ERISA Compliance for PEOs and Worksite Employers—What's the Wrap?
It starts like this. A letter comes in the mail. It's from an investigator of the U.S. Department of Labor (DOL): "Dear Plan Administrator…Your health plan is scheduled for an investigation from this office…." For a PEO sponsoring benefit plans, that plan administrator is you. Attached to the letter, usually 'Attachment A,' is a laundry list of items and documents you are requested to forward to the DOL investigator within 10 business days to help the onsite field investigation, and which "may eliminate the need for an onsite visit entirely." The laundry list on Attachment A consists of documents relating to your health and welfare benefit plans, including your plan documents, summary plan descriptions (SPDs), summary of benefits and coverage (SBC), contracts with all carriers, sample certificates of coverage under the Health Insurance Portability and Accountability Act (HIPAA), copies of written procedures for enrollments, claims denials, 5500 filings over the past four years, a copy of the plans' internal claims and appeals processes, and much more.