EBSA Issues Self-Compliance Checklists For ACA, HIPAA

The Employee Benefits Security Administration (EBSA) has issued two self-compliance checklists for group health plans to use to test compliance with the Patient Protection and Affordable Care Act (ACA) and HIPAA, and other health care-related provisions.

ACA. Under the ACA, various provisions apply to group health plans and health insurance issuers, and various protections and benefits apply to consumers. These are beginning to take effect or will become effective very soon.

EBSA indicates that the ACA checklist is intended to assist those involved in operating a group health plan to understand the laws and related responsibilities. It provides an informal explanation of the statutes and the most recent regulations and interpretations and includes citations to the underlying legal provisions.

The information is presented as general guidance, however, and should not be considered legal advice or a substitute for any regulations or interpretive guidance issued by EBSA. In addition, some of the provisions discussed involve issues for which the rules have not yet been finalized. Proposed rules, interim final rules, and transition periods generally are noted.

EBSA indicates that the compliance tool will be updated in the future to further address additional requirements as they become applicable, as enforcement grace periods expire, or as additional guidance is issued.

For the ACA checklist, see http://www.dol.gov/ebsa/pdf/part7-2.pdf.

HIPAA. Group health plans, plan sponsors, plan administrators, health insurance issuers, and other parties can use the HIPAA self-compliance tool to determine whether a group health plan is in compliance with some of the provisions of Part 7 of ERISA.

If a plan answers “No” to any of the questions in the checklist, the plan is in violation of the HIPAA provisions in Part 7 of ERISA.

For the HIPAA checklist, see http://www.dol.gov/ebsa/pdf/part7-1.pdf.

Visit our News Library to read more news stories.