Whether or not you’re required by the Affordable Care Act (ACA) to provide health coverage to employees, most small businesses want to do so, and many find a way to offer a company medical plan. Having a plan means paperwork. Be sure that you do the necessary paperwork to stay in compliance with ACA requirements as well as other federal laws. The following information was provided by Victoria Braden of Braden Benefit Strategies in Atlanta, Georgia. It is not a complete list, but it covers the essentials.
Group health plans
Under ACA you must provide to employees and/or the government (depending on the notice requirements) all of the following that apply to your situation:
- Summary plan description (including lifetime maximums, annual coverage limits, and extended coverage for children under age 27)
- Summary of material modifications to the plan
- Coverage information (creditable coverage, special enrollment periods, eligibility, and qualifying events)
- Exchange (federal or state marketplace) notification
Privacy notices and training requirements
Under privacy law HIPAA, short for the Health Insurance Portability and Accountability Act, you must take action in your workplace to maintain the confidentiality employees’ health care information, including:
- Notices disclosing the privacy rule and requirements for special enrollment
- Permitted uses and disclosures of health information
- Notices of privacy practices, including workforce training, data safeguards, privacy policies and procedures, documentation and records retention, and workstation security
Annual employee notices
A variety of federal laws beyond ACA and HIPAA mandate that employers provide annual notices annually to employees on:
- Children’s Health Insurance Program Reauthorization Act of 2009
- Genetic Information Nondiscrimination Act (GINA)
- Medicare Part D and secondary payer rules
- Mental Health Parity and Additional Equity Act
- Michelle’s Law
- Newborns’ and Mothers Health Protection Act (NMHPA)
- Women’s Health and Cancer Rights ACT (WHCRA)
Other notices
Are we done yet? No. Other notices:
- Form W-2 information about health coverage is required for employers with 250 or more W-2s (employers with fewer than 250 W-2s may choose to provide this, but it is not mandatory).
- COBRA details are required for employers with 20 or more employees that maintain a health care plan. There are at least 32 separate COBRA notices.
Conclusion
If you don’t recognize or understand any of these requirements, check the U.S. Department of Labor. For example, here’s information about the notice of coverage options online. A better course of action: Ask a benefits expert.
