Q&A on Employee Benefits Compliance with Heather Toller: How to Calm the Nerves of Anxious Employers

When it comes to running a business, owners have many responsibilities including the ever-changing regulatory world of employee benefit plans. The rules are complex relating to the Employee Retirement Income Security Act (ERISA), Health Insurance Portability and Accountability Act (HIPAA), and Consolidated Omnibus Budget Reconciliation Act (COBRA), with additional requirements now in effect to comply with the Affordable Care Act (ACA).

To support our clients in addressing the complex landscape of employer requirements, Aldrich Benefits has added a new compliance advisor professional.

Please meet Heather Toller, a longtime member of the Aldrich Benefits team. She will be focused as a compliance resource and available to provide a comprehensive review of employee benefit plan compliance matters for our clients.

For the past 11 years, in my role helping clients with their benefits renewal process, implementation, and education, I noticed employers are facing a great deal of regulatory pressure with the Department of Labor requirements. We recognize there will be an increase in DOL audits for clients who may not prepared to respond quickly or are out of compliance in some areas. My goal is to help clients identify and minimize those gaps in compliance when it comes to health and welfare employee benefit regulatory issues.

We want to find ways to identify anything we foresee being potential issues and minimize them in advance. In my role, I will connect clients with potential solutions whether it is through vendors or perhaps by encouraging them to seek legal counsel. In addition, we want to help employers find ways to insert compliance delivery into their everyday procedures, for example, helping them set up processes or recordkeeping. Some clients fear the unknown, especially in unfamiliar areas, but often having a conversation and working on a plan together to make sure the business is as compliant as possible provides a real sense of relief. I am excited to serve as an additional resource to them.

There are some Affordable Care Act requirements employers do not completely understand, especially if they are considered an “applicable large employer.” For example, if they have approximately 50 employees, or just recently grew to have more than 50, they potentially have reporting requirements they didn’t know about, regardless if they offer benefits or not. Another common difficulty is that employers may be unaware they need to have some type of summary plan description for their policies and the documentation provided by the insurance carrier does not meet the requirements. We’re able to connect them with resources to help create a summary plan description document that will wrap their policies together and meet the ERISA requirements.

Another area business owners tend to overlook relates to COBRA administration for exiting employees. We generally recommend clients use an outside COBRA vendor to administer the program. Businesses often tend to self-administer, but they don’t realize the many little nuances of how to effectively manage COBRA requirements. It can be overwhelming and problematic if not administered correctly.

Lastly, for those businesses who offer wellness programs, they may not be aware of the ever-changing requirements and notices to be sent to employees. There is much more involved in wellness than a simple biometric screening process or fitness challenge.

A typical review may include assisting with the evaluation of compliance delivery vendors or recommendation to seek additional counsel. The compliance review will help uncover missing items and reassure clients their organization is taking positive steps to be in full compliance. Taking proactive steps from a compliance perspective will help prepare your business in the event you receive a notice of audit from the Department of Labor.

Health and welfare benefit compliance is important and not something to ignore, but it’s also not as overwhelming as it may seem. Our goal is to help our clients feel less apprehensive of the situation and help them through the proper steps to maintain compliance.