• Review of privacy and security policies
• Preparation of documents containing  necessary policies and procedures
• Annual required training and testing of agency employees
• Ongoing compliance support 

Item# RR3 - Guide for Employers Moving from Fully-Insured to Self-Funded (but Still Insured) Healthcare Benefits

As the costs of fully-insured health insurance programs continue to rise and as the marketplace adjusts to ACA, the need for smaller employers’ (10 to 250 employees) and mid-sized employers (250+) to self-fund group health benefits and realize the advantages is more apparent. This Guide on self-funding identifies the risks involved, shows how to limit and fully-fund the risk and outlines the “newest” technologies, products, regulations and concepts in health care benefit program administration and management so as to reduce and / or avoid healthcare costs. Content examples include TPA vetting, ERISA benefit design flexibility, lowering premium taxes, navigating to self-funding, overviewing IRC Section 105 and 105(h), HRA custom document creation, SPD and stop loss insurance coordination, health care analytics & predictive modeling, solutions for pharmaceutical benefits management, description of wellness programs and more. Results allow the employer to enter into a self-funding arrangement with an understanding of the pros and cons and to have a program that exactly meets the employer’s needs.

RR4 - Mock DOL / EBSA Audit to Prepare for an Actual ACA Group Health Insurance Audit by DOL

DOL is forecasting the collection of over $10 Billion over 10 years in new fines levied against employers for failing to comply with the ACA. Thus, employers need to understand the DOL audit process and take action today to ”audit proof” their benefits as much as possible. This non-law-firm benefits consultancy conducts a due diligence type audit to assess the employer’s ACA mandates compliance requirements and the strengths and weaknesses of current response activities. The end product is identification of a best course of action and a DOL Healthcare Reform Audit Manual. This helps the employer comply with ACA and maintain a state of DOL audit readiness 

Item# RR5 – Summary Plan Description (SPD) and Wrap Document Preparation Services for Employers with Fully-Insured Healthcare Plans

The ERISA Plan Administrator (typically the employer) is legally obligated to provide benefit plan participants in writing the most important facts they need to know about their health benefit (and retirement) plans including plan rules, financial information and documents on the operation and management of the plant.  Participants must also receive, free-of-charge, a compliant SPD which is most often not part of the Fully Insured insurance company-provided health insurance benefits materials. In addition to the SPD, the plan administrator must automatically provide participants a copy of the plan's Summary Annual Report SAR) each year. This service provider prepares the SPD, SPD Wrap and SAR for each employer client on behalf of the agency so as to help assure compliance with ERISA.