5/6/2016 APRIL 28, 2016 DISCLAIMER

Transcription

1 APRIL 28, 2016 DISCLAIMER The information in this presentation is provided by Minnesota Benefit Advisors as a general informational source and is not intended to constitute legal or tax advice in any particular manner. You must not rely on the information in this publication as an alternative to legal advice from your attorney or other professional legal services provider. If you have any specific questions about any legal matter you should consult an attorney or other professional legal services provider. 1

2 ERISA Employer Retirement Income Security Act WHAT IS ERISA? Federal law from 1974 that sets minimum standards for most voluntary established pension and health plans in private industry to provide protection for individual s in these plans. ERISA requires plans to provide participants with plan information including important information about plan features and funding. It provides fiduciary responsibilities for those who manage and control plan assets. It requires plans to establish a grievance and appeals process for participants to get benefits from their plans. It also gives participants the right to sue for benefits and breaches of fiduciary responsibilities. plans/erisa 2

3 WHO DOES THIS IMPACT? Any employer with one employee or more who offers health, retirement, or welfare benefit plans 3

4 WHY IS ERISA SUDDENLY BEING TALKED ABOUT? The government needs to pay for the Affordable care act 4

5 LAW ENFORCEMENT CAN BE PROFITABLE SPEED LIMIT 55 SO WHAT DO YOU NEED TO HAVE? 1. Plan Document 2. Summary Plan Description (SPD) 3. Wrap document 4. Notices and Disclosures 5. Summary of Material Modification (SMM) reporting (100 employees+) 7. Summary Annual Report (SAR) 5

6 PLAN DOCUMENT VS. SUMMARY PLAN DESCRIPTION Plan document the instrument by which the plan administrator must operate the plan Summary plan description the instrument by which the plan notifies the participants of the plan s terms and their rights and obligations under the plan (must be distributed to participants) 6

7 Will the insurance carrier s certificate of coverage satisfy the Summary Plan Description requirements? No, the documents from the carrier may contain much of the information that is required to be contained in the SPD, but most will not satisfy all of the requirements Wrap Document: used to wrap any required and missing ERISA language around a carrier s certificate of coverage Mega wrap Document: used to bundle many employer sponsored plans into a single plan, to simply Form 5500 filing 7

8 NOTICES The notices required by ERISA include, but are not limited to: Special Enrollment Notice Wellness Program Disclosure Newborn s Act Disclosure Women s Health and Cancer Rights Act (WHCRA) Enrollment Notice WHCRA Annual Notice Notice of Adverse Benefit Determination Notice of Final Internal Adverse Benefit Determination Notice of Final External Review Decision Notice for Grandfathered Health Plans 8

9 NOTICES CONTINUED Patient Protection Disclosure Employer Notice Regarding Premium Assistance under Medicaid or CHIP New Health Insurance Marketplace Coverage Options Notice COBRA Continuation General Notice COBRA Election Notice Notice of Unavailability of COBRA Notice of Early Termination of COBRA Coverage Please note: this is not a comprehensive list. To learn about other disclosures or notices that may be required, refer to the Department of Labor Reporting and Disclosure Guide: 9

10 SO WHAT ARE YOUR OPTIONS? Do it yourself ERISA compliance is not easy to accomplish on your own, but that does not mean it is not possible Each step you take, could be one less penalty that you have to pay Hire a third party administrator to assist you Hire an attorney AL NAGEL & KELVIN NELSON (320)