COMPLIANCE BASICS USER INSTRUCTIONS

Transcription

1 COMPLIANCE BASICS USER INSTRUCTIONS 1

2 Table of Contents Topic I) Compliance Basics Service Overview 3 Page II) ed Solutions: 3 a. Legal Updates & Due Date Reminders b. Best Practice - HR Bulletins III) Web-based Solutions: 4 a. Employee Notices All-in-one Employee Notification Document Service b. Qualifying Event Notices c. New Hire Paperwork & Forms d. Past Legal Updates & Legal Topics IV) Creating Employee Notices 5 V) Answering Company Profile Questions that drive Employee Notices 6-8 VI) Distributing Employee Notices 9-11 VII) Compliance Calendar VIII) Employment Law Requirements

3 I) Compliance Basics Service Overview Compliance Basics is designed to give you peace of mind knowing you are kept informed of all state and federal employment law changes, required notices and tools to help. The service provides you with both ed and web-based solutions. s are typically sent twice a month providing you with one legal update and one best practice HR Bulletin. To access web-based services login to our system at and click on the Login option in the upper right corner. You should have received a user name and password when you first joined this service. If you are missing this information, select the Forgot Your Password? option under the log in box. You can also call for assistance at our toll-free phone number: (855) , Ext 4. II) ed Solutions 1. Legal Updates & Due Date Reminders PPACA Health Care Reform & ERISA Requirements Receive step-by-step instructions on employer actions and requirements to comply with the Patient Protection and Affordable Care Act, ERISA and other health care laws. Employment Law Updates Stay informed of federal and state employment law changes and needed actions to comply. This service includes most employment law such as FLSA, FMLA, Title VII of Civil Rights Act, ADAAA, OSHA, etc. State by State Changes are summarized at the bottom of each legal update. Select highlighted states that apply to your organization to receive a summary of important changes. Free Poster Updates for all states are provided including download links, eliminating the need for expensive poster subscription services. Legal Due Date Reminders Receive compliance date reminders such as PPACA, OSHA posting, EEO-1 Report filing, VETS 100 filing, and more. Never miss another deadline. These important dates are summarized at the top of each update. Each year you also receive a Compliance Calendar outlining important compliance dates and employer actions. 2. HR Bulletin Receive state-of-the-art HR techniques and ideas on best practices, people management challenges, compliance concerns, trends, and changes in this informative monthly bulletin. 3

4 Web-Accessed Solutions 1. Employee Notifications Service (All-in-one) Easily meet most employee notification requirements using this all-in-one employee notice report to distribute to employees. Notices are customized based on information you provide in your Company Profile. Depending on the number of employees and benefits offered, the following notices may be required: COBRA Initial CHIP (Child Health Insurance Plan) MHPA (Mental Health Parity & Addiction Equity Act) NMHPA (Newborns & Mothers Health Protection Act) WHCRA (Women s Health & Cancer Rights Act) HIPAA (Health Insurance Portability and Accountability Act) Patient Protection Wellness Program Disclosure Grandfathered Plan (if applicable) Medicare Part D Health Exchange Notice Once you login to the Compliance Basics Center, go into Employee Notices, then Employee Notice Report to answer basic questions about your company and benefit plans. This information customizes the all-inone Employee Notification Report and s it to you for distribution. (See instructions below on how to run and distribute this Employee Notifications Document.) Also contained in this section is a separate option to create the required Health Exchange Notice. 2. Health Exchange Notice Our Web-based system allows you to create and this notice to you for distribution to your employees 3. New Hire Forms Receive the latest new hire forms and documents such as W-4, I-9, W-9, and job application all in one simple location. 4. HR Articles & Compliance Library Access past HR Bulletins and Legal Updates, providing leader, human resources and compliance best practices and requirements. 5. HIPAA Tool Kit Receive guidance, polices, forms and tools needed to comply with HIPAA and setup your HIPAA program. 4

5 III) Creating Employee Notices Step 1 Login to Compliance Basics Center at: with your user name and password. If missing password, select Forgot your Password? (Note: Most user names are your and passwords is the first three letter of your business name and last four letters of your phone number (no spaces)). Step 2 Select Employee Notices, then Employee Notice Report Step 3 Answer all questions in the Company Profile and upload your business logo, if desired. Step 4 Save and exit or Generate Employee Notifications Document. If Employee Notifications Document is generated, the all-in-one notice is ed to the address indicated in the Contact field in the company profile. Note: the current day s date appears in the Date Last Created field each time the Employee Notifications Document is completed. (See detailed instructions on answering questions below.) 5

6 Step 5 Distribute the Employee Notification Document to participating employees. (See delivery instructions below.) Make this part of your new hire process as well. Step 6 Provide a copy of the Employee Notification Document to all new benefit participants annually. Health Exchange Notice Select the button at the bottom of the Company Profile page to Generate Health Exchange Notice Document, if you have not done so already. Distribute to all current and new employees. New Employees As indicated above, provide all employees with a copy of the Health Exchange Notice regardless of whether or not they are a plan participant. Provide a copy of the all-in-one Employee Notification Document only to plan participants. IV) Answering Company Profile Questions that drive Employee Notices Although most questions are pretty straight forward, some questions are more challenging, especially in the Medical Insurance section. Below are questions asked in this section with a brief explanation below each question. Explanation: Select the appropriate box indicating whether benefits are offered to all employee or only eligible employees. Next, define eligible employees such as regular full-time employees who work 30 or more hours on average. Use the definition you follow with your insurance provider that follows your policy. Explanation: Select the box that best defines how your company offers coverage to dependents, and then define eligible dependents. For example, Legal spouse and dependent children 6

