Smart Benefits: Get your Documents in Order for a DOL Audit

Rob Calise,GoLocalProv Business/Health Expert

Smart Benefits: Get your Documents in Order for a DOL Audit

If the DOL issues you a health plan audit letter, it’s important to have your documents in order. And spring is a great time to review plan materials to ensure they comply with regulations – and are ready for review.

A DOL audit addresses compliance with rules affecting welfare benefit plans, such as employer-sponsored health, dental, vision, life and disability plans. An audit can be triggered as part of enforcement efforts or for a variety of other reasons, including participant complaints or answers on a plan’s Form 5500. 

During an investigation, the inspector will want access to all records related to the audit. So review every record, such as written eligibility criteria for enrollment, plan documents, summary plan descriptions (SPDs), notices, and other written materials, to ensure they are easily accessible and can track your plan’s compliance with the relevant requirements. 

GET THE LATEST BREAKING NEWS HERE -- SIGN UP FOR GOLOCAL FREE DAILY EBLAST

In addition to maintaining documentation that demonstrates group health plan compliance, organizations can take several other steps to prepare for an audit:

•    Review the DOL Self-Compliance Tool for Part 7 of ERISA to understand the requirements that apply to group health plans.
•    Conduct a mock compliance audit to gauge your readiness and address areas that need correction.
•    Respond to any participant questions or requests for information in a timely manner.
•    File Form(s) 5500 fully, accurately, and on time.
•    Distribute required notices to participants on time and maintain records that demonstrate they were provided.
•    Update plan documents and SPDs to reflect legal and design changes.

The fines for violations of the civil provisions of ERISA can be significant so now’s a great time to scour your records and procedures for compliance.

Rob Calise is the Managing Director, Employee Benefits. of Cornerstone|Gencorp, where he helps clients control the costs of employee benefits by focusing on consumer driven strategies and on how to best utilize the tax savings tools the government provides. Rob serves as Chairman of the Board of United Benefit Advisors, and is a board member of the Blue Cross & Blue Shield of RI Broker Advisory Board, United HealthCare of New England Broker Advisory Board and Rhode Island Business Healthcare Advisors Council. He is also a member of the National Association of Health Underwriters (NAHU), American Health Insurance Association (AHIA) and the Employers Council on Flexible Compensation (ECFC), as well as various human resource associations. Rob is a graduate of Bryant University with a BS in Finance.

RI Business Rankings in US

Enjoy this post? Share it with others.