Name: Open Enrollment Readiness: Compliance First, So Execution Runs Smoother
Uploaded: 2026-10-06T18:30:15.974Z
Duration: 1 h 3 s
Description: Open Enrollment Readiness: Compliance First, So Execution Runs Smoother

Transcript for "Open Enrollment Readiness: Compliance First, So Execution Runs Smoother": Hi, everyone, and welcome. Thank you for joining us today for open enrollment readiness, compliance first. So execution So Yeah. It's been planned for Open enrollment takes a lot more than choosing benefits and setting enrollment dates. There are planned documents to review, required notices to distribute, employee communications to prepare, and eligibility and requirements... Or reporting requirements to keep track of. And the preparation really starts well before employees make their elections. Today we're going to look at some of those areas where compliance gaps can surface including dependent eligibility, ACA reporting and other filing obligations. So you can identify potential issues while there's still time to address them. So let me advance the slides here and, let me catch up. And so what this session is and is not. Before we get started today, I wanna quickly set expectations. This is designed to be a practical discussion about open enrollment, compliance for HR professionals, benefits administrators, and finance teams. We'll focus on areas like plan documents, required notices, dependent eligibility, and upcoming report obligations. What this is not is legal advice or a deep dive into every, everything on the books. Our goal is to keep this practical and focused on what employers should be thinking about now as they prepare for open enrollment. And just a quick note on who we are for anyone who may be new to Mitratech. We support more than 28,000 organizations across legal, GRC, and HR solutions. Within our HR solutions business, we help employers manage compliance across the employment life cycle, including HR compliance and guidance, I nine and employment eligibility, background screening, performance, and talent management, as well as our... One of our newest solutions, lead management. We work directly with employers, but we also work through partners, including leading health insurance carriers, HCM platforms, benefits brokers, and, we bring these resources to the employers they serve. And, a couple quick housekeeping items. We are recording today's webinar, and we will send both the recording and slides out after the event. Please submit your questions through the q and a throughout the presentation. We'll leave time at the end to address as many as questions as we can. You'll find the q and a on the right side of the screen. There's the chat section. In the q and a, we ask that you put your questions in the q and a. We'll have four poll questions throughout today's sessions. The poll tab, once I launch a poll, will be in that same section as the chat and q and a. And finally, we'll share some registration links for webinars that we have coming up and some blog posts that you should check out. And so without further ado, I'll introduce today's prince... Presenter, Angela Surra. Angela is a principal benefits expert at Mineral by Mitratech and holds a number of designations. She brings nearly thirty years of experience in the insurance industry as a licensed agent and has advised employers and brokers directly on benefits and HR compliance. What makes Angela particularly valuable for a session like this is her ability to take complex requirements including ACA rules, state mandated benefits, and other regulatory obligations and turn them into practical guidance, that employers can actually use. Angela has also lobbied on behalf of insurance professionals in Washington, DC and is a faculty member of the Risk and Insurance Education Alliance. And with that, I'll turn the presentation over to Angela. Angela? Thank you, Brian. I thought you were gonna say it's because I make compliance fun, right? I mean, sometimes it is a bit of a snooze fest. But, welcome everybody. I'm super excited that you're here today. Here's just a quick kinda run through of our agenda. We're gonna start by looking back at last year to really help with planning ahead. We're gonna cover the documents that need to be created or updated before enrollment opens. From there, we'll spend some real time on dependent eligibility audits. That's a big one. After that, some execution tactics and a sample timeline that hopefully you can use. We will wrap up with some other compliance reminders and some common mistakes that I see employers make. And don't worry, I'll do my best to leave time for questions. If we start running low, fortunately, I will, tell Brian to jettison some poll questions. But with that, let's get started. So before we get into the how, I wanna really ground ourselves in the why. And the laws that are quietly running in the background of every renewal, every open enrollment, There are six big ones. So ERISA, the Employee Retirement Income Security Act, the Affordable Care Act, which I'll refer to as ACA, the Medicare Modernization Act or MMA, COBRA, which really needs no explanation there on what that acronym is. And then HIPAA, Health Insurance Portability and Accountability Act. And of course, we can't forget those Periodic Consolidated Appropriations Act, acts that like to drop in there. You're gonna see these six names come up over and over again. So I guess consider this kinda your cast of characters. Quick reference before we move on since these six are going to come up quite a bit. ERISA is basically the law that sets the minimum standards for employer sponsored health plans and retirement plans, requires plan documents, fiduciary duties, and disclosure obligations. We've got ACA that sets the employer mandate, affordability standard, has