who manage assets covered by a plan. Setting up procedures for employee grievances about the plan, as well as an appeal for those grievances. The fines may not exceed $1,000 per day for each violation, for noncompliance.
The fines ARE $100 per day per beneficiary for each violation, for noncompliance.
An employer may be liable for compensation and benefits lost by reason of the violation, for other actual monetary losses sustained as a direct result of the violation, and for appropriate equitable or other relief.
If 100 or more of your employees participate in a health and welfare benefits plan, you must complete IRS Form 5500. Failure to do so can mean possible criminal penalties for deliberate failure to report, and fines of up to $1,100 a day (per employee) for missing or incomplete information.
HIPAA violations are expensive. The penalties for noncompliance are based on the level of negligence and can range from $100 to $50,000 per violation.
Medicare Part D
Employers who sponsor group health plans must provide prescription drug coverage to Medicare Part D-eligible individuals. Insurance carriers certify whether or not a health plan is creditable; however, employers are responsible for the actual notifications and liable for con-compliance penalties.
Employers are obliged to ensure that their Flexible Spending Arrangements (FSAs), Health Reimbursement Arrangements (HRAs), Group Term Life Insurance, and Self-Insured Medical Plans do not discriminate in favor of Highly Compensated Individuals. The penalty for failure to meet the nondiscrimination tests is that the plan sponsor must pay an excise tax equal to $147 per day per non-highly compensated employee who is discriminated against, to a maximum of $500,000 per taxable year for inadvertent failures. Thus, for each employee affected, the annual penalty on the employer will be $36,500, subject to the annual cap of $500,000.
Employers are responsible for the CHIP Notice which must be sent annually – not just to plan participants but also to each employee who is or might become eligible for employer group health benefits & should be part of annual open enrollment packet. Noncompliance could result in a penalty from the Department of Labor (DOL) of $100 per day per non-notified employee.