Educating Employees & Compliance

Employers are responsible for educating their employees about the health coverage options they offer. Employees have the right to receive clearly presented health and benefit information and assistance reading health materials, if needed. We will assist you in this process.

Employees need to know:

  • What benefits are covered in the offered health plan(s)
  • Cost-sharing requirements and arrangements
  • Procedures for resolving complaints and appealing decisions
  • Licensure, certification and accreditation status
  • Methods for measuring consumer quality and satisfaction
  • Composition of the provider network
  • Obtaining referrals to specialists
  • Cost of emergency care services
  • Price, quality and safety of health benefits provided by the offered plans

Required Documents:

  • Summary plan description
  • Summary of material modifications (whenever the plan is amended)
  • Summary annual report (contains information on the financial condition of the plan)
  • Summary of Benefits and Coverage
  • Model Notices
  • Premium Only Plan election form

We Can Help

Compliance Assistance

Our comprehensive DOL Audit Guide will give you access to the items most commonly audited by the Department of Labor. We assist with providing you with all of the necessary information needed to pass a DOL Audit.

Review DOL Audit Guide

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(330) 315-6200


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