Healthcare reform has brought added complexity to benefits administration. This is probably the greatest challenge in today’s benefits world. Our biggest goal is to keep our clients compliant at all times which includes ERISA, IRS, HIPAA, and ACA compliance, plus any other regulatory agency that requires audits and ongoing assessment.
Winton-Ireland, Strom & Green Insurance Agency also has the capability to prepare Premium Only Plan (POP) Documents and Wrap Plan Documents. POP documents are required if you are providing employees the opportunity to make their required employee contributions on a pre-tax basis. WISG can help you avoid any penalties in the event of an IRS audit.
Most private sector employers, such as Corporations, Partnerships, Sole Proprietorships, and Nonprofit Organizations, are subject to ERISA. Every ERISA plan must have a written plan document. Insurance carrier booklets or certificates of coverage do not satisfy all the ERISA requirements.
Please contact Andrea Hiykel, Compliance Manager for additional details, including cost, on POP or Wrap Plan Documents or any other compliance question.
Medicare Part D NoticesIn order for Medicare Part D eligible individuals to make informed and timely enrollment decisions, group health plan sponsors must disclose the status (creditable or non-creditable) of the plan’s prescription drug coverage.
Disclosure notices must be provided to all Part D eligible individuals who are covered under, or who apply for, the plan’s prescription drug coverage, regardless of whether the prescription drug coverage is primary or secondary to Medicare Part D. The disclosure notice requirement applies to Medicare beneficiaries who are active or retired employees, disabled or on COBRA, as well as Medicare beneficiaries who are covered as a spouse or a dependent.
WISG recommends sending to all employees to ensure dependents, who are under 65 and potentially Medicare eligible due to disability or other reasons, receive this notice; however, it is at the company’s discretion on how to proceed with distribution. Retain a copy of the list of individuals to whom the letter was mailed for audit purposes. Also, retain a copy of this letter should anyone request a copy in the future.
The creditable coverage status is available by clicking on the link below for the respective carrier who administers your group health plan coverage. Model notices are also available and can be customized to your needs.
If your group health plan and/or carrier is not listed on the website, please contact Andrea Hiykel, Compliance Manager.
- Aetna 2016 Small Group Plans (pdf, 209Kb)
- Anthem Blue Cross 2016 Small Group Plans (pdf, 477Kb)
- Anthem Blue Cross 2015 Small Group Plans (pdf, 476Kb)
- Blue Shield of CA 2016 Small Group Plans (pdf, 200Kb)
- California Choice Plans (pdf, 76Kb)
- Kaiser Permanente 2016 Small Group Plans (pdf, 42Kb)
- Kaiser Permanente 2015 Small Group Plans (pdf, 513Kb)
- September 2016 Compliance Bulletin (pdf, 686Kb)
- Sutter Health Plus 2016 Small Group Plans (pdf, 1.3Mb)
- United Healthcare 2016 Small Group Plans (pdf, 196Kb)
- Additional Carrier Plans (pdf, 121Kb)