reporting requirements for group health plans, and more. MMA, this created the Medicare part d and the annual creditable coverage, or noncreditable coverage, disclosure to Medicare eligible employees. COBRA certainly requires eligible employers to offer, continued group health coverage on a self pay basis. HIPAA is all about privacy and security. It does guarantee portability of benefits and special enrollment rights. And then with regard to the CAAs, we've got transparency requirements, gag clause prohibition, RxDC reporting, and so many other things. But what isn't out here, but certainly plays a big part is the internal revenue code. That's the separate body of law that decides whether certain benefits get favorable tax treatment. It's where cafeteria plans and self funded plan nondiscrimination testing lives, and quite a bit more. So I wanna start by looking back because as the saying goes, or maybe I created this saying, I don't really know. We need to look in the rear view mirror, to to really look at what we learned from past enrollments, to make sure that we're going in the right direction, for the current period. So what exactly do we need to look back at? Well, a few things. First and foremost, I cannot stress this enough. If you've ever been in any of my webinars, I'm sure I talk about this, is know your applicable large employer status by looking at the prior year's employee count that is so, so, so important. If you've conducted or haven't think about it, conducted employee survey on, you know, what were their satisfaction levels of the benefits that you had in place last year, the the process that you put them through for open enrollment. Did you use the Ben admin system? If so, how do they feel about it? You know, you might... May wanna think about looking at claims data. If you're considering going from fully insured, maybe to level funded, for your plan, you definitely wanna take a look at what kind of utilization, did you have last year. Review open enrollment communications. There's always, seems to be a gap where, or there's no best solution. Sometimes we over communicate about open enrollment before it gets here and during. Sometimes we don't communicate enough. The... That employee survey would help with that as well to make sure you're communicating as much, and as often as, you know, works for your folks. We wanna take a look at the number of enrolled individuals from, last year to see, gosh, are we in a position where we may have to do 5,500 filing? And then are we stepping into any nondiscrimination testing that we need to do? I would say specific to likely the cafeteria plan. You... That's generally a good practice to do that in the last quarter of the current plan year. So hopefully, you know, when we talk about looking back, this kinda gets, the brain juices flowing for you. So when we think about applicable large employer status, this is one of those areas that really is so critical to define what you need to do going forward. So let's define it. So an applicable large employer or an ALE is an employer who employed an average of 50 or more full time and full time equivalent employees in the preceding calendar year. Now, an employee is basically a common law employee. Right? Whether it's a full time, part time, seasonal, temporary. You know, there are certain calculation factors that you need to include there. But an employee is not a self employed individual, so it's not a sole proprietor. It's not a partner in an LLP or member of an LLC, 2% or more shareholder in an s corp, or correctly classified independent contractors. So that kinda gives you a bit of the definition. But when we think about what else is involved here, if I'm trying to count my employees to determine whether I'm an ALE or not, you don't want to forget about counting all employees together for any commonly owned businesses or controlled group entities that you may be part of. You gotta count everybody together to determine ALE status for common ownership and control groups. So let's think about planning ahead a little bit because it... It's really important to have a strategic plan in place, something that's gonna set you up for a successful open enrollment season. Things like review and update your eligible employee census. Review your benefits budget. I mean, it's no secret that benefits cost tend to go up every year. I don't know if there's really been a year where if you kept the same plan that it went down in cost, that probably never happens. Review your enrolled, dependence for eligibility. And we're gonna talk more about dependent eligibility when we talk about dependent, audits here in a little bit. Consider scheduling a meeting with your insurance broker early so that that's on the books and you have something to work towards. Calendar out those employee communications that you're going to plan to send, before and during that open enrollment window. Make sure you're building in enough time to update your benefits administration technology. If you utilize that, that step tends to take, longer than people expect. And one more flag, make sure if you are an applicable large employer, that your contributions meet ACA affordability standards. That threshold is 10.22% for 2027 when your plan year renews in 2027. So we've got a quick poll here. Brian, if you wanna pop that in. Which open enrollment task needs the most attention at your organization right now? And we've got four choices here. And again, if you know where the chat tab is, you will see the poll tab there as well. Brian, you wanna talk through what their choices are? Absolutely. So, a, updating plan documents and notices, b, confirming employee and dependent eligibility, c, planning employee communications, and d, tracking and... Tracking, reporting, and filing obligations. Need a comma