This week’s episode looks into the problem areas of every regulation that puts industries through expensive endeavors and tons of paperwork. Sarah Borders, co-founder and principal consultant at Benefits Compliance Solutions, gives interesting tidbits that clients can do right away to mitigate some of the risks.
What You’ll Learn From This Episode:
- 03:23 About COBRA: What are its problem areas, loopholes, and opportunities?
- 08:41 About ACA: Misclassification of employees is identified as the biggest problem area. How do employers usually deal with late filing/incorrect filing?
- 13:38 About HIPAA: Challenges toward privacy and security
- 16:09 With the differences in regulations per state, how can advisors give guidance to clients who are multi-sited in multi-states?
- 19:06 Updates on new regulations and their possible impacts on the industry
03:41 “A lot of the times when we use vendors or service providers to help us comply with their requirement, we might think that we have no obligations any longer— that we’ve sort of indemnified ourselves. Because of that, I believe the oversight in COBRA or the knowledge that an employer should probably have [at least basic knowledge] isn’t there because they aren’t thinking about it.”
06:22 “I think we all get that termination of employment triggers COBRA, but there are other triggering events such as death, divorce, child aging up the plan, also a reduction in hours. But when you have one of these triggering events, you also have to have a loss of coverage. And so [I think] sometimes employees or former employees get left out of COBRA because there isn’t enough oversight and did this person actually trigger COBRA, or should we have been offering them COBRA.”
11:46 “Before, we’ve seen a little bit of leniency related to late filings or incorrect filings or even just penalty letters for premium tax credits. However, it takes hours and hours of work to demonstrate, to go back and have to prove that this employee shouldn’t have been offered coverage in the first place or was and waived it. Also if you never file (…) or you filed late, you have to spend the time, the hours, the energy, and even paying somebody to help you to be able to [again] prove to the IRS that you did or did not comply.”
14:07 “HIPAA: Privacy, security, and the administrative simplification rules apply to covered entities. And a health insurance plan, a group health plan, is a covered entity (…) And so because an employer is responsible for that covered entity plan, they have to provide HIPAA privacy and security, which has a lot of owners’ requirements, to make sure that that PHI is being properly maintained, stored, transmitted, and so forth.”