Sterling ensures regulatory and industry compliance with every product we offer, including HSAs, HRAs, FSAs, POPs, COBRA and self-insurance plans. New requirements under the Patient Protection Affordable Care Act (ACA) make our compliance expertise even more important to our clients in a number of ways:
Clients can access a portfolio of compliance services:
- ACA Reporting
- PCORI Fee Calculation
- Nondiscrimination Testing for Fully Insured Health Plans
- ERISA Wrap and Form 5500 Filing
The PPACA, or “ACA” is a US healthcare reform law designed to expand and improve access to healthcare through regulations, reporting and taxes. Part of the law affects employers, who now need to report on the healthcare offered to their employee population.
Reporting and Documentation
Sterling offers reporting tools through its easy-to-use interface, including:
- Intuitive data input form
- IRS reports required under ACA and employer tracking tool for IRS reporting
- 1094 and 1095 Form preparation and filing services
PCORI Fee Calculation
Under PPACA, or “ACA,” the nonprofit Patient-Centered Outcome Research Institute (PCORI) was formed. PCORI was created to research and evaluate clinical effectiveness of medical treatments. The ACA stipulates that this entity will be funded in part by the PCORI fee. The fee is imposed on insurers issuing health insurance policies and on employers sponsoring self-insured health plans, including HRAs. The rule applies to policy and plan years ending on or after October 1, 2012 and before October 1, 2019.
PCORI Fee Calculation Services Include:
- Calculation of the average number of lives subject to the fee for the HRA plan year.
- Calculation of the PCORI fee due based on the average number of lives, depending on the plan year-end date.
- Sterling will then provide to the employer the total fee due, the IRS Form 720 that the employer must complete when submitting payment to the IRS, and instructions on how to complete the filing and make payment. We cannot complete Form 720 or process the payment to the IRS.
ERISA Wrap Service
Sterling provides the professional preparation of ERISA Wrap plan documents for employers with large and small groups for their welfare benefit plans.
ERISA is a federal law that regulates group-sponsored benefits, often called welfare benefit plans. Besides requiring the provision of specific plan features and funding information, the law mandates employers to comply with strict requirements for disclosing plan information to all eligible employees.
Any employer sponsoring health or welfare benefits must determine the best way to document benefits for legal compliance and to effectively communicate with employees. Employers sponsoring insured benefits must also worry about missing ERISA provisions in their insurance documentation. Sometimes using a “wrap document” to bundle benefits into one plan and/or supplement insurance documents is much easier for the employer.
Services may include:
- Preparation of “mega wrap” or wrap document and Summary Plan Description (SPD).
- Form 5500 and associated schedules A, if applicable
- Preparation of summary of material modification with amendment when plan changes are made
- Summary annual report (SAR)
- Guidance on document retention
- Assistance with employee access and rights
- ERISA compliance requiring guidance and technical assistance
- Provide the following notices at the employer’s request: COBRA notice, certificate of creditable coverage, QMCSO procedures, WHCRA annual notice, ARRA election form, and a CHIPRA annual notice.
- Additional compliance services include:
- Form 5500 late filing
- PPACA notices for non-grandfathered plans
Form 5500 Filing Service
Whether or not Sterling administers your benefit plans, HRA or FSA, we can complete the Form 5500 Filing for you. You must have at least 100 plan participants under a health and welfare plan.
We complete a needs assessment by reviewing Form 5500 Filing history and plan details. Then we gather the required data using a custom worksheet and employer provided information to prepare a signature-ready Form 5500 document for filing with the IRS.
Documents are available for employer review on a secure, password-protected portal. Employers can choose to file electronically after they review the documents we prepare. Or, employers can print, sign and scan the signature page, return it to Sterling and we do the filing. If employers file directly, we’ll help with e-filing instructions.
Timely filing requires that all information be provided to Sterling by the first of the month when the filing is due. For employers who need more time to work with us in gathering data, we’ll also prepare IRS Form 5558 to request a filing extension.
We can also work with employers to amend past incorrect or insufficient filings (DFVC) so Form 5500 filing records are current and compliant with the IRS.
Sterling will maintain the data we gather and all filings to reference for Form 5500 Filing in future years and in the event of questions from the IRS or Department of Labor (DOL). We help with DOL communication and keep you updated on changes in regulations.
We prepare and provide the Summary Annual Report (SAR) for distribution to your employees, if they request a copy. The SAR is a narrative summary of Form 5500 (it is not required for defined benefit pension plan years beginning after December 31, 2007).
The Form 5500 application process is conducted entirely online. Simply log in to get to get started.