Developments in Benefits, Compliance
DOL Issues Model Exchange Notice and Sets Compliance Deadline 
Beginning Jan. 1, 2014, individuals and employees of small businesses will have access to insurance coverage through the Affordable Care Act’s (ACA) health insurance exchanges (Exchanges). Open enrollment under the Exchanges will begin on Oct. 1, 2013. ACA requires employers to provide all new hires and current employees with a written notice about ACA’s Exchanges. This requirement is found in Section 18B of the Fair Labor Standards Act (FLSA).
On May 8, 2013, the Department of Labor (DOL) released Technical Release 2013-02 to provide temporary guidance on the Exchange notice requirement. This temporary guidance will remain in effect until the DOL issues regulations or other guidance. According to the DOL, future regulations or other guidance will provide employers with adequate time to comply with any additional or modified requirements.
In connection with the temporary guidance, the DOL announced the availability of model Exchange notices for employers to use to satisfy the Exchange notice requirement. The DOL also set a compliance deadline for the Exchange notices. Employers must provide employees with an Exchange notice by Oct. 1, 2013.
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Nondiscrimination Rules for Fully-Insured Group Health Plans
Under health care reform, non-grandfathered, fully insured group health plans will be required to comply for the first time with federal nondiscrimination rules related to compen-sation. These rules, which have historically applied only to self-insured health plans, prohibit discrimination in favor of highly compensated individuals (HCIs).
The nondiscrimination rules were set to be effective for plan years beginning on or after
Sept. 23, 2010. However, they have been delayed indefinitely, pending the issuance of regula-tions. Once regulations are issued, they will specify the new effective date.
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Compliance Steps for the Final HIPAA Rule
On Jan. 25, 2013, the Department of Health and Human Services (HHS) issued a final rule under HIPAA’s administrative simplification provisions. The final rule updates HIPAA’s privacy, security, enforcement and breach notification requirements, and includes changes required by the Health Information Technology for Economic and Clinical Health Act (HITECH Act).
This Legislative Brief provides an overview of key changes made by the final HIPAA rule and outlines compliance steps for health plans. - View the PDF
HIPAA Certificates Required During 2014
Effective for plan years beginning on or after Jan. 1, 2014, the Affordable Care Act (ACA) prohibits group health plans and issuers from imposing pre-existing condition exclusions (PCEs) on any enrollee. Currently, ACA prohibits PCEs for enrollees who are under 19 years of age. ACA’s restrictions on PCEs apply to both grandfathered and non-grandfathered plans. - View the PDF
Delinquent Filer Voluntary Compliance Program
The Delinquent Filer Voluntary Compliance Program (DFVCP) is a Department of Labor (DOL) program designed to encourage voluntary compliance with ERISA’s annual reporting requirements. ERISA’s annual reporting requirement is commonly referred to as the Form 5500. The DFVCP gives delinquent plan administrators a way to avoid potentially higher civil penalty assessments by voluntarily filing late Forms 5500 and paying reduced penalties.
This Legislative Brief provides an overview of the DFVCP, including the program’s eligibility requirements, penalty structure and participation procedures. Please read below for more information. - View the PDF
What is a medical child support order?
A medical child support order is a judgment, decree, or order (including an approval of a property settlement) that: Is made pursuant to State domestic relations law (including a community property law) or certain other State laws relating to medical child support (see Q1-8); and Provides for child (more)
