Group health plans must comply with many rules set by the U.S. Department of Labor (for those subject to ERISA), the Internal Revenue Service, and other federal agencies. It is important for plan sponsors to understand their compliance obligations.
The Department of Labor periodically audits group health plans for legal compliance. Before being selected for audit, employers should review their plans’ operations to ensure ongoing compliance. The DOL has published a self-compliance tool for ERISA-covered group health plans. This self-compliance tool can be found by clicking here.
The tool offers a series of questions for the group health plan to answer. It addresses:
- HIPAA (portability provisions, nondiscrimination provisions, wellness provisions)
- Multiemployer plan and MEWA rules
- Mental Health Parity Act
- Newborns and Mothers Health Protection Act
- Women’s Health and Cancer Rights Act
- Genetic Information Nondiscrimination Act
- Michelle’s Law
- Affordable Care Act
Employers and plan sponsors may wish to review the self-audit checklist to confirm their plan is complying with applicable laws.