7 Explanation: If you medical plan meets the minimum value standard and the cost is intended to be affordable, check this box. If not, leave the box blank. Coverage is considered to meet the minimum value standard if the plan s share of the total allowed benefit costs covered by the plan is no less than 60% of such costs. The Department of Labor provides a Minimum Value Calculator at the following link: Most plans do meet the minimum value standard and are intended to be affordable. A plan is considered affordable if the cost for the individual coverage does not exceed 9.5% of W-2 wages or 9.5% of the Federal Poverty Level). If you are still unclear on whether or not to check this box, consult your insurance provider or broker. Explanation: Check the box indicating if your medical plan is fully-insured (contracted with an insurance provider) or self-funded (employer shares in risk of claims). Explanation: Insert the name(s) of your group health plan provider. If more than one, enter all names that apply. Separate each plan name with a comma. 7

8 Explanation: Indicate whether or not your plan is a Grandfathered Plan. A grandfathered plan is one that existed on or before March 23, 2010 where the employer elected to exclude various PPACA provisions and limitations such as not applying lifetime limits to key health benefits. To maintain this status, grandfathered plan are restricted from making significant changes that reduce benefits or increase cost to participants. Visit this link for more details on grandfathered plans or speak with your insurance provider or broker for further clarification: Explanation: Indicate if your plan requires or allows you to designate a primary care provider. If yes provide details on who they contact to designate their primary care provider and phone number. Explanation: Indicate if your plan includes health or wellness elements with rewards tied to individual participant health factors such as weight loss or other factors. Review this link for more details on wellness program determination: 8

9 Explanation: Indicate if your prescription drug plan is creditable or not. A prescription drug plan is deemed to be creditable if it: 1) Provides coverage for brand and generic prescriptions; 2) Provides reasonable access to retail providers; 3) The plan is designed to pay on average at least 60% of participants prescription drug expenses; and 4) Satisfies at least one of the following: a) The prescription drug coverage has no annual benefit maximum or a maximum annual benefit payable by the plan of at least $25,000, or b) The prescription drug coverage has an expectation that the amount payable by the plan will be at least $2,000 annually per Medicare eligible individual. c) For entities that have integrated health coverage, the integrated health plan has no more than a $250 deductible per year, has no annual benefit maximum or a maximum annual benefit payable by the plan of at least $25,000 and has no less than a $1,000,000 lifetime combined benefit maximum. If you are still unclear if your prescription plan is creditable, contact your insurance provider or broker. Explanation: Indicate if employee s current prescription coverage will be affected if he or she joins a Medicare drug plan. If unclear, contact your insurance provider or broker. Explanation: Indicate if an employee joins a Medicare drug plan and drops the employer s plan, will the employee and their dependents be able to get back on the employer plan? If unclear, contact your insurance provider or broker. V) Distributing Employee Notices 9

10 Once you answer questions in the Company Profile and generate your Employee Notification Report, it will be ed to you with the below distribution instructions. EMPLOYER INSTRUCTIONS - Employee Notifications Report Based on the information you entered about your organization in your company profile, attached is your Employee Notifications Report for you to distribute to benefit eligible employees covered on your medical insurance plan. This report helps meet your employee notifications requirements. This also needs to be given to all newly hired employees if they elect to participate in your medical insurance plan. Please follow the below instructions. Instructions: 1) Review the document to make sure it contains the correct contact information and details about your organization. We assumed you would be the primary contact regarding questions or needs related to these notices. If this information is different, please insert the change. Feel free to add in your logo or to copy the information onto Company letterhead. 2) Provide notification to all participating employees: Notices should be provided annually. However, in order to meet the various notice due dates, we suggest distributing notices to all eligible new hire employees at time of hire and annually to all eligible employee s during your medical benefit open enrollment period. Be prepared to prove you furnished notices to participants in a way "reasonably calculated to ensure actual receipt," using a method "likely to result in full distribution." Acceptable methods of delivery include: A paper document sent via first class mail; Posted to an intranet, with a separate notification sent to each employee notifying them of the document s availability and the significance (under this method, employer must ensure employees have the ability to and can access these documents at will during and after business hours); Hand delivery, if using a hand delivery method, obtain receipt from employee of the notice delivery; Sent via to employee s work address, as long as: o the work is specifically for and used by the employee on a regular basis; o an actual receipt of transmitted information is confirmed, such as through return receipt, failure to deliver notice, or through periodic review or survey of employees to confirm materials are being received; o the includes a statement as to the significance of the document; o contains the right to request a paper version at no cost and instructions on how to request a copy; 10

11 If employees do not have a primary work-issued address, they may elect, with written consent, to provide the employer with a personal address for receipt of specific electronic notice. This consent must be obtained yearly and can be revoked by the employee at any time. Documentation: Regardless of the distribution method used, the employer should always retain evidence of the notice being given, including a copy of the notice/s, the date provided, and to whom it was provided. 3) Include/attach a copy of the summary of prescription drug benefits and terms with the employee notifications letter. 4) If the company has a Cafeteria (125) plan with automatic enrollment (Negative election or Evergreen) provisions, you are required to provide affected employees notification of automatic enrollment and the cash alternative annually and when newly hired. Additional information can be obtained at: 5) New Hires: Provide new plan participants (new employees) with a copy of the Employee Notification Report as a part of your new hire process, if they sign up for medical insurance. Annual Notifications Repeat Process To obtain a new notification, simply log in to your account at: update your company's information, and select the Generate Employee Notifications button. The system will automatically a new notice document for distribution. Medicare Creditable Coverage Registration Employers are to complete the online disclosure for the Center for Medicare Services (CMS) to report the creditable coverage status of their prescription drug plan. The Disclosure should be completed annually, no later than 60-days from the beginning of a plan year (contract year, renewal year), within 30 days after termination of a prescription drug plan, or within 30 days after any change in creditable coverage status. Visit 11