Acme

Your scores

1. ERISA/5500

   1. Wrap distribution timeline
      Make sure wrap is in place and is distributed to plan participants within 120 days
   2. Wrap distribution timeline for new plan participants
      Make sure wrap is in place and is distributed to new plan participants within 90 days of enrollment

2. Section 125

   1. Retroactive plan changes prohibited
      Make sure employer only allows prospective mid-year plan changes only due to qualifying life events

3. HIPAA

   1. HIPAA policies & procedures
      Employer must have written policies and procedures for the handling of PHI, regardless of fully insured or self-insured

4. CAA

   1. CAA: Machine Readable Files required of TPA
      Confirm if the TPA has made publicly available 2 separate Machine-Readable Files of required healthcare costs
   2. CAA: Balance billing prohibition requirements
      Confirm with carrier/TPA that prohibitions on balance billing are followed
   3. CAA: No Surprises Act notice
      Make sure employer provides participants with the No Surprises Act notice

5. Non-Discrimination Rules

   1. Section 105h non-discrimination testing
      Make sure Section 105h nondiscrimination testing is performed at least annually
   2. Add imputed infome for domestic partnership coverage
      Make sure employer is imputing income for portion of the domestic partner coverage cost

6. State Requirements

   1. State requirements: mandatory disability benefits
      Confirm with carrier or applicable state(s) (CA, HI, NJ, NY, RI) if mandatory disability benefits are being provided
   2. State requirements: domestic partnership coverage
      Make sure employer is providing registered domestic partner coverage for employees in applicable states (CA, DC, ME, NV, OR, WA, WI)
   3. State requirements: state-specific notices
      Review any state-specific health insurance notices, including IL EHB comparison for employees residing in IL
   4. State requirements: leave mandates
      Review any state or local leave mandates with employement law specialist
   5. State requirements: healthcare spending requirements
      Confirm the employer is complying with state or local-specific healthcare spending requirements ((San Francisco Health Care Security Ordinance; Hawaii Prepaid Health Care Act, etc.)

7. ICHRA

   1. ICHRA opt-out requirements
      Ensure employer is offering an opportunity for participants to opt-out of ICHRA coverage at least annually

Not assessed