Author: Phil Bushnell
From fostering a workplace culture centered on supporting the physical, emotional, career and financial wellbeing of employees, to ensuring that benefit programs are compliant with local, state and federal requirements, effectively protecting the wellbeing of your employees connects directly to protecting the wellbeing of your organization overall.
Compliance Connections delivers actionable guidance designed to help you manage and optimize the connections between the compliance of your benefits and human resources programs to overall organizational wellbeing.
Nonprofit employers face unique issues with employee benefits compliance. Here are some important topics for consideration.
| Goal | Ask yourself |
| Stay on top of prescription drug data collection (RxDC) reporting. | How have you prepared to annually gather and submit the required information? |
| Be aware of continued telemedicine flexibility. | What have you communicated with plan participants about telehealth flexibility? |
| Continue working with vendors on meeting the price comparison tool requirement. | What progress have you made on the price comparison tool requirement? |
| Watch for additional guidance on advanced explanations of benefits (AEOBs). | What have you done to ensure your plan service providers are ready to comply when guidance is issued? |
| Coordinate with insurers and third-party administrators (TPAs) to prepare for new air ambulance services data reporting (when it becomes required). | What discussions have you had to prepare to meet this new reporting obligation? |
| Communicate all recent plan changes | Do any changes to your plan design or benefits require a summary of material modifications (SMM)? |
| Consider conducting an eligibility audit. | Have you considered conducting an eligibility audit? |
| Ensure compliance with the Mental Health Parity and Addiction Equity Act (MHPAEA). | Are you overlooking MHPAEA compliance? |
| Check your plan documentation. | What employee benefits documentation requirements apply to you and have you ensured all are met? |
| Stay tuned for additional guidance. | How is your organization staying up to date on developing employee benefits compliance requirements? |
For more information on these issues, read Compliance Connections.
Compliance is a series of actions, not a final destination. As a trusted advisor, Gallagher has developed this Compliance Connections series to help you pursue a path through employee benefits compliance issues as part of an overall continuing compliance plan. Employers should carefully evaluate their health and welfare plans to determine if they're in compliance with both federal and state law. If you have any questions about one or more of the compliance requirements listed above, or would like additional information on how Gallagher constantly monitors laws and regulations impacting employee benefits in order to support employers in their compliance efforts, please contact your Gallagher representative.
