Coverage
Compliance & Administration
Navigate the complex regulatory landscape of employee benefits with confidence. ALKEME provides expert compliance guidance on ACA, ERISA, COBRA, HIPAA, and Section 125 requirements to protect your organization from penalties and litigation.
The challenge
Compliance fails silently. A missed 5500, a late COBRA notice or an ACA filing error surfaces as a penalty letter months later, usually addressed to an HR team who believed it was handled.
How ALKEME solves it
We run the calendar, prepare the filings and keep the documentation current, so the obligations are tracked by someone whose job it is rather than remembered by someone whose job it is not.
A tracked compliance calendar, not a reminder in someone's inbox.
What Compliance & Administration Covers
Benefits compliance encompasses the full spectrum of federal and state regulations that govern employer-sponsored benefit plans. The Affordable Care Act (ACA) requires Applicable Large Employers to offer minimum essential coverage that is affordable and provides minimum value to at least 95 percent of full-time employees or face Section 4980H(a) and 4980H(b) penalty assessments. ACA compliance involves measurement period tracking for variable-hour employees, affordability safe harbor calculations, and annual electronic filing of Forms 1094-C and 1095-C with the IRS and distribution to employees.
The Employee Retirement Income Security Act (ERISA) requires employers sponsoring welfare benefit plans to maintain written plan documents, distribute Summary Plan Descriptions (SPDs) and Summaries of Material Modifications (SMMs), file Form 5500 annual returns for plans with 100 or more participants, and follow claims and appeals procedures that comply with DOL regulations. COBRA continuation coverage administration requires timely notice delivery to qualified beneficiaries, accurate premium calculation, and meticulous recordkeeping. Section 125 cafeteria plans must satisfy eligibility, benefits, and nondiscrimination requirements, and employers must conduct annual testing to ensure the plan does not discriminate in favor of highly compensated employees or key employees.
Who Needs Compliance & Administration Support
Every employer that sponsors a group health plan, retirement plan, or welfare benefit plan has compliance obligations. However, the complexity and risk increase significantly with organization size, multi-state operations, variable-hour workforces, and the number of benefit plans offered. Applicable Large Employers face the most extensive ACA compliance requirements, while even small employers must comply with ERISA disclosure rules, COBRA or state continuation mandates, HIPAA privacy regulations, and Section 125 nondiscrimination testing.
Employers undergoing mergers, acquisitions, or workforce restructuring face heightened compliance risk as plan eligibility, coverage levels, and administrative processes change. Organizations that have experienced IRS penalty letter assessments (Letter 226-J), DOL audit inquiries, or participant complaints about benefits administration have an urgent need for compliance remediation and ongoing monitoring. ALKEME provides compliance support scaled to each employer's size and complexity, from basic plan document maintenance for small businesses to comprehensive regulatory oversight for large, multi-state employers with thousands of employees.
Why Compliance & Administration Matters
The financial consequences of benefits compliance failures are substantial and growing. ACA employer shared responsibility penalties can exceed hundreds of thousands or even millions of dollars for large employers that fail to offer qualifying coverage. ERISA violations can result in penalties of up to 110 dollars per day for failing to furnish plan documents requested by a participant, plan disqualification, and fiduciary liability for plan losses. COBRA violations expose employers to penalties of 110 dollars per day per qualified beneficiary and potential excise taxes under IRC Section 4980B.
Beyond financial penalties, compliance failures create employee relations problems, litigation exposure, and reputational risk. Employees who do not receive required plan documents, whose COBRA notices are delayed, or whose claims are improperly denied may file complaints with the DOL or pursue legal action. ALKEME's compliance approach is preventive rather than reactive, establishing systematic processes for tracking regulatory deadlines, distributing required notices, maintaining plan documents, and responding to government inquiries. We monitor legislative and regulatory changes continuously and provide timely guidance on how new requirements affect your specific benefits program.
Key Features of ALKEME's Compliance & Administration Consulting
- ●ACA employer mandate compliance including full-time employee identification, measurement period administration, and affordability safe harbor analysis
- ●IRS Forms 1094-C and 1095-C preparation, review, and electronic filing with error correction support
- ●IRS Letter 226-J penalty response and appeal services for ACA employer shared responsibility assessments
- ●ERISA plan document drafting and maintenance including wrap plan documents, SPDs, SMMs, and SMBCs
- ●Form 5500 annual return preparation and filing for health, welfare, and retirement benefit plans
- ●COBRA administration oversight including qualifying event processing, notice generation, premium tracking, and subsidy compliance
- ●Section 125 cafeteria plan document maintenance and annual nondiscrimination testing for premium-only, FSA, and HSA components
- ●HIPAA privacy and security compliance guidance including notice of privacy practices, business associate agreements, and breach notification procedures
- ●State and local benefits mandate compliance including paid family leave, paid sick leave, commuter benefits, and health insurance continuation laws
- ●Regulatory change alerts and legislative update summaries with action item checklists tailored to your plan designs
Frequently Asked Questions
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