there. So, we'll just give folks a couple more seconds to enter those in, and we're gonna close this out in three, two, one. Awesome. Can't wait to see. share the results. Oh, oh, And plan documents. you go. I like that. Not surprising there. Planning employee communications. That is a challenge. It is a challenge, which is why if you've not implemented an employee survey before, I highly recommend you do that. That's a great way to determine how much do I need to communicate or am I over communicating. Great stuff. Thanks for participating. So let's talk about documents and events, specifically what needs to be updated before open enrollment and how you know it's time to act. So there are really two experiences that tell you it's time to update your documents. The first and and really the bulk of what's on this slide are changes you make as the employer, plan changes, maybe new coverage tiers, maybe you added benefits or dropped some type of benefit. And if you bring on a new carrier and nearly everything then is gonna refresh, you know, with that, premiums, deductibles, co pays, out of pockets, etcetera. All of that is really plan design, and it only changes because you decide to change it. The second category is true regulatory updates and, you know, these are gonna happen whether you touch your plan or not. Think about the annual IRS adjustments to HSAs, FSA contributions, or we just talked about the Affordable Care Act percentage, you know, that updates every year. These are are set externally. They're generally set on a schedule, and they can require a document update even in a year when you don't make any other changes. So anything that changes the deal you have with your employees may trigger a summary of material modification or, of course, you know, there's acronyms all over the place in our industry. Right? So a summary of material modifications known as an SMM, it may require that you completely restate your plan document and summary plan description. So if we talk about, I guess, each of these documents, let's start with the plan document. ERISA requires a written plan document, and this is what governs the plan. From that, you need a simplified version of that plan document, which is known as the summary plan description or SPD that then you distribute to participant. Next, cafeteria plan document. So internal revenue code section one two five requires that if employees are given a choice, to contribute to their plan on a pretax basis, then we've gotta have a cafeteria plan document in place. Then there's the summary of benefits and coverage. This is required by the Affordable Care Act, which summarizes the coverage in the health plan. It's that 12 to 14 page document that breaks down deductibles and co pays and out of pockets and so on and so forth. And then finally, there's your carrier's evidence of coverage or certificate of coverage document. And don't forget, of course, there are required notices, which ERISA, ACA, and other laws require that you distribute at open enrollment and other specific times during the plan year. So that's a lot of stuff so that we basically need to review, get updated, you know, get updates from carriers and so on and so forth. That is a lot. I wanna go a little bit deeper on plan documents specifically. Private employers subject to ERISA must do two things. They've gotta have a written plan document, and they have to distribute a summary of that plan the SPD to participants. Separately, again, we talked about internal revenue code. That's its own set of plan documents. But here's kind of one distinction really is that a cafeteria plan, SPD isn't required, but it doesn't hurt to send one so employees are educated. So when we think about the ERISA plan document, again, this is that governing vehicle that runs the entire plan. I wanna give you a little bit more clarity about, what needs to be included in there. And I'm not gonna go over everything on this slide. We'll be sharing a copy of the deck with you. But there are specific notices and disclosures that can be can be included in the plan document and SPD. General information, the plan name, the plan year, the plan number, eligibility, and what benefits are included in there. Is the plan level funded, self funded, fully insured? You know, all of those different things need to be included in there. And honestly, we get a ton of questions coming in at Mineral by Mitratech who are experts, and a lot of the answers that we give back start with what does your plan document say? Again, this is that legal governing document, so you wanna make sure that you have, an ERISA compliant plan document in place and that, you're updating it accordingly and as needed. So let's shift and and continue talking about cafeteria plans. So this document is required if you give employees the option to pay for qualified benefits. Think, what they're contributing to the medical plan premium or if you have, the option for flexible spending, they're contributing to that likely on a pretax basis. There's a couple guardrails to know when we think about cafeteria plans. So, essentially, elections have to be made before the start of the plan year, and they are irrevocable unless the plan includes any of the permitted election change events. There's also discrimination testing. The plan cannot discriminate in favor of highly compensated employees. And, you know, although there is an ex... Exception for simple cafeteria plans available to small employers with, fewer than a 100 employees. So take a look at your plan documents. Make sure that they are up to date. And, you know, since we just met the cafeteria plan itself, this is kinda what keeps everything compliant. Every plan that lets employees elect pretax benefits has to clear three different nondiscrimination tests, unless, of