← Employer Compliance

Failure to Comply

  • Failure to:

    Furnish an SPD to a participant upon request

  • Penalty:

    $110 per day beginning on the 31st day after the request is made

  • Failure to:

    Provide required COBRA notices

  • Penalty:

    $110 per qualified beneficiary for each day of the non-compliance period

  • Failure to:

    File a completed ERISA Form 5500

  • Penalty:

    $2,586 per day beginning on the last day for filing

  • Failure to:

    Distribute a Summary of Benefits and Coverage (SBC)

  • Penalty:

    $1,362 per failure per day calculated on a per participant or beneficiary basis

  • Failure to:

    File a 1094 or 1095 return

  • Penalty:

    Up to $270 per form

  • Failure to:

    Provide notice and information regarding the Children's Health Insurance Program (CHIPRA)

  • Penalty:

    $137 per day per affected individual

  • Failure to:

    Comply with GINA

  • Penalty:

    $137 per participant per day,
    $3,439 minimum

  • Failure to:

    Pay/file PCORI Fee

  • Penalty:

    5% of the excise tax due for each month or part of a month the return is late, with a cap of 25% of the unpaid tax

  • Failure to:

    File/submit Drug Cost Reporting (DCR)

  • Penalty:

    Non-compliance penalties of $100/day may be issued by the Internal Revenue Service (IRS) for health plans that do not comply as required

  • Failure to:

    Furnish required MHPAEA reports upon request

  • Penalty:

    Up to $110 per day for failure to furnish documentation on request, IRS excise taxes of $100 per day, public disclosure of the plan’s noncompliance, and potential litigation