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DOL Issues Compliance Self-Tests: PPACA and HIPAA

Posted in Plan Administration, Welfare Plans

These are trying times for employers sponsoring health plans and as we get closer to January 1, 2014, PPACA guidance is not always easy to come by.  Lots of regulations still have to be written.  However, today the DOL did issue a couple "compliance tools" to help employers self-test to see if their plans are complaint with HIPAA and some of the provisions of PPACA as they presently sit.

The HIPAA Self-Compliance Tool looks primarily at regulations and requirements other than PPACA.  It is designed to help determine whether a plan is compliant with the HIPAA non-discrimination rules and also such things as wellness programs, mental health parity and the WHCRA and Newborns Act.  The PPACA Self-Compliance Tool provides a checklist of items that are already in effect for PPACA and gives some guidance to plans on how things should already be operating. 

Neither checklist predicts the future, and while they do include useful tips about how to comply or what may be required, they do not provide definitive guidance on all issues.  Specifically missing from the PPACA tool is an explanation of how to count employees or hours or any explanation of how to determine who will ultimately be eligible for coverage.  But they do give us some way of determining if a plan is doing things correctly so far.  Plan sponsors should review these lists and take this as an opportunity to self-correct deficiencies, even while planning for how things will look next year.