Compliance Assistance

Clark & Lavey provides a wealth of information about compliance with laws such as ERISA, COBRA, HIPAA, FMLA, New Hampshire SB110, Massachusetts Universal Healthcare Act, and others. We also have extremely well-qualified strategic partners who provide compliance and administrative services to all our clients.

Click these links for more information on this page about:

Employment Retirement Income Security Act (ERISA) Compliance (top)

The Employee Retirement Income Security Act is a federal law that fixes standards for pensions and health plans in private-sector industry. ERISA affords protection for people in these plans.

The provisions of ERISA ensure that all plans:

  • Provide participants all necessary plan information
  • Provide monetary responsibilities for managers and controllers of plan assets
  • Provide grievance and appeals systems, to make sure plan participants receive benefits due to them
  • Empower plan participants with the right to sue for benefits (and breach of duty)

Over the years, a number of amendments to ERISA have been made, which widen protections available to health benefit plan members and beneficiaries. These include:

  • The Consolidated Omnibus Budget Reconciliation Act (COBRA)
  • The Health Insurance Portability and Accountability Act (HIPAA)
  • The Newborns’ and Mothers’ Health Protection Act
  • The Mental Health Parity Act
  • The Women’s Health and Cancer Rights Act

Navigating the twists and turns of ERISA, and its subsequent amendments, can be a daunting task. It’s made much easier for you by the benefits professionals at Clark & Lavey.

COBRA Administration (top)

The Consolidated Omnibus Budget Reconciliation Act gives former employees, retirees, spouses, former spouses, and dependent children the right to a temporary continuation of their health coverage at group rates (plus a 2% administration fee). COBRA coverage, though, is only available when coverage is lost due to specific events.

Group health coverage for COBRA participants is generally more expensive than health coverage for active employees, as the employer usually pays some of the premium for active employees. COBRA participants generally pay the entire premium themselves. Still, COBRA is, in most cases, less expensive than individual health coverage.

COBRA administration can be extraordinarily time-consuming, difficult and confusing. Clark & Lavey can connect your organization to experts in COBRA administration who provide such services as issuing all notices and HIPAA (Health Insurance Portability and Accountability Act) certificates - collecting premiums and handling terminations.

HIPAA Compliance (top)

The Health Insurance Portability and Accountability Act of 1996 is a federal law that protects an individual’s right to both the privacy and the security of their health information. HIPAA also sets requirements and limits under which pre-existing conditions exclusion(s) can apply. If you have a pre-existing condition, HIPAA aids in minimizing the impact of that exclusion on your access to health coverage.

HIPAA also establishes rules with which employers (among others) must comply. Employers have specific responsibilities under these laws, such as the establishment of a Privacy Officer. Up-to-date policies, procedures and staff training are all part of the privacy compliance requirements.

Compliance with HIPAA can seem an overwhelming task. Let Clark & Lavey connect you with the right strategic partner - one who will work with you to assure compliance.

Family Medical Leave Act (FMLA) Administration (top)

FMLA can seem confusing and overwhelming. Clark & Lavey helps companies work with professionals to ensure full compliance with FMLA.

Under FMLA, eligible employees may take up to a total of 12 work weeks of unpaid leave during a given 12-month period for one (or more) of the reasons listed below:

  • The birth and care of the newborn child of the employee
  • Placement with the employee of a son or daughter for adoption or foster care
  • To care for an immediate family member (spouse, child, or parent) with a serious health condition
  • To take medical leave when the employee is unable to work because of a serious health condition

FMLA contains notification requirements. Questions often arise about leave taken intermittently or on a reduced leave schedule. There are numerous questions involving the interactions between FMLA and COBRA. Employers have questions regarding eligibility. Clark & Lavey has strategic partners who can help make sure you are in FMLA compliance whenever the situation arises.

Massachusetts Universal Health Care (top)

The Massachusetts Universal Health Care Act establishes mandates for:
Employers doing business in, or employing residents of, the Commonwealth of Massachusetts. There are mandates for employers, insurance carriers and for individuals, one of which is the requirement that all Massachusetts residents over the age of 18 maintain health insurance.

Clark & Lavey professionals work to help you satisfy the requirements of the act, and to make sure that your coverage is also in compliance.