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Increasing Number of DOL Audits Threaten Employers with Large Fines – Are You Ready?

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The Department of Labor (DOL) has made it clear that the honeymoon is over and full compliance with the Affordable Care Act and ERISA are expected.

It is clear that the DOL has hired thousands of new auditors to ensure compliance with the Affordable Care Act.  What is also clear is that many employers aren’t prepared for the possibility of an audit. Although many audits are triggered by an employee complaint, most are random, or triggered by a failure to file.

Recently released statistics show that employer health and welfare plans are being audited at a higher rate than ever before with more than 37% of the audits resulting in fines greater than $10,000, with 5% of the fines exceeding $50,000.

What are the auditors looking for?  Below is just a small sample of the documents and requirements reviewed in the audit process:

  • Formal plan document (Summary Plan Description) required by ERISA
  • List of all plan service providers
  • Form 5500 information
  • HIPAA compliance documents
  • COBRA compliance proof
  • Documented compliance with mandated notices such as Women’s Heath and Cancer Rights Act, and CHIP
  • ACA required Summary of Benefits and Coverage
  • Exchange Notice/SHOP Notice

The effort to comply with this increasing burden of regulation is a time-consuming task that frequently is delayed in favor of more pressing issues facing employers.  ABS can help you be ready for a DOL audit with a wide range of assistance available, from personal visits from our PHR-certified staff, to free access to our 40-page DOL Audit Guide that is a wealth of information focused on getting your firm prepared in case of an audit.  Contact us to learn more!

In his career, Gregg has developed specialized expertise in “consumer-driven” and high deductible health plans with HSA and HRA strategies, and sold the first HSA plans issued in Virginia through Assurant Health. He is an expert in analyzing plan design data and has served as account executive for national accounts such as Coca-Cola Enterprises and Tenet HealthCare. Gregg utilizes a strategic approach to establish goals based on each client’s unique culture and competitive environment, and measuring results against jointly established criteria. Gregg Kennerly is a Principal at Advanced Benefit Strategies of Virginia, LLC.
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