Compliance Corner: The DOL’s List of Federal Laws Impacting Employer-Based Coverage
For us as insurance agents and brokers, we believe it’s our responsibility to help customers navigate employer requirements set by the government. Over the next several months, we’re going to provide brief overviews of areas of compliance that we hope will help you better understand these obligations.
The Department of Labor has compiled an exhaustive list of federal laws impacting employer-based coverage. It’s only 154 pages if you’re looking for a real page-turner. It doesn’t currently incorporate the new transparency requirements of the Consolidated Appropriations Act (CAA) as those have not come into effect yet.
Federal requirements nearly all fit under one of these broader topics:
- Notices: Annual and situation-specific
- Coverage Rules: What benefits must be offered. These are most often addressed by health insurers in their product development.
- Eligibility, Cost to Employees, Privacy, and Discrimination Rules: These are rules meant to prevent discrimination of who is covered, when they get coverage, and how much they pay for coverage. There are also some rules about expectations of employers for the handling of the employee share of premiums.
- Government Reporting includes such things as ACA reporting, notifying CMS of the creditability of prescription coverage, PCORI reporting and fee due each July.
Look out for the next Compliance Corner in May where we will discuss the various notice requirements that apply to employee benefit programs. Stay tuned!
As always, contact your ARC client relations advisor with any questions.