Compliance Services

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The compliance of employee health benefit plans is an overwhelming task for employers. Additional ambiguity and concern surfaced when The Patient Protection and Affordable Care Act was signed into law. It’s incredibly challenging to navigate increasing regulatory requirements, the ever-changing legal landscape and an unpredictable future.  IntegraFlex’s compliance services offer an in-depth look at plan documents, summary plan descriptions, policy review and non-discrimination testing needs. Our expertise delivers a comprehensive examination of current benefit policies, plan documents, summary plan descriptions, required tax filings and non-discriminaton testing requirements. Employers can rest easy when utilizing our expertise for the review of their health benefit plans.

Our compliance services cover a wide range of reporting and planning needs:

request-proposal_button.pngCompliance Services

Compliance Package

This comprehensive bundle of compliance services will include review and drafting of those additional documents that you need to be in compliance with the laws and regulations that affect your employee health plan.  

  • The Wrap Documents tie the benefits that you offer together into one plan for legal purposes and includes all additional information that you are required to provide to plan participants
  • The Premium only Plan includes the wording required to allow employees to make premium contributions on a pre-tax basis.
  • The Enrollment Notices include the notices that are required to be provided to participants on an annual basis

We will not just prepare these documents, but will make sure that they are consistent with the terms of your plan and that all documents work together. This package, along with documents that you ask us to prepare or that you already have, will ensure that you have what you need to respond to a Department of Labor Audit.

First Year Package includes

  • Collection and review of documents that relate to your health and welfare plans
  • Drafting or review of Wrap Plan Document and SPD
  • Drafting or review of Premium only Plan Document
  • Preparation of annual Enrollment Notices and New Hire Benefits Notice (Exchange Notice)
  • List of laws and regulations that your Plan must comply with and potential consequences for failure to comply
  • Report Card outlining any outstanding Compliance issues that need to be addressed

Renewal Package includes

  • Review and update of Wrap Documents and Premium only Plan
  • Review and update of Enrollment Notices and New Hire Benefit Notice
  • Report Card outlining any outstanding Compliance issues that need to be addressed

Additional Services

5500 Filing

Employers are required to file a Form 5500 with the Department of Labor within 7 months after the end of their plan year, if they have 100 or more participants on the first day of that plan year, or if they pre-fund their claims. Upon receipt of the information needed to complete the Schedules, we will prepare the filing for you and send it to you to submit to the Department of Labor. 

HIPPA Privacy Compliance Documents

HIPAA requires health plans with access to Protected Health Information to protect that information and, in some cases, to notify participants of their privacy rights. These documents are updated with regulations that were issued in January 2013. The HIPAA Privacy Package includes the following:

  • Privacy Policy and Proceduces
  • Privacy Notice
  • Privacy Forms
  • Training Log
  • Privacy Officer Job Description

Full Cafteria Non-Discrimination Test

Employers are required by Section 125 of the Internal Revenue Code to test their Cafeteria Plan for discrimination issues on an annual basis. The first test looks at the eligibility, contributions and benefits to ensure that there is no discrimination in favor of the highly compensated participants. We will also perform the Key Employee Concentration Test and provide you with a report showing the results of all tests performed. 

Medical, HRA or Health FSA Section 105 Non-Discrimination Test

Every self-funded health plan is required to perform a non-discrimination test under Section 105 of the Internal Revenue Code to ensure that the plan does not discriminate in favor of high compensated employees. We will perform that testing and provide you with a report showing the results of the test.

Affordable Care Act Services

4980H Applicable Large Employer Testing

Employers with close to 50 employees, with a large number of part-time variable hour employees and employers with multiple small companies will need assistance determining whether they are subject to the Shared Responsibility provisions in 4980H of the Internal Revenue Code that go into effect in 2015. We will perform the calculations and provide you with a Report that shows the results of the testing.

4980H Applicable Full-Time Employee Testing

Employers will need to know which employees must be offered coverage when the employer coverage mandate takes effect in 2015. We will provide a report that shows recommendations for setting measurement, administrative and stability periods, along with a listing of those employees that must be offered coverage. Reports that are prepared in advance for planning purposes will show simulated results.