Documentation

It is not enough to say you have provided your employees with the required notifications within the indicated timelines or that you have completed notifications to those agencies managing reporting, like the DOL or CMS. Proof of notification must be documented with the employer carrying the burden of proof, should it be needed. Regardless of the delivery method used to provide notification, whether that is sending notification through the mail, handing out a physical hard copy in an employee meeting, or use of electronic methods like company email, it is advised that some form of documentation is maintained as evidence of the notification. Documentation should include, at a minimum:  the date sent, method used, list of notifications included, and names of individuals notified.

Exchange Notice

Regardless of whether the employer offers Health insurance or not, they are required to provide their employees with a Health Exchange Notice by October 1 st , 2013 and, going forward, to all New Hire employees within 14 days of hire. The notice must include specific items like existence of the Marketplace, how employees may contact the Marketplace for assistance, if the employer’s share of total cost of provided benefits is less than 60 percent (i.e., whether it offers minimum value) and is affordable in accordance with the Affordable Care Act (ACA).

SPD & SPD Wraps

Summary Plan Descriptions (SPD) are required to be given to all participating employees, regardless of group size, disclosing to participants specific provisions they need to know about what the plan provides and how it operates. This requires more information than is provided by insurance providers to comply with ERISA, and there is no small company exclusion. All employers groups must comply in order to avoid penalties and pass an audit by the Department of Labor. Employers are required to provide SPDs to all participating employees within 90 days of coverage for each health and welfare benefit provided. Many employers elect to use an SPD Wrap document that creates a single SPD for all benefit, wrapping in missing insurance provider information and required ERISA information. The SPD requirement is not new, ERISA has been around since 1974. Because it was not actively enforced with smaller organizations, many employers are unaware and out of compliance. In light of healthcare reform, DOL audits are taking place with groups of all sizes with penalties of up to $1,000 for each failure and possibly $100 – $110 per day per employee with a three year look-back for ERISA language up to a $549K max. Keeping current with employee notices is critical to avoid costly fines and meet DOL requirements.

By Deborah Siddoway, HR Coach, HR Service, Inc. Employee Notifications & SPD Wraps

Employee Notifications & SPD Wraps

Contact HR Service, Inc. for resources to comply with notification requirements. Clients receive access to our all-in-one employee notice service, including legal updates and our new automated Health Exchange Notice all part of our Compliance Basics service. SPD Wraps – We provide a web-based SPD Wrap service that allows clients or their agent to easily create, store and edit SPDs for all required benefits.

Enroll online at www.HRServiceInc.com or Call: (855) 447-3375. Email: Info@HRServiceInc.com