Health Insurance Compliance Risk Assessment

Health Insurance Compliance Assessment

Regulatory & Health Insurance Compliance Services

Hitting the moving target of compliance is rarely easy, but it is absolutely critical to ensuring the safety of your business and the satisfaction of your employees.


The first step to staying compliant is to have a partner help you effectively anticipate and manage developing regulatory issues. Working with AEIS reduces your risk of financial and reputational damage, ensuring you remain “audit-ready” year-round. Our experts will continually assess, report, and strategize on the effects ACA, HIPAA, COBRA, ERISA, and state & local laws (such as San Francisco Ordinances) have on your benefits plan. The end result is a tailored compliance review and action plan designed to keep you protected at all times. 

health insurance compliance assessment, health insurance risk assessment

Compliance Resources For Complete Confidence

There is no better feeling than the peace of mind that comes from understanding your biggest liabilities and having a reliable guide walk you through every step of the mitigation and compliance process. This confidence is what AEIS excels in delivering.

In our advisory role, AEIS works to assess and address your needs through the following resources:


✓ Monthly compliance webinars conducted by Fisher Phillips

✓ An NAHU ACA Certified Compliance Analyst

✓ Monthly and quarterly bulletins

✓ An ERISA attorney on retainer

✓ Regular updates on the Affordable Care Act (ACA) and other legislations

✓ SPD’s/Wrap Documents for your health and welfare benefit plans

✓ Assistance with Form 5500 filings

✓ Provide Broker and Consultant Services Compensation Disclosure Notice      required under ERISA Section 408(b)(2)(B)

Schedule an Appointment

Customizable Compliance Assistance Based on Your Needs

Gain a greater understanding of your compliance related issues through a health insurance risk assessment. AEIS works to simplify the rules and regulations you need to focus on most while proactively integrating compliance procedures and strategies. What compliance related issues are troubling you?

Affordable Care Act (ACA) Requirements

All medical health insurance policies sold after January 1st, 2014 must comply with the regulations set forth by the Affordable Care Act (ACA). What does this mean for your business? Further complicating the world of regulatory requirements, the ACA has created a unique set of challenges you need to overcome to stay compliant. Fortunately, our ACA Certified Compliance Analysts are by your side, assisting your growing business in navigating the space and meet compliance requirements with ease.

Health and Welfare

With the exception of church and government benefit plans, all other group health and welfare plans are required to comply with the Employee Retirement Income Security Act (ERISA). While the title does not include the words Health and Welfare, it does apply to these types of group plans.

Employers must also follow reporting and disclosure laws on a set schedule, delivered to plan participants on Form 5500, a Summary Plan Description (SPD), or other annual notifications. Those who fail to comply can face fines in excess of $100 per day, person. Ensuring you are protected by plan administrators and ERISA compliance experts is crucial to meeting the three main components of compliance: 

• Proper Reporting

• Full Disclosure

• Complete Payment of Claims

Save yourself from costly future consequences. Remain cautious and stay up to date on requirements and regulations with our team.



COBRA Coverage

The Consolidated Omnibus Budget Reconciliation Act (COBRA) ensures employees who are no longer eligible to receive an employer’s health insurance benefits can keep their plan for 18 to 36 months after becoming eligible for COBRA.

There are numerous requirements, criteria, and events that must take place in accordance with set timeframes. Any mistakes in COBRA administration can be costly. Our team will make sure you have the right tools and players to make the administration of COBRA as smooth as possible.

HIPAA Standards

The requirements of HIPAA Compliance ensure the privacy and protection of important personal information and data. Protected health information or “PHI” includes addresses, names, social security numbers, financial information, and more. Covered entities and business associates should be aware of the 4 main HIPAA rules:

• HIPAA Privacy Rule

• HIPAA Security Rule

• HIPAA Breach Notification Rule

• And HIPAA Omnibus Rule


These privacy rules are applicable not only for large corporations, but any business that has access to PHI, even when not being used for claims administration. Understanding and implementing a HIPAA compliant plan is crucial for protecting your business and your employee’s information. Our team can help you do both.

Health Care Security Ordinance (HCSO)

Under the San Francisco Health Care Security Ordinance (HCSO), covered employees must:


• Satisfy an Employer Spending Requirement

• Maintain records to demonstrate that compliance

• Post HCSO notices where Covered Employees work

• Submit the Annual Reporting Form to the Office of Labor Standards Enforcement each year 


AEIS is well equipped to ensure your business and your employees remain compliant with these requirements on an ongoing basis.


AEIS: Creative Solutions for Complete Compliance

Equipped with the finest team of advisors and resources available, AEIS is ready to support employers and organizations navigate the tricky world of compliance regulations and rules. Evaluate potential benefits and risks with us: Call (650) 348-6234 or schedule an appointment today!

Get in Touch!

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