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DOL revises ACA group plan audits

The U.S. Department of Labor (DOL) recently updated its audit process to accommodate changes mandated by the Affordable Care Act (ACA). The new changes pertain to group health plans and the audit requests demand several documents to prove employer compliance with healthcare reform mandates.

In an article for Supra Law News, the Employee Benefits Practice Group outlines some of the important updates in the DOL’s audit letter employers should be aware of. Organizations must provide:

  • Sample of plan notice that acknowledges employee enrollment rights for dependent children ages 26 and younger
  • Proof a list of all affected individuals is provided to individuals within 30 days for plans that rescind coverage – if a plan has rescinded coverage, the DOL will investigate whether it was for reasons compliant with the ACA
  • Clearly stated monetary limits for plans that impose them on health benefits
  • Sample of the notice it sent employees when their lifetime limits were canceled
  • Documentation to prove grandfathered plans, if applicable, and a copy of the notice given to participants
  • Copies of claims and appeals forms for non-grandfathered plans and proof of independent review from an outside administrators

Employers may consider reviewing resources provided by the DOL pertaining to the ACA.

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Erin Woulfe
Erin Woulfe
Erin Woulfe likes to write about things that matter. Keeping her finger on the pulse of what’s happening in the public sector world, she blogs about the latest legislative news and employee benefit trends that affect our school, city and county clients. She’s been with NIS since 2002. “I love connecting to our clients and providing them with the tools they need in order to administrate their plan,” says Erin. “Whether that be materials to educate their employees on certain benefits, how to effectively communicate change within an organization or just providing tips and how-to’s to help them make their job easier.”

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