Welfare Benefit Plan ERISA News
April 2014

New ERISA & ACA Self-Compliance Tools Available
These self-compliance tools are useful for group health plans, plan sponsors, plan administrators, and health insurance issuers to determine whether a group health plan is in compliance with some of the provisions of ERISA and the Affordable Care Act.
HIPAA and Other Health Care-Related Provisions
  • HIPAA, p. 1
  • MHPA and MHPAEA, p. 22
  • Newborns' Act, p. 30
  • WHCRA, p. 33
  • GINA, p. 35
  • Michelle's Law, p. 38
Affordable Care Act Provisions
  • Grandfather Status, p. 2
  • Dependent Coverage of Children to Age 26, p. 6
  • Rescission Provisions, p. 8
  • Lifetime Limits and Restrictions on Annual Limits, p. 9
  • Prohibition on PEC Exclusions, p. 12
  • Summary of Benefits and Coverage (SBC), p. 12
  • Patient Protection Provisions of ACA, p. 16
  • Internal Claims & Appeals and External Review, p. 23
"Pay or Play" Regs Finalized
Effective January 1, 2015, employers with 100 or more full-time employees must offer affordable, minimum value group health coverage to 70% or more of their full-time employees or pay a penalty. This requirement increases to 95% on January 1, 2016. Note however, the penalty for not offering such coverage still applies to employers in 2015, regardless of whether or not 70% of employees were offered coverage.
Employers that offer no group health coverage will pay a penalty (as long as at least one full-time employee purchases coverage on an exchange and receives a subsidy) of $2,000 x [the number of full-time employees minus 80]. In 2016, the number of excludable employees will drop to 30.:
Employers with 50-99 full time employees will not need to comply until January 1, 2016. More Details.
Fidelity Bonds and Fiduciary Liability Insurance...
Do You Need Both?
"While commonly confused as the same thing, a fidelity bond is separate and distinct from fiduciary liability insurance. A fidelity bond is specifically required by ERISA § 412(a) for any "plan official." For this purpose, a "plan official" is a fiduciary of an employee benefit plan and/or a person who handles funds or other property of such a plan. Each plan official must be bonded for at least 10% of the maximum plan assets that he or she handles. Unlike a fidelity bond, fiduciary liability insurance is not mandated by ERISA." More at Benefits Bryan Cave.
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© 2017 ERISAPros, LLC, All rights reserved. Information on ERISAPros' website, its newsletter, “News & Views,” and its blog, “ERISA Wonk,” is published as a general informational source. Information and articles are general in nature and are not intended to constitute legal or tax advice in any particular matter. Blog posts and comments reflect the personal views of their respective authors - not those of ERISAPros. Transmission of this information does not create an attorney-client relationship. ERISAPros, LLC is not a law firm and is not giving legal or tax advice. It does not warrant and is not responsible for errors or omissions in the content on its website or in its newsletters. ERISA is a complicated and confusing law. Summary Plan Descriptions (SPDs), Wrap Plan Documents, and Form 5500s require review and updating by qualified ERISA compliance professionals.


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