This course reviews ERISA Title I as it applies to health and welfare plans for all employers.
ERISA (Employee Retirement Income Security Act of 1974) is a requirement for employers of all sizes. Designed to protect the rights of workers, it provides the framework for employee welfare benefit plans such as medical, dental, vision and other ancillary coverages.
Unfortunately, many employers are not in compliance simply because they don’t realize it is applicable to them, have not updated their plans with newer laws, or because they assume that their insurance carrier is handling it all on their behalf.
The course will cover the basics of ERISA compliance, including what is covered, obligations and risks, and what is required of companies, depending on their size, in order to be compliant. We will also touch on other applicable benefit laws, including the ACA and HIPPA.
We will discuss:
- Reporting and disclosure
- Fiduciary responsibilities
- Administration and enforcement
- Additional standards—including COBRA
- Group health insurance requirements
Intro Video Transcript
Hello. This is Ruthann Laswick and we're going to spend some today time talking about ERISA, the employee retirement income security act because this is a requirement for employers of all size and, quite frankly, many employers are not in compliance with ERISA simply because they either didn't realize it was applicable to them or because the assumption was made that maybe they were fully insured and their insurance carrier is handling it on their behalf. So we're going to spend some time talking about what the requirements are, what you have to do and what the penalties are for failing to be compliant with ERISA.
The purpose of this course is exactly that. We are going to review ERISA Title 1, specifically as it applies to health and welfare benefits. While ERISA certainly applies to retirement plans we are not going to dive into those today, but contain our conversation around welfare benefit plans. In addition, we're going to cover on some of the other applicable benefit laws. The Affordable Care Act has had a major impact on ERISA, as has HIPAA, the Health Insurance Portability and Accountability Act. The combination of those three makes this fairly daunting. Just to give you an example, for those of you who feel that maybe you are already in compliance with ERISA, you've had a summary plan description written in the past five years, you have a fully insured plan, lots of things that make it a little bit easier. Certainly it does make it a little bit easier but under the Affordable Care Act there are a number of components that have been merged into ERISA and if you have not had a summary plan description written for your plan since the passage of what actually is the Patient Protection and Affordable Care Act, which was March 23 of 2010, then you're probably not in compliance.
We're going to cover the basics. We're not going to dive into the intimate little details of ERISA, but cover the basics. We're going to talk about your obligations, your risks, and what's required, and how you go about getting there, quite frankly.
Let's go ahead and do an overview of ERISA. First of all, what is it? Well I mentioned when we first started the presentation as a means of introduction, it's the Employee Retirement Income Security Act of 1974. I know many times when I speak with employers they're like, "Well how long has this been around?" The 1974 kind of throws them because this means that if you've had a plan for many, many years, you haven't been compliant unless you've acknowledged ERISA.
This is the primary piece of legislation that provides the framework for employee benefit plans. Again, I'll mention one more time that we're going to deal with the Welfare Benefit plans, not Retirement Plans. So when we talk about the Welfare Benefit plans; medical, dental, vision, sometimes some other ancillary coverages. We're going to dive into those.
ERISA protects the rights of the employee. Okay? That's what ERISA Title 1 does. So under Title 1 we have reporting and disclosure. Certain things have to be reported, either to the federal government or disclosed to the participant in the plan. Then we have the fiduciary responsibilities, you know? Well, most employers sign a contract for a fully insured plan, so a health insurance plan. Really excited, I'm signing my contract, I've bought my first group health insurance plan.
Rarely does the either insurance carrier representative or the broker go, "Oh, by the way, you've now assumed all these fiduciary responsibilities." So we're going to talk about what you've assumed in signing that master contract. We're going to talk about the administration of ERISA and the enforcement of ERISA. We're going to talk about some of the additional standards, for example, COBRA. Then finally, the group health insurance requirements. These are the areas of Title 1 under ERISA that we're going to cover.
Learning Objectives
- Clearly identify the level of compliance with ERISA for all health and welfare plans offered.
- Discern what actions will require additional compliance documents or a rewrite of current documents.
- Differentiate between requirements of various laws and at what size of company each is applicable.
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Prerequisites
Prerequisite: Exposure to employee health and wellness plans
Advanced Preparation: None
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