The Affordable Care Act presents employers with a variety of compliance challenges that range from ensuring plans cover the required benefits to notifying employees about the public Exchange. For fully-insured plans, many of these matters will be handled by the carrier, such as ensuring the plan covers preventive health services. However, sponsors of both fully-insured and self-insured plans need to ensure they comply with certain requirements, such as providing the Notice of Marketplace (Exchange) Coverage Options. The information below will help keep you informed about your compliance obligations.
Automatic Enrollment
Cafeteria Plans: Mid-Year Election Changes
Claims and Appeals
Clinical Trials
Consequences for Noncompliance
Coverage of Dependents to Age 26
Coverage of Preventive Health Services
Essential Health Benefits
Exchange Coverage and COBRA
FSA, HRA, and HSA
Grandfathered Plans
Limits on Out-of-Pocket Maximums
Medical Loss Ratio
Mental Health Parity
Nondiscrimination Rules
Notice of Coverage Options
Plans Exempt Under ACA Mandates
Prohibition on Lifetime and Annual Dollar Limits
Prohibition on Pre-Existing Condition Exclusions
Provider Nondiscrimination
Quality of Care Reporting
Rescission of Coverage
Transparency in Coverage Reporting and Cost-Sharing Disclosures
Uniform Summary of Benefits and Coverage
Waiting Periods
Wellness Programs
Whistleblower Protections