course, you qualify for that simple cafeteria plan that we just talked about. The eligibility test is asking whether the plan's rule, whether the plan's rules, like who can join, how long they have to wait when they pay, are they actually treating everyone the same, not just your highly compensated group. The, the contributions and benefits test, this is gonna look at what people actually get once they're in. The same contribution levels and and options for highly compensated employees and everyone else, and then, of course, that key employee concentration test. So if a test fails, the consequence really lands on the people that it favored, those, highly compensated and key employees. What happens is their pretax contributions end up becoming taxable wages, which usually means a corrected w two. Again, if you qualify for a simple cafeteria plan, fewer than a 100 employees, and a few other rules involved in there, then you don't have to actually go do this nondiscrim testing. But if you don't qualify for a simple, you do need to do this. I generally recommend that you do this in, the last quarter of your existing... Or your current plan year. Just in case you need to make any corrections, you can do that, and then you'll know what you need to update for the next plan year when open enrollment gets around. Section one zero five h is another type of nondiscrimination test, but it's only for self insured and level funded plans. This has three tests. The... Or sorry. The eligibility test has three ways to pass. Most plans use a 70%, 80% test. But, again, the whole concept of this test is to make sure that we are not discriminating. Benefits test, again, we're looking at benefits that are available, waiting periods, eligibility terms, and things like that. Again, one zero five h, only for self insured and level funded plans. If you have a fully insured plan, you do not have to worry about this. Great, best practice, do this, you know, in the current plan year. This slide is really your notices reference card. We have to have, you know, certain notices distributed to employees. Open enrollment is a great time for many of these. If you are a client of Mineral by Mitratech, we do have a notices toolkit. You can take a look, all of these notices and many more based on certain different events and whatnot, are all included in there. But what I popped on the screen here really is what's applicable to open enrollment just to kinda give you an idea. For example, the CHIP notice that goes out at enrollment and annually, general COBRA rights notice within ninety days of initial enrollment. Medicare part d, notice of creditable or noncreditable coverage goes out annually prior to October 15. Although it's perfectly permissible to include this during open enrollment. Excuse me. Newborns and mothers health protection act, you can include this in the SPD. It doesn't have to be a separate notice. Special enrollment rates notice at or before, each enrollment period, those SBCs that we talked about, the summary of benefits and coverage along with the uniform glossary at initial enrollment and annually, women's health and cancer rights act notice at enrollment and annually. I mean, it's a pretty lengthy list. Right? And and these are just kinda the key ones that I have here. Certainly not all of them. Other notices may be required depending on your specific plan and workforce. So this isn't necessarily exhaustive, of all of that. Great question. Are brokers and employers responsible for ensuring your business has the cafeteria plan and the nondiscrimination testing done? No. They're not responsible for that. They may offer reminders to you about it, but honestly, these are responsibilities of of the employer that's that's sponsoring the plan. But excellent question. We've got, one thing I wanna point out because I often get asked, well, do do, you know, my disclosures need to be in other languages. And these are kinda hiding a little bit, so I wanted to pull it out kind of in the open, before I get the question is, so when we think about ERISA, so we're thinking about the SPD and and any ERISA required notices, it's really about your own participant population. Right? You don't have to automatically translate in another language. You can keep it in English unless, your participant population warrants it. So for example, if your plan has less than a 100 participants, the trigger to translate into another language is if 25% of that population are literate in another language. So let's say 25% of your population or 30% of your population or more are fluent in Spanish, right, that Spanish is their native tongue, then you would want to, not necessarily translate the whole thing, but at least include a notice kind of prominently displayed in that language that says, hey. We provide assistance, either written or oral, if someone needs assistance in in understanding what that notice or or that document states. If you have a 100 or more participants, it's whichever is smaller. 