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Compliance Updates for Brokers: Stay Informed and Ensure Compliance

Friday December 1st, 2023

Estimated time to read: 1 minute, 45 seconds

Compliance Guide OG image

According to our 2023 Broker Survey whitepaper, 97 percent of the brokers surveyed consider compliance services very-to-extremely important to their portfolio. And 64 percent say compliance education is a major reason their clients engage with them. Compliance is one of the most important topics for brokers and staying updated with the latest regulations is crucial.

Each year, it’s essential to be aware of the compliance updates that will impact your clients and their benefit plans. Understanding the most important factors of compliance is critical to ensuring your clients stay on track throughout the year. Here are the most important concerns to keep on top of.

Documentation: Maintain Accuracy and Up-to-Date Records

Accurate and up-to-date documentation is vital for tracking plan participation eligibility and benefit accruals, as well as resolving disputes and claims. It ensures transparency and trust and minimizes financial and legal risks for your clients. As a trusted business partner, brokers are relied on to ensure their clients maintain accurate and comprehensive documentation.

Disclosure: Empower Employees with Informed Decisions

Proper disclosure is crucial to inform employees about their rights and benefits. It allows them to make informed decisions regarding their coverage. Transparency in coverage rules requires carriers to provide information on negotiated rates, payments to out-of-network providers and net prices for prescription drugs. Compliance with these disclosure requirements promotes employee engagement and trust in the benefit plans.

Reporting: Monitor Compliance and Prevent Fraud

Regular reporting to government agencies is necessary to monitor compliance, prevent fraud and ensure the appropriate use of plan funds. It is important to stay up to date with reporting requirements. Electronic filing is now required, and clients should verify with carriers and third-party administrators (TPAs) if they will assist with reporting, especially for level-funded plans.

Continuation: Support Employees During Transitions

Continuation coverage, such as COBRA, allows employees to maintain health insurance during transitions. It is crucial for insurance brokers to ensure that their clients understand the continuation options available to their employees. Brokers should familiarize themselves with state continuation requirements and the rights provided under the Family and Medical Leave Act (FMLA).

Challenges and Changes: Navigating the Complexities

Compliance requirements are constantly evolving, and staying informed about the changes is essential. Legislative and regulatory changes, updates to required notices, limits for benefit plans and plan documents are some of the challenges brokers need to address. The COVID-19 pandemic has also impacted timelines and managing employer group size, which can affect compliance with regulations such as COBRA, FMLA, and ERISA.

Keeping Clients on Track

As a broker, it’s up to you to navigate the complex world of compliance and keep your clients informed and protected. By maintaining accurate documentation, providing proper disclosure, monitoring compliance through regular reporting and supporting employees during transitions, you can ensure that your clients remain compliant and minimize risks. Stay informed, seek expert assistance when needed and continue to prioritize compliance year after year.

To learn more about compliance, watch our webinar, A Year in Review: Compliance Updates Brokers Should Know on-demand and read our eBook, Help Your Clients Remain Compliant

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