Comply With Us

Top Ten “True” Health Plan Compliance Cliches

December 17, 2019

Here at the Friends…With HEALTH Benefits Blog, we love to make checklists and we talk about strategic planning a whole lot. We also love to discuss how brokers can provide greater client value by assisting with health plan compliance obligations.  So, with the New Year on the horizon, we thought we’d share a list of ten tips for brokers who are interested in building more compliance services into their business practices during 2020.

1. Just Make Time. If you want to make health plan compliance an effective part of your practice next year, you need to dedicate time in your schedule. You should also consider the schedules of affected account managers and other employees. Clear duties and tasks need to be built into agency operating procedures, and you need to make space for the increased time and effort it will take to do those jobs effectively.

2.  Just Because You Can, Doesn’t Mean You Should. After you commit to making compliance a key part of your practice, also establish limits. If you act beyond your capabilities, not only is it overwhelming, but it can put you, your agency and your clients at legal risk.

3.  Size Matters. For group health plans, the size and structure of the sponsoring company, as well as plan design, make a huge difference when it comes to compliance requirements. Take the time to gather appropriate demographic data from all clients and keep it up-to-date.

4. Get It on The Calendar. Schedule time each month to reach out to clients about specific compliance issues. Different topics can be linked to key points in the plan-year cycle. An annual planning calendar can really help.

5. It Will Only Take A Minute. While working, if a compliance issue comes up or relevant information changes, make it a habit to always take the extra minute to update the appropriate client files and keep current.

6. Don’t Let the Perfect Be the Enemy of the Good. Most agencies and employers have bare bones compliance procedures in place, if that. Don’t be intimidated by all that needs to be done. Start small and build out and improve as you go. It’s also okay to scale your efforts to the type of client!

7. Garbage In, Garbage Out. Compliance efforts are useless if you don’t include the right data. Investing the human capital to review draft forms, plan documents and notices thoroughly is critical. Building compliance checks into each client’s onboarding and renewal process will also pay big dividends in the end.

8. It’s Okay to Ask for Help! If you have compliance questions that you can’t answer, do not hesitate to reach out for help from a professional association, compliance advisor, attorney or tax professional. You will save time and money in the long run, by shielding yourself from liability.

9. You Get What You Pay For, So Pay for What You Need. Vendors offering all kinds of services abound. Carefully evaluate what each one provides for the money, focusing on quality, what you and your clients need, and what services you will truly use.

10. Put Your Own Oxygen Mask on First. Dedicating time to internal agency compliance, including licensing issues, data security protections and appropriate risk management, will yield great benefits for both you and your clients.