500 participants or 10% of them are all, fluent in another native language. We talked about Spanish, but there could be others. And, again, you're not required to translate the entire thing, into that other language, but you are required to post, that notice in that language, you know, right on that English version that tells people how they can get help, and then certainly you wanna provide that actual help to them. The ACA rule works a bit differently, and it applies to the summary of benefits and coverage and your claims and appeals notices like an adverse benefit determination. And it's not about who's in your plan. It's actually about the county the notice is being mailed to. So very different. If 10% or more of that county's population is literate only in Spanish, traditional Chinese, Navajo, Pennsylvania Dutch, Tagalong, Samoan, Carolinian, Chamorro, per the census data, then the requirement kicks in. So whether or not you actually, employ anyone who speaks that language, you do have to follow those rules based on the county that you're sending that notice into. HHS, Health and Human Services, keeps an updated list of those qualifying counties. So you could clear the ERISA threshold perhaps based on your own population, but still owe ACA disclosures in other languages or vice versa. They're not testing the same thing. Let me just double check. I wanna see if there's any other questions. Good question. Who does the 105 h nondiscrimination testing? The employer is is generally responsible for taking care of that. So knowing your note, which notices you owe is really half the battle. The other half is delivering them correctly. So let's talk about distribution rules. If it's an ERISA required notice, you need to follow, these rules. And ERISA says your method of distribution has to reasonably ensure delivery. And there are a few accepted methods today, hand delivery, snail mail delivery. Electronic delivery only works for employees with work related computer access or others who you have gotten consent from in advance to receive, notices electronically. And that's really been the standard since about 2002. In 2020, they made some updates for retirement plan notices, but we've been stuck with the 2002 for, benefit plans. I do wanted to spend a minute or so on something that's kinda moving in this space. On July 23, the Department of Labor's, Employee Benefits Security Administration, they proposed a new, additional electronic disclosure safe harbor specifically to group health plans. Very loosely under the proposal, administrators could post covered disclosures to a, secure website, notify participants that they're available without the need for advanced consent. Certainly, participants would retain their right to request a paper copy if they wanted to, the right to opt out of electronic altogether. There is a lot to unpack in those proposed rules, and and we're monitoring it very closely. I think the the DOL comment period just closed towards the end of September. I did link the rule here. Take a look. No action items for this. There's no changes yet. It is literally just a proposal right now. We're still living by the 2002 rules. So, we covered the general rule, hand delivery, mail, or electronically where the person has work related access or has consented. Now I kinda wanna map that onto the actual notices list from earlier. So six of the eight are pretty straightforward. COBRA's general notice, CHIP notice, special enrollment rights, WHCRA, newborns act, and the patient, protection notice, those all come from ERISA or from laws that amended ERISA. So the rule we just walked through is exactly the rule that governs how you deliver those. The SBC, the summary of benefits and coverage, that's different. That's, ACA. Right? It's required for generally all major medical, medical plans by the ACA. It runs on its own separate electronic delivery standard that's a bit more relaxed than ERISA. For example, if you use a benefits enrollment platform online, SBCs, you know, can be distributed electronically within that platform, you know, when an employee makes an online request for one. If the method is accessible via the Internet and the employer has notified eligible employees by email where they have those available, that's cool. Keep in mind, though, for any of these, an employer is obligated to provide a paper copy if an employee requests it. In other situations, it's permissible to follow the standard ERISA safe harbor. It's kind of a good practice simply because, the ERISA safe harbors are stricter. And so, you know, you'll be kind of in line, with what you need to do there. The Medicare Part D notice, it's, again, it's a little different. That one comes from CMS, not ERISA. So strictly speaking, it isn't a... An ERISA required notice, really, but, CMS has said you're allowed to deliver using the ERISA safe harbor there, which is why most employers fold the Medicare Part d notice, into the same process as everything else. I wanna move on to a topic that doesn't seem to really receive enough conversation, and that's the dependent eligibility audit. And I think we have... Do we have reactions, emojis? Give me a thumbs up for, y'all if you've done a dependent eligibility audit before. I'd love to see that. So at its core, it's a voluntary compliance process. Oh, okay. I got a thumb. I'm getting some thumbs up. Thank you. Voluntary compliance process that employers use to really verify that the dependents enrolled in the plan actually meet the plan's eligibility requirements. If, again, if you are a client of Mineral by Mitratech, we do have a mini guide, in the compliance library on dependent eligibility audits. If you wanna go a little bit deeper than we're gonna go today. But we've seen a ton of statistics and and commentary that there are actually, oftentimes, dependents enrolled in a plan that don't really meet the eligibility requirements of your specific plan. So some solid reasons, you know, to do this is auditing supports your ERISA fiduciary duty. It can certainly lead to potential health plan savings. It helps reduce denied claims down the line, which no one ever wants to get involved in. And it gets you real documentation instead of relying on an employee's verbal attestation. So if you're considering one, it may be less disruptive if you run it prior to open enrollment rather than in the middle of open enrollment. And and the key with these audits is communicate with employees ahead of time that you're going to run this kind of audit. You you certainly wanna prepare, some documentation. You know, what what does our plan say is an eligible