Penalties for Noncompliance
If a plan does not comply with applicable Health Care Reform plan design mandates (or meet the requirements to maintain grandfathered status) the employer may be subject to the excise taxes imposed under HIPAA. The penalty is generally $100 per day for each affected individual up to the date of correction (which essentially means making a correction that would give the participant the benefits to which he or she is entitled under the Health Care Reform law).
- Who is tasked with enforcing the Health Care Reform requirements?
Answer: It depends on the requirement. Three federal agencies share jurisdiction over the Health Care Reform plan design mandates that amended HIPAA: the Departments of Treasury, Labor, and Health and Human Services. Tax provisions are generally interpreted and enforced by the Department of Treasury and IRS. Some provisions are enforced under state law, such as certain components of rate review, external review, and medical loss ratio requirements.
American Fidelity Assurance Company does not provide tax or legal advice.