United Benefit Advisors Insight and Analysis Blog

Preparing for a DOL Audit with a Mock Interview

Posted by: Bill Olson    Jun 23, 2015 12:00:00 PM

As the likelihood of an audit from the U.S. Department of Labor increases, every organization should be prepared so that this potential disaster can be handled with confidence. Conducting a mock audit can be key part of your prevention and preparation strategy.

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Topics: DOL, Department of Labor, white papers, Josie Martinez, Michael Cramer, Audit, Don't Roll the Dice on Department of Labor Audits, Deanna Johnson, Beneflex Insurance Services, EBS Capstone, mock audit

It’s Not a Matter of “If,” But “When” You Get Audited By the U.S. Department of Labor

Posted by: Bill Olson    Jun 2, 2015 5:44:00 PM

Department of Labor AuditAs the saying goes, an ounce of prevention is worth a pound of cure, and that’s definitely the case when it comes to a health plan audit by the U.S. Department of Labor (DOL). And prevention is certainly warranted, according to Jeff Hadden, Partner at LHD Benefit Advisors (a UBA Partner Firm), because it’s not a matter of “if” you’re getting audited, but “when” you get a letter from the DOL that your company is being audited.

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Topics: DOL, Department of Labor, white papers, Jeff Hadden, Michael Cramer, Audit

Can Employers Assist Employees with Premiums for Individual Plans?

Posted by: Carol Taylor    Nov 13, 2014 8:56:00 AM

On November 6, 2014, the collective Departments of Health and Human Services (HHS), Labor (DOL) and the Treasury released three Frequently Asked Questions (FAQs) directed at employer payment plans for the purchase of individual insurance. While the departments had previously released several other pieces of guidance about these arrangements, this latest round exclaimed an emphatic no!

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Topics: HHS, DOL, employers, employees, premiums, individual plans, Carol Taylor, FAQ

Reference-Based Pricing and Cost-Sharing Limits

Posted by: Linda Rowings    Nov 11, 2014 10:19:00 AM

The Department of Labor (DOL), the IRS, and the Department of Health and Human Services (HHS) have jointly issued a FAQ that addresses how "reference-based pricing" works with the Patient Protection and Affordable Care Act's (PPACA) restrictions on out-of-pocket maximums. PPACA limits the out-of-pocket maximum a non-grandfathered plan may impose, and generally requires that co-pays, coinsurance, and deductibles be counted toward this limit. However, premiums, balance billed amounts for non-network providers, and non-covered services do not need to be applied to the out-of-pocket limit. (For 2015, the limits are $6,600 per individual or $13,200 per family.) The new FAQ explains how the out-of-pocket limit applies to plans that use reference-based pricing--i.e., a design under which the plan pays a fixed amount for a particular procedure (such as a knee replacement), which certain providers have agreed to accept as full payment.

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Topics: Linda Rowings, IRS, HHS, DOL, Reference-Based, Pricing, Cost-Sharing, Limits, Department of Labor, Department of Health and Human Services