Top 10 Compliance Issues

The beginning of June serves as a reminder that we’re approaching the halfway point of 2016. Now is a great time to pull out those strategic plans and assess what you've accomplished and what's left to do. And don't forget to do a mid-year compliance check. I know, it's not the most exciting task, but it is a necessary evil. To make it a little easier, I’ve asked Mercer's compliance experts to describe – in just two minutes each – the top 10 compliance issues on their checklists. Here’s what they had to say.

1. Employer Shared Responsibility: Transition relief ended this year – coverage of “substantially all” increased from 70% to 95%. Are there ACA full-time employees that you don’t cover?

2. ACA Reporting: Make sure it’s right – no more good faith standard and the old deadlines return for the 2016 reporting year.


3. Cost-sharing limits: Know your limits – the ACA in-network out-of-pocket maximums differ from the maximum for high deductible health plans used with health savings accounts (HSAs).

4. Wellness Plans: More innovative designs make it critical to know the new rules that begin on January 1, 2017.


5. Mental Health Parity: Make sure your benefits are aligned with current law and best practices.

6. Cadillac Tax: Remember it hasn't been repealed – it's in your best interest to prepare.


7. Essential Health Benefits: Check those dollar limits and maximum out-of-pocket maximums against updated benchmark plans for 2017.

8. Affordability: Know the impact of opt-out cash and flex credits.


9. 30-hour: Understand what payments must be converted to hours of service.

10. Summary of Benefits and Coverage: New model SBC must be used for open enrollments on and after April 1, 2017.

Tracy Watts
by Tracy Watts

Senior Partner, National Leader for U.S. Health Policy

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