Plan Compliance Services
ERISA compliance, Form 5500 preparation, HIPAA compliance, nondiscrimination testing and dependent eligibility verification are the plan-level services hold-harmless protection can reach, depending on the agreement.
What to know.
These services are different from notice services because the work is analysis and preparation rather than dated mailings. An error can be a wrong figure on a form, a test run on the wrong data or an eligibility check that missed a person.
Confirm which of these the provider performs for you and which the protection names. Ask what the provider needs from you to do each correctly.
Where to look next.
Form 5500 and Plan Documents
When a plan has to file and what it has to show.
HIPAA Privacy Rule
What a plan owes participants about their health information.
Dependent Eligibility Verification
Checking who is actually eligible.
Matching each service to its failure mode.
Plan-level services fail in a different way from notice services. A Form 5500 can be filed on time with the wrong participant count, a nondiscrimination test can pass on bad data, and a dependent eligibility review can miss a person. These are errors of analysis, which means they may not surface until a regulator or an auditor looks.
So the control is verification, not just a calendar. For each service, ask what the provider checks, what you supply, and how an error would be found. Ask for a copy of each completed deliverable, read it against your own records once a year, and keep your review on file.
Common questions on this topic.
Four questions to settle before you rely on it.
Is Form 5500 preparation covered?
It can be, if the service agreement lists it as a covered service.
Does it cover nondiscrimination testing?
Ask whether testing is named and what data the provider needs from you.
Does it cover HIPAA compliance?
Only where HIPAA compliance is a named service. Ask what the provider handles.
What do we have to supply?
Accurate and timely data. Errors that begin with the data are generally outside the protection.
How would an analysis error be found?
Usually in a review by a regulator or auditor, or in the next year’s work when numbers do not reconcile. An annual comparison of the deliverable with your own records catches many of them earlier.
What do we owe the provider for these services?
Accurate and timely data: participant counts, plan documents, payroll and eligibility information. Errors that start with your data are generally outside the protection.
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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 Covers
The overview this page belongs to.
Compliance Services With Hold-Harmless Protection
What the protection is, what it covers and what to ask.
What Counts as a Provider Error
The next question on the same topic.
ERISA Part 7 Group Health Plan Requirements Checklist
A checklist of the group health plan rules in ERISA Part 7.
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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