dependent? You know, we really want to make sure that we're arming employees with enough information. They don't necessarily have to, go through and dig up the SPD or request about... You know, everyone's gonna come requesting a paper copy of it. You can pull that x... You know, that excerpt out. But you wanna make sure that before you do the audit, you are looking at any applicable laws. You wanna look at your own plan documents, your carrier contracts, so that you clearly understand first who is and who is not considered an eligible dependent. Let's think about a few examples of, you know, what could I possibly find, that that could show up if I'm doing an audit of my plan? So some examples would be children who have exceeded the plan's age requirement. So, you know, with the Affordable Care Act and we think about group health plans, you can keep your dependent on, until they're age 26. Now a lot of times, carriers are going to automatically, you know, kick that employee... Or that employee's adult child off. At the end of the month, they reach 26, but it doesn't always happen. So you definitely want to check into that. Divorced spouses or non qualifying domestic partners, non qualifying step children, deceased individuals. You know, none of these are unusual. They're just the kind of things that can quietly linger on a plan for years if nobody checks. If you're running a dependent eligibility audit, I mentioned documentation, communication. Communication is everything here. You'll want to create some materials covering the audit timeline, a summary of your dependent eligibility rules, the types of substantiation documentation that you'll accept. So for example, if someone says, yes, we're married, maybe you wanna collect a copy of their marriage certificate. It it really is gonna... You know, there's no, I guess, hard and fast rules of here's the types of substantiation documentation you you can take or that you should take, but you wanna have a list so employees know. Okay. I just got married. What do you need from me? They'll already know in the communication, you can provide a copy of your marriage certificate. You wanna have a process in place. So if you are coming back to an employee and saying, hey, this dependent doesn't meet our eligibility rules anymore, that there's a process for them to appeal that decision. And just as important, you need a secure system for collecting and retaining that documentation. Since, you know, this can be sensitive personal information, you wanna make sure that you've got that somewhere secure. Brian Costello, we've got another poll, and I'm due for a quick drink. So go ahead and talk us through it. You bet. You bet. So, I'm gonna launch the poll right now. So when did your organization last verify that enrolled dependents meet your plan's eligibility? You'll find this up on the right side of the screen in between chat and q and a. Couple answers here. Within the past year, more than a year ago, we have not conducted a review, or I'm not sure. So we'll give folks a couple seconds to go ahead and, answer. Thank you very much for your participation. So we're gonna close that out and share the results here. Oh, And there we go. interesting. Within the past year, 29%. Got it. Yeah. And not that. not conducted. almost 30%. I'm not sure. Oh, yeah. So, you know, Yeah. something. to think about, folks. We love that you're you're engaging with these, but definitely something to think about. Again, if you're a mineral client, we've got some resources and platform to take a look at, guides and and different things to help you. But this is also something that you can work closely with your insurance broker on. They are going to be a great resource to kinda talk through this with you and to help you, you know, plan this out and, you know, help you launch a successful audit. And again, I think a best practice is to do this before open enrollment hits, just in case. It's usually way more disruptive if you try to do it during open enrollment. So before we wrap up, I wanna run through a few other compliance obligations that tend to land around the same time of year. I mean, doesn't... Isn't that always the case? We... You know, you've got a million things to do as it is, at year end and and whatnot, but, you know, we just might as well add a few more things to that list. So if you're providing prescription drug coverage to Medicare eligible individuals, you do owe a disclosure to CMS. That is due within sixty days after the start of the plan year. K? So think about this piece ties closely to that part d notice of creditable or noncreditable coverage. The disclosure is the second half of it. There's a there's a nice question for you, Brian, in the chat. Alright. So let's not forget about that. That's done on the CMS portal. Affordable Care Act reporting. We are... Gosh. It's October, folks. We are coming up on, and should be planning now, if if not already, for ACA reporting season. But it applies in two main scenarios. If you're an applicable large employer, you need to do ACA reporting. But if you are any size and you sponsor a self funded or level funded health plan, you also have reporting obligations. And if you are sponsoring a self insured or a level funded plan, you also have PCORI filing obligations. So ACA reporting occurs, in q one each year for the past year, and PCORI is due the July 31, after the end of a plan year. So two two more filing obligations. Two more deadlines to know. Prescription drug data collection, also referred to as RxDC. This applies to most employer sponsored health plans is due annually by, June 1. The gag clause prohibition attestation also applies to most employer sponsored health plans. This one is due annually by December 31. My advice to you on both of these is to confirm with your