In an age where genetic testing is becoming more prevalent, safeguarding genetic information has become a top priority. The Genetic Information Nondiscrimination Act (GINA) is a federal law designed to prevent discrimination based on genetic information in health insurance and employment. Let’s take a closer look at GINA and what it means for your employee benefits program. Understanding GINA GINA was enacted in 2008 to prohibit health insurers and employers from discriminating based on genetic information. The Act is divided into two parts: Title I, which prohibits genetic discrimination in health insurance, and Title II, which prohibits genetic discrimination in…
Author: ericjohnson
In today’s digital age, the privacy and security of personal health information are paramount. Employers, as part of their employee benefits programs, often handle sensitive health information, which requires careful stewardship to prevent unauthorized access or breaches of privacy. This is where the Health Insurance Portability and Accountability Act, commonly known as HIPAA, comes into play. Understanding HIPAA HIPAA was enacted in 1996 with two main goals: to help people keep their health insurance when they change or lose their jobs (the “Portability” part of the Act), and to establish standards for electronic health care transactions to protect sensitive health…
For many businesses, the use of independent contractors, often known as 1099 workers, offers significant benefits. But as this flexible workforce grows, many employers are asking: should we offer benefits to 1099 workers, and if so, how? Why Consider Offering Benefits to 1099 Workers? The demand for benefits among 1099 workers is high. According to a 2022 study by the Freelancers Union, 20% of independent contractors consider access to benefits as their top concern. In a competitive marketplace, offering benefits can help attract and retain top-quality independent contractors. It can also foster goodwill and increase worker loyalty and engagement. Legal…
Benefits brokers play a crucial role in the world of employee benefits. They are experts in navigating the insurance market, identifying insurance solutions that align with the needs of a business and its employees, and ensuring competitive pricing. But when it comes to compliance with the myriad of laws governing employee benefits, brokers may not be the go-to source for expertise. Understanding the role and limitations of a benefits broker can help businesses more effectively manage their employee benefits program and compliance obligations. Brokers: Insurance Experts, Not Compliance Gurus Benefits brokers excel at understanding the complexities of the insurance market.…
Nobody is perfect and mistakes can happen, especially when navigating the complex landscape of benefits compliance. However, when errors occur, it’s essential to promptly identify and rectify them to minimize potential penalties and ensure the wellbeing of your employees. In this post, we’ll highlight some common compliance errors and offer guidance on how to correct them. Mistake #1: Missing Required Notices Employers are required by various laws to provide certain notices to employees, such as the Summary of Benefits and Coverage (SBC) or the COBRA General Notice. If these notices are missing or delayed, it could lead to hefty fines.…
Employers with a mix of older and younger employees often find themselves navigating the tricky intersection of employer-sponsored health plans and Medicare. It’s not uncommon for employers to wonder whether they can or should encourage employees to transition to Medicare when they become eligible. The answer, like many things in the world of benefits compliance, is nuanced. The Law and Medicare Eligibility According to the Medicare Secondary Payer rules, for companies with 20 or more employees, an employer-sponsored group health plan is considered primary and Medicare is secondary. This means the employer plan pays first on any health claims. For…
The Medicare Secondary Payer (MSP) rules are designed to shift costs from Medicare to other, primary payers such as employer group health plans. Understanding MSP status and how it’s determined is critical for employers to ensure compliance and optimal plan administration. What is MSP? Medicare Secondary Payer refers to situations where Medicare is not the primary insurance for an individual. In these cases, another entity, such as an employer’s group health plan, is responsible for paying medical claims first, with Medicare covering only secondary or remaining costs. Determining MSP Status Determining MSP status depends on a variety of factors, including…
The Summary of Benefits and Coverage (SBC) is a document that insurance companies and group health plans must provide to consumers to help them understand their health coverage and compare different coverage options. Under the Affordable Care Act (ACA), both the employer and the insurance carrier share the responsibility of providing SBCs. Monitoring the delivery of these documents is a critical part of compliance. What is SBC Monitoring? SBC Monitoring involves confirming that all eligible employees have received their Summary of Benefits and Coverage (SBC) and tracking the method of delivery. This process is important because failing to provide SBCs…
Navigating the world of employee benefits compliance can be challenging for many employers. In an attempt to simplify their obligations, some employers might consider offering to pay for individual health coverage for their employees instead of providing a group health plan. While this approach may seem like an easy way to avoid compliance requirements, it’s not as straightforward as it seems. In fact, it could have significant legal and financial implications for employers. Is Paying for Individual Coverage Legal? The answer to this question is nuanced. The Affordable Care Act (ACA) prohibits employer payment plans, which are arrangements in which…
Employee benefits compliance can seem like a labyrinth of rules, regulations, and requirements. As an employer, it might feel like you need a law degree to keep track of all the various laws governing employee benefits. So why are there so many rules? The Intersection of Multiple Policy Areas Employee benefits encompass a broad range of policy areas, each with its own unique set of laws and regulations. For example, health benefits intersect with healthcare law (the Affordable Care Act), tax law (tax advantages for employers offering benefits), and labor law (rules about who must be offered benefits). Retirement benefits…