September 14, 2016
As more businesses prepare for the process of renewing their group health insurance plan, the topic of ACA compliance becomes increasingly important… just as stressful. Regardless of whether you're offering employee medical benefits for the first time, or well-versed on the ever-evolving tenets of healthcare reform-based regulation, it's important to make sure all your proverbial bases are covered.
Here's a rundown of the most common group enrollment issues to consider when preparing to renew or purchase group health coverage for your employees.
Employee Benefits Overview
This is an updated benefits summary, provided to staff, that clearly states benefit details to the group, including: plan options, copayment amounts, network coverage details, deductibles, carrier information, agent contact details and more.
SPD Wrap Documents
SPD documents, or Summary Plan Descriptions, provide a detailed breakdown of all benefits being offered to staff as well as the ERISA provisions not covered in the employee handbook or presentation. This is one of the foremost ACA compliance documents.
Section 125 Documents
These IRS documents are mandatory for any groups enrolled in a Section 125 program, allowing employees to convert salary into non-taxable benefits. Under Section 125, premiums on qualified benefits can be paid pre-tax for additional savings.
COBRA Rights Notification Letters
New employees must be notified of their right to continue group health insurance benefits under the COBRA Act. As new employees join the group plan, they should receive a notice reviewing their right to remain on the plan. COBRA enrollment forms need to be mailed within 10 days of leaving the plan.
Current Employee Census
Having a current and up-to-date employee census will streamline many of the processes involved in offering affordable group coverage, as it will be submitted to the agent and carrier early in the quote and plan selection process.
Employee Election Forms
Each employee will need to fill out, sign and date a health insurance election form, indicating the type of coverage they wish to enroll in. They will also have the option of adding dependents, or declining coverage if so desired.
Subsidy & Marketplace Documents
If you have employees who receive health insurance subsidies or federal tax credits under Obamacare, be sure to have copies of any and all related documents to help prevent delays and other potential compliance violation issues.
Form 1095
Individuals enrolled in a qualifying plan under the health insurance marketplace will receive a Form-1095, allowing them to claim their premium credits. Depending on how your group plan is structured, you may be required to send these out to all applicable staff members.
Forms 6055-6056
These are IRS reporting forms that provide information relating to individuals covered under your group health plan. An agent can provide additional information on these or any other related group health coverage forms.
Free Assistance with IL Group Health Insurance Plans and Renewals
The new system of healthcare reform has significantly increased the role and responsibilities of employers who provide health and medical benefits, and making mistakes can be costly. If you're in Illinois or the Chicago area and want to make sure that your compliance issues are covered, Premier of Lisle can help.
Call us today to learn more about IL group health plan compliance, or set up a time to meet with one of our licensed staff agents to discuss your needs more thoroughly. We can be reached at our Lisle IL health insurance agency by calling 800-369-0287, or by e-mail through our secure contact page.