carrier whether they're filing on your behalf or not so nothing falls through the cracks. Typically, with the RxDC, the carrier, if they are doing it for you, they are going to need some information from you, not a lot. So keep an eye out for any requests for information that they may send out to you. Looks like we've got another question here. If you are a small employer and have a level funded plan, in addition to PCORI, do we have to do ACA reporting? Yes. The, law looks at level funding as self insured. Because basically, what the law says is a fully insured... If your plan isn't fully insured, fully backed by an insurance contract, where all you as an employer pay your premiums and the claims and all of that responsibility, lies on the carrier to pay claims, then it's considered self insured. So level funding is considered self insured, and you do owe ACA reporting. If you're not an applicable large employer, the the semi good news is it's not as complex of reporting as an ALE would have. But yes, you do owe ACA reporting if you have a level funded plan regardless of your size. That's often a a common mistake or misconception there by, small level funded groups. So definitely want to make sure you are keeping up on that responsibility. I know when when we're small and we're not an applicable large employer, we, you know, we get to ignore a lot of things about ACA reporting or the ACA law itself, but not, reporting when it comes to that. And the last one I wanted to kinda walk through is form 5,500 filing. So plans with a 100 or more participants, excluding enrolled dependents at the beginning of the plan year, and some small plans do need to file form 5,500. That's due within seven months following the end of the plan year. If you do have to file form 5,500, you also need to prepare a summary annual report, and deliver that to employees within nine months of the plan year end. We've covered a lot of ground, haven't we? Let's let's turn into a kind of a an actual plan now that we have all of this information. And this next section is really about some best practices to make open enrollment run as smoothly as we possibly can. I've got a sample timeline here, and then I wanna wrap up with some common mistakes. So when we we think about executing a solid open enrollment plan, we wanna start planning several months in advance. This isn't a last minute project. Your broker is absolutely here or there to help you. You know, we've gotta review and update all of those required documents and notices. Lean on your broker to help you with that, and for supporting you with educating employees and maybe open enrollment meetings. You know, that's really what they're there for and what they're... They want to help you with that. Establish your open enrollment, window start and end dates, and varied communications before and during that window. Here's what it kinda looks like laid out on a calendar. So at four months out, you wanna prepare your census, schedule a meeting with your insurance broker. At three months, meet with your broker, you know, review any proposals that they... You may have asked them to prepare for you. So you can start working on finalizing what your plan of action is going to be, what benefits are gonna roll into open enrollment, which may not be moving forward. At two months, review and update all required notices, documents, those communications. Remember, we we need to either do a summary of material modifications or restatement of our summary plan description if we've made a bunch of changes, collect those SBCs from the carrier. At one month out, you wanna start sending the enrollment communications to get employees kind of ready. Hey. Here's what's coming up. Here's our timeline for that. Here are some meetings that we're going to be hosting. You know, a a variety of things. But you wanna give them a heads up of what's coming a good thirty days in advance. During the enrollment window itself, you wanna make sure you're reviewing the activities, you know, sending out reminders. You can take a look at, okay, I've had, you know, half my population complete after the first week. I've got more that haven't. So those are the folks that you want to send those reminders to. And you may need to send reminders every single week, during the open enrollment window. And, you know, when we're in the last week, you may wanna send reminders daily to those folks that haven't done, their open enrollment process. You know, a lot of employees may think, well, I'm not changing anything. Why do I need to do this? Well, you know, if they wanna waive again this year, you still wanna capture that. But they do need to do something, typically, so that you'll stop sending them reminders. And then, you know, after it closes, you really want to take stock of what went well and what didn't. Identify those gaps of what didn't go well so that you can start early for next year to fix that, to fill those gaps. Right? You wanna make sure that every open enrollment season goes better and smoother than the year before it. So I I wanna bring us back really to kinda where we started today. And, honestly, it's... Compliance is a huge, huge factor. So if we think about what are some common mistakes that we can try to avoid, try to mitigate? And, you know, these are the ones that I see most often talking to employers and and from my own experiences over the last thirty years. But I want you to know what you can avoid. So a big one is failing to establish a strong, accessible communication plan. Right? When when we're thinking about what do I need to develop for my employees so that we're communicating well before and during open enrollment, think about different modalities. You know, maybe it's short videos. Maybe it's an email communication. Maybe it's an infographic. So, you