COVID-19 Changes to Health Plans Must Be Documented, Circulated

| posted in Blog, Newsletter

A number of plan sponsors have made changes to their group health plans in response to the COVID-19 pandemic, such as covering testing and sometimes treatment without any cost-sharing by the plan enrollee. Any changes that are made must be followed up by amending the plan and communicating the changes to the enrollees. Under the Employee Retirement Income Security Act (ERISA), all health plans are required to deliver a Summary Plan Description (SPD) to enrollees to inform them of the full spectrum of coverage and their rights under the plan. Whenever a plan sponsor makes a material modification to the…
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Federal Agencies Stepping up Audits. Here’s What They Are Looking at

| posted in Blog

As the Affordable Care Act takes hold further, government agencies are stepping up their audits of health plans across the country. With many employers still unclear over exactly what they need to do to fully comply with all of the sections of the ACA – from providing affordable insurance to reporting on their plans – the risk is great that you may be found not in compliance at least in some area. There are a number of government entities that are responsible for auditing employer health plans, and they all have different areas of responsibility: Department of Labor (DOL) •…
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