Key ERISA and ACA Reporting & Disclosure Rules for Employer and Association Plans
Employers and associations must follow ERISA reporting requirements to maintain ACA compliance and protect plan participants’ rights. These rules promote transparency and accountability across health plan operations. To stay compliant, employers should focus on timely reporting, accurate documentation, and clear disclosures.
Additionally, challenges can arise without expert guidance or up-to-date knowledge of ACA regulations. Fortunately, Enrollment First, Inc (EFI) offers support through tailored services that simplify ERISA and ACA reporting requirements. Moreover, Third Party Administrators (TPAs) play a crucial role in managing filings, disclosures, and compliance deadlines efficiently.
Relevant Items for Meeting ERISA Reporting and Disclosure Requirements:
- Summary Plan Description (SPD): Employers and associations must prepare and distribute an SPD that clearly explains the health plan, benefits, and participant rights. They must provide the SPD within 90 days after a participant joins or becomes covered under the health plan. To stay ERISA and ACA compliant, employers should ensure the SPD is accurate, readable, and easy for participants to understand. Furthermore, reviewing and updating the SPD regularly improves transparency and prevents confusion about group health plan details.
- Summary of Benefits and Coverage (SBC): The Affordable Care Act (ACA) requires employers and associations to provide a Summary of Benefits and Coverage (SBC) to all plan participants and beneficiaries. The SBC must clearly outline coverage details, costs, and key plan features. Employers and associations should distribute the SBC on time and ensure it remains accessible. Clear and timely SBC delivery helps participants make informed decisions about their group health plan options.
- Form 5500 Filing: Employers and associations must file an annual Form 5500 report with the Department of Labor (DOL). This report provides information about the plan’s financial condition, operations, and investments. Proper completion and submission of the Form 5500 are necessary to ensure compliance with ERISA reporting requirements.
Challenges and Addressing Them:
Meeting the ERISA Reporting and Disclosure Requirements can present challenges for employers and associations. Some challenges include:
- Understanding the Requirements: ERISA reporting and disclosure requirements can be complex, requiring a thorough understanding of the rules and regulations. Employers and associations can address this challenge by partnering with experts like Enrollment First, Inc, who can provide guidance on interpreting and meeting these requirements.
- Timely and Accurate Completion: Employers and associations must submit accurate reports on time. However, limited resources can make managing reporting time-consuming and difficult. Therefore, partnering with Third Party Administrators like EFI helps coordinate and manage reporting tasks efficiently and ensures accurate, timely submissions.
- Keeping Up with Changes in Regulations: ERISA reporting and disclosure requirements may change over time due to updates in regulations. Employers and associations need to stay updated with these changes and make the necessary adjustments to their reporting and disclosure practices. EFI keeps employers and associations informed about any regulatory changes and assists in implementing them accordingly.
Enrollment First, Inc and ERISA Reporting and Disclosure Requirements:
Enrollment First, Inc understands the challenges employers and associations face in meeting the ERISA Reporting and Disclosure Requirements. EFI provides services that assist in meeting these requirements:
- Compliance Review and Guidance: EFI reviews group health plans thoroughly to identify requirements. Then, they guide employers in preparing accurate SPDs, SBCs, and documents.
- Form 5500 Filing Assistance: EFI partners with Third Party Administrators to file Form 5500 accurately and on time, easing the employer’s burden.
- Regulatory Updates and Support: EFI keeps employers and associations informed about any changes in ERISA reporting and disclosure requirements. They offer ongoing support and guidance, helping organizations stay compliant with evolving regulations.
Meeting ERISA Reporting and Disclosure Requirements:
Employers and associations must carefully follow ERISA rules and pay close attention to every reporting and disclosure detail. To improve compliance, they should leverage the expertise of Enrollment First, Inc. and support from experienced Third-Party Administrators.
Sources:
[1]: Department of Labor (DOL) – Employee Retirement Income Security Act (ERISA) Reporting and Disclosure [https://www.dol.gov/agencies/ebsa/employers-and-advisers/plan-administration-and-compliance/reporting-and-disclosure].
[2]: Summary Plan Description (SPD) [https://www.dol.gov/agencies/ebsa/about-ebsa/our-activities/resource-center/faqs/spd].
[3]: Summary of Benefits and Coverage (SBC) [https://www.dol.gov/agencies/ebsa/about-ebsa/our-activities/resource-center/faqs/aca-part-x-disclosure-of-material-modifications].
[4]: Form 5500 Overview [https://www.dol.gov/agencies/ebsa/employers-and-advisers/plan-administration-and-compliance/reporting-and-disclosure/form-5500].
[5]: Enrollment First, Inc. Home Page [https://enrollmentfirst.com/].