Keep Compliance Top of Mind in Preparing for Open Enrollment This Year

As employers invest time and resources in planning for open enrollment, addressing ongoing compliance is a natural fit to include in the process. It’s especially important this year as employers seek to rebalance their programs in the wake of the tumultuous changes brought on by the COVID-19 crisis. Not only did Federal regulators relax existing and mandate new administrative provisions for health and welfare plans, but many plan sponsors made quick changes on their own to respond to urgent workforce needs.

Heading into open enrollment, employers need a strategy to identify and review changes made during the 2021 plan year and determine whether those changes can or will extend into 2022. Employers should consider the following:

Temporary plan changes that may or may not extend into 2022. Many employers made temporary changes related to telehealth, cafeteria plans and flexible spending arrangements (FSAs). These changes include eased restrictions on midyear elections, carryover and grace-period extensions, and a higher dependent care FSA limit. Once you’ve determined whether temporary changes will expire or be made permanent, you may need to amend your summary plan description (SPD) or other plan documents to reflect the changes.

Relaxed timing requirements. The government mandated relaxed timing for HIPAA special enrollment, ERISA claims and appeals, and COBRA administration during the “outbreak period”. The temporary extensions may be expiring and employees need to be notified in case they need to act quickly.

New requirements related to transparency, parity, and surprise billing.  You will need to coordinate with plan vendors on how to handle health plan transparency disclosures, comparative analysis reporting on mental health parity, and restrictions on surprise medical billing. In addition to renewal discussions with vendors, make sure you understand and are in compliance with upcoming rules related to these items.

It’s a lot to tackle, but you still have time to check for all of these items and come up with a communication strategy for all of the temporary plan changes. If SPDs have not been updated, should you draft a summary of material modifications (SMM) to be given to plan participants during open enrollment? You also need a process to ensure compliance with all of the recent laws and regulations impacting health and welfare plans to limit compliance risks.

It’s better to be proactive, rather than waiting until the last minute!

Patty Cartwright
by Patty Cartwright

Principal, Regulatory Resources Group

Byron McQuain
by Byron McQuain

Employee Benefits Attorney, Mercer

Wade Symons
by Wade Symons

Partner, Mercer Health

Register for Mercer US Health News to receive weekly e-mail updates.