Failure to comply with ERISA, COBRA, and HIPPA can lead to having to pay thousands of dollars in damages to an employee or in penalties to a regulatory agency. If you are asking yourself how you can learn about your responsibilities concerning the "Big Three Benefits Laws", you should consider taking a look at this report titled - Tackling the Benefits Law Triumvirate: How to comply with ERISA, COBRA, and HIPPA.
Target Audience
This report will appeal to a Benefits Specialist who wants to ensure compliance with ERISA, COBRA, and HIPPA and avoid legal liabilities.
Table of Contents
Appendix A: IRS Notice 98-12
Appendix B: Cobra changes
Appendix C: Case citations
Special Features:
The report includes a number of different Figures and Templates:
Summary
The three laws addressed in this report - Consolidated Omnibus Budget Reconciliation Act (COBRA), the Employee Retirement Income Security Act (ERISA), and the Health Insurance Portability and Accountability Act (HIPAA) - relate to a variety of different benefits like medical plans, 401 (k)s, Employee Stock Ownership Plans, and retirement plans that are offered by organizations. The legal issues concerning each of these Acts and how the three interact are addressed in this Executive Briefing published by Alexander Hamilton Institute Publishing.
Although there is a lot of information contained in the report, I will provide a brief overview of the kind of information provided for each of the laws:
Consolidated Omnibus Budget Reconciliation Act (COBRA)
It is important to understand that if a group health insurance plan has to be terminated for any reason, COBRA requires employers to extend the health plan to the employee if she wishes to pick up the cost on her own. There are a number of qualifications that the beneficiaries must meet. These requirements are highlighted in the Tackling the Benefits Law Triumvirate report.
Remember, COBRA applies to employers who offer a health plan and employ 20 or more employees. Each employee and her spouse have 60 days after the loss of the coverage to elect to be covered by COBRA. In terms of the duration of COBRA coverage, it may apply for 18-, 29-, or 36 months.
Who is qualified for what duration depends on the circumstances under which the benefits were terminated. The first chapter covering this Act ends with two sections titled: COBRA´s Impact on Other Laws and COBRA Regs issued by the IRS.
Employee Retirement Income Security Act (ERISA)
The aim of this Act is to ensure that employee benefits plans are created fairly and; administered and maintained appropriately.
This report takes the reader through some of the key terms that are essential to understanding the Act. For example, concepts such as Vesting, contributions and benefits, named fiduciary, non-fiduciary administrators, and plan administrators are given a brief overview.
Issues relating to ERISA coverage; vesting and withdrawal provisions; and denial of benefits are addressed in detail. The section called Investment Advice: Watch what you say gives guidance on legal requirements for providing "sufficient information" about investment choices available to workers.
Health Insurance Portability and Accountability Act (HIPAA)
HIPPA provides protection for workers in danger of losing health care coverage. The Act allows employees to purchase insurance on their own - provided some conditions are met.
Some of the terms associated with this Act - such as guaranteed availability, portability, continuation of coverage, creditable coverage, restrictions on limitation period, job lock and premiums are explained in this report.
The HIPAA requirements such as 1. Guaranteed Availability, 2. Preexisting conditions, 3.Portability, 4. Medical Savings Accounts (MSAs) and 5. Premiums are also explained. HIPAA´s impact on other laws like COBRA and the ADA is addressed in chapter 3 of this report. This section also provides HIPAA compliance tips, medical privacy policy pointers and advice from IRS and DOL concerning this Act.
As an employer, your record keeping and notification obligations in terms COBRA, ERISA, and HIPAA are given extensive attention. Checklists for what documents you need to have on file are also provided. Various case examples highlight who you must inform about eligibility under the three Acts and the consequences of failure to notify. HIPAA´s effects on COBRA and on ERISA are clearly outlined in this report.
Some of the questions that you will find answers to in the Frequently-Asked Questions & Answers section of this report include:
If employees voluntarily resign or go on strike, must they be offered COBRA coverage? Absolutely.
Does ERISA mandate the types of welfare benefits which have to be provided to employees? No.
Does HIPAA apply even if employees aren´t changing jobs? Yes.
The last chapter of the report shares a number of actual cases relating to legal problems caused by failure to comply with ERISA and COBRA. Issues of notification, fiduciary duty, disability benefits, and benefits modifications are addressed. More than twenty five cases are included to exemplify and explain how you can avoid such legal problems.
Why would an HR professional be interested?
No employer wants to be dragged into court and forced to pay fines or penalties because of failure to comply with the various Acts that apply to employee benefits. It can be difficult to determine how the Acts interact but it is important that HR professionals or Benefits professionals understand their obligations or know where to go to learn about them when the need occurs.
HR.COMmentary
I am always skeptical when a company claims that their report on a complex topic is written in "straightforward, easy-to-read - plain English". However, I have looked at a number of publications by Alexander Hamilton Institute and I am pleasantly surprised by how easily they can clarify the most complex laws and make them understandable to lay people. Tackling the Benefits Law Triumvirate: How to comply with ERISA, COBRA, and HIPPA really is easy to read!
This is a good source of reference because you are not expected to read the whole report but can skip to the section that will answer whatever question you have at the time.
At only $50.00, this comprehensive and complete report will definitely guarantee a ´return on your investment".
About the company:
Alexander Hamilton Publishing publishes newsletters, booklets, and loose leaf manuals targeted to top management, Human Resource directors, Personnel managers, front-line managers, and supervisors at small-to-medium sized firms.
The publications deal with all aspects of employment law and are written in a practical and easy-to-read style.http://www.ahipubs.com/