GBS Benefits

The changing compliance rules impacting benefit plans are difficult to track due to their complex nature. Failing to meet these obligations can result in penalties, costing an organization a large amount of money in fines. To avoid such penalties, employers need organization, processes, education, and technology to meet the essential compliance requirements.

Addressing these needs is GBS Benefits.

GBS Benefits assists companies navigate the changing landscape of employee benefits and satisfy compliance requirements. The company’s team, consisting of attorneys and compliance specialists understands the rules that must be adhered to, including ERISA, HIPAA, the Affordable Care Act, and more. This overarching knowledge base and skillset allows GBS to provide comprehensive benefit plan education and direction.

An example provided by Matt Kiisel, senior vice president of operations at GBS Benefits, includes the Affordable Care Act 1094/1095 forms. These forms must be furnished by certain employers to their fulltime employees; and filed with the IRS each year in February and March. Through the forms, the IRS can determine whether the employer has been compliant with the rules.

“We have been able to help many clients avoid thousands of dollars in potential fines and penalties by helping them understand the complex rules related to the forms and take appropriate preventive steps in advance to stay compliant.”

For newer clients, the compliance team has helped address issues with 1094/1095 forms filed prior to coming to GBS benefits. “Completing the forms correctly can be a challenge if not properly educated on the process. It is not unusual to see a group unintentionally include incorrect information on the forms due to lack of education, but this can trigger expensive penalties as well because it makes it look like the group was not compliant with the underlying Affordable Care Act rules. We have assisted new groups, who had received an IRS proposed penalty letter, understand the mistakes they made on the forms and how to correct them, which has resolved the issue many times.”

GBS implements additional strategies to help clients obtain and maintain compliant group health benefits plans.

For example, recent new federal rules designed to improve transparency in health care and protect consumers adds many new rules, and thus more tasks, for insurers, providers and employers that sponsor group health plans.

Keeping track of new compliance rules on top of existing compliance rules can be challenging. Kiisel elaborates on yet another GBS compliance strategy. “GBS performs a compliance assessment for our clients, considering employment and benefits law, and asks 60 questions about their benefits plans and requests to examine necessary legal notices and documents to discover compliance gaps”. Some cases involve misinterpretation of compliance rules. In other cases, the company conducts a compliance gap analysis to find missed obligations. Once any gaps are mended, GBS establishes compliance processes throughout the year to meet and uphold each requirement. The organization utilizes compliance dashboards which allow clients to view compliance obligations they must adhere to all year round. When clients have questions, GBS is equipped with in-house compliance experts with over 15 to 20 years of industry experience to provide reliable answers.

We have been able to help many clients avoid thousands of dollars in potential fines and penalties by helping them understand the complex rules related to the forms and take appropriate preventive steps in advance to stay compliant

For one GBS client, initial analysis found a compliance gap during the new client onboarding phase. The client needed to meet one of the ERISA requirements and catch up on seven years of late filing. Facing an overwhelming penalty amount, GBS’s Compliance Team stepped in and helped the client utilize a voluntary delinquent filing program which drastically reduced the owed amount for voluntary compliance and reporting of late filings.

GBS also assists clients in compliance as they pursue costrvon- demand health models, and reference-based pricing models. Its clients efficiently save money without fear of failing to meet the compliance obligations associated with their chosen benefits strategies. One aspect contributing to GBS’s success with clients is its direct access to compliance resources. At any time, clients can contact GBS and gain immediate access to compliance experts and are navigated through the complicated compliance panorama.

With over 30 years of experience, GBS Benefits guides clients through the challenging insurance and benefits industry. It simplifies compliance rules and saves employers money by ascertaining regulations are being adhered to. Making client satisfaction its cornerstone, GBS continues to support organizations by offering better benefits.