U.S. Department of Labor Employee Benefits Security Administration (EBSA) Pension & Health Plan Options for Small Business Owners

Employee Benefits Security Administration Enforcement Perform audits or investigations to ensure that plan is operating within the provisions of Title I of ERISA

Employee Benefits Security Administration Technical Benefit Advisors Advocates for the law Advise of rights and responsibilities IAW title I of ERISA Provide guidance to employers regarding compliance issues

Employee Benefits Security Administration (EBSA) EBSAs mission is to deter and correct violations of the relevant statutes

Employee Benefits Security Administration (EBSA) Develop policies and laws that simplify compliance, and encourage the growth and preservation of employment- based benefits

Employee Benefits Security Administration (EBSA) Assist plan officials in understanding the requirements of relevant statutes in order to meet their legal obligations

Relevant Statutes Title I, The Employee Retirement Income Security Act of 1974 (ERISA)

ERISA Title I, The Department of Labor, EBSA Title II, The Department of Justice, IRS Title III, The Department of Justice, IRS Title IV, Pension Benefits Guarantee Corporation

ERISA - Title I Fiduciary Duties Reporting & Disclosure Participant Contributions

Amended Health Care Legislation Consolidated Omnibus Budget Reconciliation Act (COBRA) Health Insurance Portability and Accountability Act (HIPAA) Newborns and Mothers Health Protection Act Womens Health and Cancer Rights Act (WHCRA) Mental Health Parity Act

COBRA Continuation of health care coverage at group health rates COBRA Eligible Employers: must employ > 20 FT employees for > 50% of the previous calendar operational year; offer a health care plan

NEW COBRA PREMIUM ASSISTANCE PROGRAM The American Recovery and Reinvestment Act of 2009 (ARRA) provides premium assistance and expanded eligibility for health benefits under COBRA

Health Insurance Portability and Accountability Act (HIPAA) Limitations of Pre-existing Condition Exclusions Special Enrollment Rights Nondiscrimination Rules (health related) Guaranteed Coverage (post COBRA, etc.)

HIPAA Privacy Rules NOT DOL Governed by the Department of Health and Human Services, Office of Civil Rights Effective 14 April 2003

Newborns and Mothers Health Protection Act If group health plan offers coverage: Prevents drive through births Entitles 48 hour hospital stay following a regular delivery Entitles 96 hour hospital stay following a Caesarian section Decision to invoke entitlements is made by the mother in consultation with her attending physician

Womens Health and Cancer Rights Act (WHCRA) If group health plan offers coverage: Guarantees reconstruction on the breast on which the surgery was performed Guarantees reconstruction on the other breast to product a symmetrical appearance Guarantees subsequent coverage of ANY complication resulting from the mastectomy, to include lymphodema Special annual notice requirements regarding coverage

Mental Health Parity Act To provide parity between mental and medical health benefits If plan offers coverage: Provides identical $$ amount ceiling between mental and medical health benefits

CHIP REAUTHORIZATION Childrens Health Insurance Program Reauthorization Act of 2009 Effective April 1, 2009

EBSA Compliance Assistance Assistance for Health Plans Assistance for Retirement Plans General Fiduciary Assistance Retirement Solutions for Small Employers

Health Plan Assistance Benefit Claims Procedure Regulation FAQs 2.Health Benefits Under COBRA 3.COBRA Continuation Health Coverage FAQs 4.Notice of Changes under HIPAA to COBRA Continuation Coverage under Group Health Plans 5.Compliance Assistance for Group Health Plans – HIPAA and Other Recent Health Care Laws 6.HIPAA Nondiscrimination Requirements FAQs 7.Recent Changes in Health Care Law 8.Multiple Employer Welfare Arrangements Under ERISA (MEWA) 9.Womens Health and Cancer Rights Act of 1998

Retirement Plan Assistance A Look at 401(k) Plan Fees for Employers 2.401(k) Plan Fees Disclosure Tool 3.Pension Plans, ERISA, and EFAST 5500 FAQs 4.Cash Balance Pension Plans Frequently Asked Questions 5.Qualified Domestic Relations Order (QDRO) – An Overview 6.Determining Qualified Status and Paying Benefits

General Fiduciary Assistance Voluntary Fiduciary Correction Program (VFCP) 2.VFCP FAQs 3.ERISA Advisory Opinion and Information Letters

Retirement Solutions - Small Employers 1.Simplified Employee Pensions (SEPs) 2.Savings Incentive Match Plan for Employees of Small Employers (SIMPLEs) 3.Easy Retirement Solutions for Small Business 4.Small Business Retirement Savings Program/Employer-Employee Advisor 5.Select a Retirement Plan

Select A Retirement Plan SEP IRA Payroll Deduction IRA Simple IRA 401(k) Profit Sharing Defined Benefit

Time limits for deciding group health claims Type of Claim Initial Appeal Urgent care 72 hrs 72 hrs Pre-service 15 days* 30 days Post-service 30 days* 60 days * 15-day extension available Special rules for concurrent care

EBSA Contact Information Website address: Toll free telephone: 1 (866) (EBSA) Los Angeles Regional Office telephone: Address: U.S. Department of Labor EBSA 1055 E Colorado Blvd Ste 200 Pasadena, CA 91106