494 South Seguin Avenue
  New Braunfels, TX  78130

  (830) 625-3959 or
  (214) 870-6785

  (830) 625-3931 Fax

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   © Copyright 2003-2004
   Bruce Ruud and Assoc.
   All rights reserved.

 

 


Compliance Tools
Compliance Audit Checklist - Health Plan

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Does the Plan operate in accordance with the Plan/Trust Documents?

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Who are the Plan fiduciaries and parties-in-interest?

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Has the Plan entered into any prohibited transactions or used the plan to promote the interests of anyone other than the plan participants?

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If insured, were there any insurance rebates, refunds or credits and did the employer properly use them for plan purposes.

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Are negotiated discounts properly shared with the plan and with plan participants for co-pay purposes?

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Is there a prudent fiduciary decision making process for the selection and monitoring of insurance products and other plan services and is there sufficient documentation to support their decisions?

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Are the service provider arrangements reasonable and is the cost and quality of those services in line with the industry?

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Does the Plan meet the reporting, bonding and disclosure requirements of ERISA?

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Has the plan complied with the Health Insurance Portability & Accountability Act of 1997(HIPAA), the Mental Health Parity Act of 1996, The Newborns & Mothers Health Protection Act of 1996 and the Womens Health Protection Act of 1996 and the Womens Health and Cancer Rights Act of 1998?

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Is the plan in compliance with COBRA?

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Is the plan in compliance with the HIPAA privacy regulations?

 

If you are interested in additional information about this topic or would like to be added to our address book to receive periodic emails, please contact us.

 

Bruce Ruud and Associates   ●   (830) 625-3959   ●   Contact Us

   © Copyright 2003-2004
   Bruce Ruud and Assoc.
   All rights reserved.