|
|
 Governmental & Regulatory Compliance Oversight and monitoring are key plan governance activities. ERISA provides that a person is a fiduciary to the extent he exercises any discretionary control respecting the management of the plan or exercises an authority or control respecting management or dispositions of its assets or he has any discretionary responsibility in the administration of the plan. Furthermore, fiduciary status is defined not only by reference to particular titles, but also by the authority which a person has or exercises over an employee benefit plan.
Administering qualified benefit programs is no easy task. Complex situations and issues occur daily. Areté compliance experts are available to assist you.
Here is some helpful information and few links to help answer your questions and assist you in compliance.
The Employee Benefits Security Administration (EBSA)
The Employee Benefits Security Administration (EBSA) educates and assists 150 million Americans covered by more than 683,000 private retirement plans, 2.5 million health plans, and similar numbers of other welfare benefit plans; as well as plan sponsors and members of the employee benefits community. EBSA promotes voluntary compliance and facilitates self-regulation, working diligently to provide assistance to plan participants and beneficiaries. .
EBSA's provides direct assistance to raise the knowledge level of plan participants and beneficiaries, service providers and other interested parties and to ensure that they have access to available plan documents filed with the Department of Labor.
This enables participants to better understand and exercise their rights under the law and, when possible, to recover any benefits to which they may be entitled. This also allows practitioners the opportunity to better understand and comply with the law.
COBRA
The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events. Qualified individuals may be required to pay the entire premium for coverage up to 102 percent of the cost to the plan.
COBRA generally requires that group health plans sponsored by employers with 20 or more employees in the prior year offer employees and their families the opportunity for a temporary extension of health coverage (called continuation coverage) in certain instances where coverage under the plan would otherwise end.
COBRA outlines how employees and family members may elect continuation coverage. It also requires employers and plans to provide notice.Describe the details of this particular product or service. Consider using the same information you might include on a brochure or other catalog list.
Department of Labor (DOL) Web Pages on COBRA
Frequently Asked Questions: COBRA Continuation Health Coverage
Provides answers to commonly asked questions about COBRA.
Health Benefits Under the Consolidated Omnibus Budget Reconciliation Act (COBRA) (PDF)
Provides a detailed overview of the major provisions of COBRA.
Consumer Information on Health Plans
Provides fact sheets, booklets, and other health plan information from the Department's Employee Benefits Security Administration (EBSA)
Compliance Assistance
Provides publications and other materials to assist employers and employee benefit plan practitioners in understanding and complying with the requirements of ERISA as it applies to the administration of employee pension and welfare benefit plans.
Portability of Health Coverage (HIPAA) Frequently Asked Questions
Provides answers to questions including "what is HIPAA?" and "how does credit for prior coverage work under HIPAA?"
Your Employer's Bankruptcy: How Will it Affect Your Employee Benefits?
Provides information on bankruptcy's effect on pension and group health plans.
Health Coverage Portability (PDF)
Provides information about the major provisions of the Health Insurance Portability and Accountability Act, the Newborns' and Mothers' Health Protection Act, the Mental Health Parity Act, and Women's Health and Cancer Rights Act.
Pension and Health Care Coverage...Questions and Answers for Dislocated Workers
Top 10 Ways to Make Your Health Benefits Work for You (Español)
Provides information to help you make informed decisions about health plans
Work Changes Require Health Choices (Español)
Provides information on protecting your healthcare rights when your work life changes.
Life Changes Require Health Choices (Español)
Provides guidance on making health benefit decisions following key life events such as marriage, or the birth or adoption of a child.
Frequently Asked Questions for Reservists Being Called to Active Duty Related to their Pension and Health Benefits
Provides answers to the most frequently asked questions about pension and health benefits by National Guard and reserve members being called to active duty.
Family and Medical Leave Act (FMLA)
Covered employers must grant an eligible employee up to a total of 12 workweeks of unpaid leave during any 12-month period for one or more of the following reasons:
- for the birth and care of the newborn child of the employee;
- for placement with the employee of a son or daughter for adoption or foster care;
- to care for an immediate family member (spouse, child, or parent) with a serious health condition; or
- to take medical leave when the employee is unable to work because of a serious health condition.
Portability of Health Coverage (HIPAA)
The Health Insurance Portability and Accountability Act of 1996 (HIPAA), amended the Employee Retirement Income Security Act to provide new rights and protections for participants and beneficiaries in group health plans. HIPAA contains protections both for health coverage offered in connection with employment (group health plans) and for individual insurance policies sold by insurance companies (individual policies).
HIPAA includes protections for coverage under group health plans that:
- Limit exclusions for preexisting conditions
- Prohibit discrimination against employees and dependents based on t their health status
- Allow a special opportunity to enroll in a new plan to individuals in certain circumstances
Department of Labor (DOL) Web Pages on HIPAA
Questions & Answers: Portability of Health Coverage (HIPAA)
Provides answers to commonly asked questions about HIPAA
The Health Insurance Portability & Accountability Act (HIPAA)
Provides a brief overview of HIPAA
Compliance Assistance for Group Health Plans: HIPAA and Other Recent Health Care Laws
Assists in complying with the Health Insurance Portability and Accountability Act, the Newborns' and Mothers' Health Insurance Portability and Accountability Act, the Mental Health Parity Act and the Women's Health and Cancer Rights Act.
Compliance Assistance
Provides publications and other materials to assist employers and employee benefit plan practitioners in understanding and complying with the requirements of the Employment Retirement Income Security Act (ERISA) for the administration of pension and health plans.
Health Coverage Portability (PDF)
Provides information about major provisions of HIPAA, the Newborns's and Mothers" Health Protection Act, the Mental Health Parity Act, and the Women's Health and Caner Rights Act.
Health & Human Services (HHS) Webpages on HIPAA
Compliance & Assistance
ERISA
The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that sets minimum standards for retirement and health benefit plans in private industry. ERISA does not require any employer to establish a plan. It only requires that those who establish plans must meet certain minimum standards.
ERISA covers retirement, health and other welfare benefit plans (e.g., life, disability and apprenticeship plans). Among other things, ERISA provides that those individuals who manage plans (and other fiduciaries) must meet certain standards of conduct. The law also contains detailed provisions for reporting to the government and disclosure to participants. There also are provisions aimed at assuring that plan funds are protected and that participants who qualify receive their benefits.
ERISA has also been expanded to include new health laws. The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) amended ERISA to provide for the continuation of health care coverage for employees and their beneficiaries (for a limited period of time) if certain events would otherwise result in a reduction in benefits. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) amended ERISA to make health care coverage more portable and secure for employees.
EBSA's compliance assistance information will assist employers and employee benefit plan officials in understanding and complying with the requirements of ERISA as it applies to the administration of employee retirement, health and other welfare benefit plans.
Department of Labor (DOL) Web pages on ERISA
Laws and Regulations
Technical Guidance
Compliance Assistance
|
|