know, all people learn and comprehend and understand differently. You wanna, plan that and make sure that it's a strong communication plan. Another one to avoid, failing to distribute required notices. There are a lot of notices and documents that need to go out during open enrollment. So make sure you have your arms around that and that you have that, prepped and ready to go. Failing to have or to update your benefit plan documents, whether it's the ERISA, plan document and summary plan description or the cafeteria plan document, you wanna make sure that those are updated, they're up to date, they are accurate every single year. Failing to adhere to ERISA distribution rules. I know that we all wish we could just email everything out or, you you know, post it into our intranet and think we're good to go, but it doesn't always work that way. And, you know, we're still living in rules that were designed in 2002. So much has changed in the world since 2002. Keep an eye. We will be reporting back if the, EBSA does decide to adopt any of those proposed rules and maybe bring us up a little more current to, how we can communicate into the, you know, new millennium, for goodness sakes. The other thing is failing to plan for required filings. I'm a huge fan of put everything on your calendar so you don't forget. Maybe it's me, but I love to put everything on my calendar. Otherwise, I'm going to forget. And I put things on my calendar like, okay. We need to plan out this. So for example, for you with ACA reporting or ALE status, calendar out when you want to, schedule some time to go look at your ALE status. Schedule time to start preparing whatever it is you need to do ACA reporting. You know, I like to take... If there's a specific deadline I have to adhere to, like IRS or something, I like to back into that, by scheduling out some of the tasks that I need to take care of. Same goes for that CMS disclosure, same for 5500. If you walk away from today remembering one thing, I really hope it's this list. Every single mistake on here is absolutely preventable. We've got another poll. Brian, do you wanna launch that while I take a peek at the chat in the Q and A? Brian, did we lose you? Oops. Alright. Brian may be having connectivity issues. Let me see if he's got anything in the comments for me. Alright. Here's another question. Our brokers are employ... There he is. Brian, there you are. Do you wanna go ahead and pop this poll? So can you hear me, There you are. Angela? I can hear you now. Yeah. So, unfortunately, I am experiencing some low bandwidth. No worries. That... Okay. No no worries. I'll go, ahead and... I can, go ahead and read it. is for folks that, would be interested in seeing a demonstration of the Mineral HR and compliance platform, if it would be helpful for your team. So if you're not a current Mineral customer, you can select, yes. I'd like to schedule a demo, or b, not at this time. If you are a Current Mineral customer, you already... Oops, Brian. You might have frozen. There you are. Alright. I'm gonna go ahead and answer this question while we've got the poll up. If you have an employee count that could very easily go over 49 employees and throwing the company into an ALE situation? How can you handle the switch if it happens? So, if you're teetering around that forty seven, forty eight, you know, and and make sure you're taking into account how to, accurately count your part time folks. You you definitely wanna be watching that very closely. If you already have compliant benefits, that's great. But you wanna make sure if you're going to move into ALE status for the following year based on your account from the prior year, that, you work with your broker. You wanna make sure that your contributions that employees are paying is affordable. You know, there are a lot of nuances when it comes to ACA and complying with that law. So so certainly, we're here at Mineral to help you really understand what that means, more so than I can do in the next couple of minutes. But, your broker will also be helpful as well to make sure that your plan is ACA compliant and so forth. Brian, you wanna go ahead and close us out on this poll? Alright. And no need to show that, since we're getting down to the wire here. Apologies. Can you hear me? hear you now. Oh, it looks like we've got one more poll now. Oh, awesome. Awesome. So... Yeah, I've opened up the other poll. And, if your business has clients who face HR and compliance challenges, and you might be interested in exploring a partnership with Mitratech to deliver those, HR solutions to your clients. You can select yes, possibly, or not at this time. Awesome. I'm gonna just keep going And the can. find that poll on the right side of the screen. Great. Okay. And then if we... While we leave that poll open, go to the next slide. My bandwidth is... You'll find a very helpful blog post. I've put this in the chat, but open enrollment is your benefits compliance stress test written by our own Angela Surra. And so you can find that on the Mitratech HRC blog. And then we have an upcoming webinar, Understanding Harassment from Definition to Investigation to Prevention on October 14. So feel free to register for that webinar, and you will find that on the, in the chat, the registration link in the chat as well. Awesome. Thanks, Brian. It looks like we, have answered all the questions, Sure. which is wonderful. I'll let you close it out. I... I'm. Yeah, absolutely. Thank you all for hanging out with us today. We really appreciate it. We certainly hope to see you on our other webinars coming up. Brian has a whole slate of webinars coming up. So keep an eye out for those. We hope to see you again. As always, I totally appreciate you spending your time with me and Brian today. Have a fabulous rest of your day.