Employer Data Errors
Wrong or missing information from the employer is the most common reason hold-harmless protection does not respond. The provider can only act on what it is given.
What to know.
Examples include an incorrect hire or termination date, a covered person left off a file, a wrong address and a change in hours that was never reported. In each case the error started before the provider touched the work.
Reduce the risk with a short routine: report changes the same week, check the provider’s confirmations and reconcile its lists against payroll each month.
Where to look next.
Benefits-Payroll Health Check
What to compare each week and month.
Send Data on Time
See the habit that prevents most denials.
Keep Records
See what to keep.
A monthly reconciliation that catches most errors.
Most employer data errors can be caught with one comparison: the provider’s list against payroll and enrollment. Once a month, check that every active employee on payroll who should be eligible appears on the provider’s list, that every terminated employee has a termination date, and that the dates match. Differences are the errors in waiting.
Add three smaller checks: confirm addresses for people on leave or recently terminated, confirm that changes in hours are reported when they cross an eligibility threshold, and confirm that dependents added or removed in enrollment appear in the provider’s file. The routine takes under an hour for a small group and produces a dated record of diligence.
Common questions on this topic.
Four questions to settle before you rely on it.
Does the protection ever cover a data error?
Generally not. Read the exclusions in the written terms.
What if the data was right but the provider entered it wrong?
That is a provider error. Dated copies of what you sent show it.
How do we catch data errors early?
Reconcile the provider’s lists against payroll and enrollment each month.
Who is responsible for eligibility data?
The employer, unless the agreement assigns it. Read the scope.
Who should run the reconciliation?
The person closest to payroll and enrollment, with a backup. It helps if the reviewer is not the same person who entered the data, so a second pair of eyes sees it.
What should we do when we find a mismatch?
Fix it at the source, tell the provider in writing and keep a copy. A mismatch caught and corrected quickly rarely turns into a penalty.
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General information about compliance service protections, not legal or tax advice. Plan-specific questions belong with your counsel, and we will bring them in.
Related guides.
What Hold-Harmless Protection Does Not Cover
The overview this page belongs to.
Compliance Services With Hold-Harmless Protection
What the protection is, what it covers and what to ask.
Late Information
The next question on the same topic.
Where the Rules Come From.
The laws and rules named on this page link to the statute or regulation they come from. This is general information, not legal or tax advice, and rules change, so check the current text.
COBRA Excise Tax (26 U.S.C. 4980B)
The tax on failures to meet COBRA continuation coverage requirements.
ERISA Civil Enforcement (29 U.S.C. 1132)
Includes the daily amounts a court may assess for failing to provide required notices.
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