What Business Owners need to know to protect your business, and provide peace of mind from potential $1,000/day fines

Whom is required to provide the 11 new 2013 ACA notices including the new Summary of Benefits
and Coverage (SBC):

All employers who offer an employer sponsored health insurance plan regardless of number of employees,
including private-sector corporations, partnerships, and proprietorships, including non-profit corporations

When do these required disclosures need to be provided to the employees?

All new hired employees and Health Plan renewals beginning/after September 23, 2012.

Why should employers care?

  • Compliance is not optional, It is law effective September 23, 2012.
  • These requirements apply to all employer sizes, not just 50+, 100+, or more
  • Insurance Carriers do not provide these notices
  • Employers can avoid costly DOL penalties

  • Many states allow Participants and Beneficiaries to bring “bad faith” claims
    against Employers
  • Up to $1,000/day fines

Below is a brief list of actual court cases, awards, and DOL fines related to employers not in compliance with ERISA laws pertaining to Welfare Benefit Plans:

$4,540 Employer indifference and irresponsibility led to disclosure violations
$5,880 Failure to deliver SPD within 30 days of request. Minimum fine of $10/day
$9,800 Failure to provide LTD Plan Document; employer only provided SPD
$10,220 Excessive delay in providing Severance Pay Plan Document
$10,560 Late delivery of SPD to employee after 3 written requests, max. Penalty $110/day
$11,550 Failure to provide SPD after written notice
$17,475 Employer did not have SPD; only provided certificate of insurance to Participant; repeatedly insisted they were the same thing
$17,550 Failure to provide requested Plan Document and SPD to Participant
$18,400 Failure to deliver SPD on request; $25 x 736 days; without prejudice or bad faith
$26,100 Failure to respond to document request over very long time
$32,850 Delay, indifference, disregard in failure to provide copy of requested Plan Document to Participant
$34,540 Failure to provide participation agreement between employer and LTD carrier prejudiced Participant’s ability to establish enrollment date
$37,650 Requested documents provided at widely spaced intervals
$55,760 Incompetence and neglect delivering insurance contracts to Participants
$62,250 Failure to deliver SPD to Participant in manner required by DOL
$64,900 Provided SPD, but failed to provide requested full Plan Document
$86,500 Failure to file complete and accurate Form 5500
$105,840 Plaintiff’s attorney’s fees in LTD claim case; award unknown
$159,000 Late entrant; employer gave employee wrong waiting period & ordered to pay claim
$241,000 Failure to provide SPD to Participant
$5,000,000 Claim wrongfully denied as experimental. State court jury trial, punitive damages