Who’s Afraid of The Big Bad Compliance Wolf?

We’ve known the classic children’s story all of our lives.

Once Upon A Time… Three friendly little pigs are happily minding their own business when along comes the BIG BAD Wolf and with a Huff & a Puff he blows their house down along the way to trying to eat them.

As you play the Three Little Pigs tune through your mind right now (go ahead, you know you want to sing or hum it), I want to use those pigs and the wolf as metaphors to help illustrate why compliance with the Affordable Care Act (ACA), as well as the wide-ranging ERISA laws are very important to your protection.

In our version of the story the Three Little Pigs represent the fine work that the professionals here at Morris & Reynolds have long provided to our employee benefit clients in the form of the Coverage that we arrange, the Costs that we aggressively negotiate for you and the excellent day-to-day service that we provide in so many areas for your business and employees including Claims. Call our Three Little Pigs, then, the three ‘C’s’ (Coverage, Costs and Claims).

ACA COMPLIANCE

With the advent of the Affordable Care Act a new set of complex laws are now in place and annual Compliance with these new requirements is very important. Compliance with the new law means more than ‘just’ providing ‘minimum essential coverage’ or making such coverage ‘affordable’ as the law requires, but supplying the federal government and your employees with details about your plan and contributions. Not only is the IRS intent on confirming that what large employers provide and pay is compliant, but they are using these regulations to confirm whether an individual that might elect to not carry coverage in your plan and instead buys individual coverage (so called ‘ObamaCare), that in about 94% of the cases includes a tax credit subsidy is, in fact, entitled to that subsidy. The new rules within IRS Codes 6055 and 6056 along with the new IRS Forms (1094-B, 1095-B, 1094-C & 1095-C), can all be found on our website or by clicking here. Answers, guidance and much more, of course, is immediately available from our fine professional agents and underwriters who will be happy to help you navigate what’s required and when.

ERISA COMPLIANCE

The ACA law offers the federal government unprecedented access to information about your medical insurance plan coverage, cost and employee contributions. The federal government’s increased scrutiny of medical plans, as a result of the ACA law, leads us to believe that the ‘BIG Bad Wolf’ (in the form of the Department of Labor [DOL] and Internal Revenue Service [IRS]) might very well want to scrutinize, not only your compliance with the ACA law, but also your ERISA Compliance.  That ‘Huffing & Puffing’ sound that you hear in the distance, combined with your fiduciary responsibility as the sponsor of welfare benefit plans, strongly illustrates that it is very important that you both understand what’s required, as well as to have all of the necessary documentation in place in the event the ‘BIG Bad Wolf’, I mean a DOL or IRS Auditor, should arrive with a welfare plan audit notice (to see what an actual audit notice letter looks like click here).

And before you assume that an ACA or ERISA compliance audit is not likely, I’d suggest we consider that the IRS, which is charged with enforcing some of these laws, has and will continue to dramatically increase its staff so as to ‘police’ the ACA mandates. And before you believe that a payroll data processing company or some other entity will take responsibility for such audits and your compliance, it is important to understand that as the Plan Fiduciary and Sponsor, as well as based on how the law is written, you and your business, not any third party, are responsible for compliance.

Since the arrival of the individual mandate in January 2014, and the ‘large’ employer mandate in January 2015, the ACA law has, of course, dominated the news of late. The Employment Retirement Income Security Act (ERISA) however, governs employee benefit and retirement plans and compliance with its laws must also be considered. Enforcement of ERISA is divided between the Department of Labor, the Department of the Treasury (the Internal Revenue Service) and the Pension Benefit Guaranty Corporation.

ERISA regulates the operation of benefit plans and what must be communicated to employees. ERISA oversees a wide range of benefit topics including the Consolidated Omnibus Budget Reconciliation Act (COBRA), the Health Insurance Portability & Accountability Act (HIPPA), the Family Medical Leave Act (FMLA), Form 5500 filing, the Newborn’s & Mothers’ Health Protection Act, the Mental Parity Act and the Women’s Health & Cancer Right’s Act, to name just  a few. As noted, it is our thinking here at Morris & Reynolds that with the advent of the ACA  law, as well as the government’s scrutiny of  whether a business complies with its regulations it is not far-fetched to think the government will increasingly take an interest in your ERISA compliance at the same time.

And just as The Three Little Pigs built a strong brick house that sent The BIG Bad Wolf running off somewhere else, so too, have we here built solutions to help with your ACA and ERISA compliance related needs. To learn more about our ACA Compliance solutions click here. To learn more about our ERISA Compliance solutions click here. We realize that each of our clients take a unique approach to their legal, accounting, payroll and compliance processes and, thus, we plan to offer customized solution that best fits your specific needs. Some of the compliance solutions that we offer you include;

  • Educational Tools
    White Papers, Newsletters, Legislative Briefs, Webinars & Videos  that ‘dig’ deep into the laws and what the government requires from you so as to be in compliance.
  • Workbooks & Calculators
    These tools guide you through the completion of the forms the ACA law requires.
  • M&R’s Smart Compliance Portal
    An online, cloud based portal that helps you and your business attain and maintain compliance with your health and welfare plans including a Compliance Calendar and the option of our My Vault secure compliance document storage solution. Best of all, our Smart Compliance portal will continue to evolve with the addition of more useful tools in the months and years ahead that are all designed to help you understand these laws and comply with them.
  • ACA & ERISA Compliance Service
    Our ERISAEdge service will easily, efficiently and expertly audit your existing approach, as well as can create the correct documents that you need to comply with all applicable employee benefit oriented laws. In fact, ERISAEdge handles all of the necessary communications, forms, and record-keeping so employers don’t have to! ERISAEdge helps employers remain fully compliant with ERISA regulations and provides the defense employers need in the event of an audit by the Department of Labor.)
  • Professional People
    Our live, local, professional agents and underwriters here at Morris & Reynolds are your greatest compliance asset and are expert on employee benefit matters including the new ACA law, ERISA and compliance. Easily your most important resource, our professional people are only a phone call away.  305.238.1000.

We realize that the thought of ACA and ERISA compliance, or for that matter an audit, can be a bit ‘scary’ just like the BIG Bad Wolf was to those little pigs. The good news is that Morris & Reynolds has built a fortress of compliance solutions for you and that the same wonderful benefit professionals that have long helped with your Coverage, Costs and Claims are here to assist with Compliance topics too. We look forward to discussing your current approach, the new law and both ACA and ERISA compliance with you to ensure your ‘brick house’ is strong so that you, too, just like The Three Little Pigs, you can live Happily Ever After… Fa La La La La!

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