What is a Quarterly Compliance Check?
When you set up your HRA, you can select for us to verify that your employees’ insurance coverage remains active on a quarterly basis.
If you select this option, each quarter or as per your company’s chosen compliance schedule, we’ll ask your employees to provide documentation that their plan remains active. We will email several reminders leading up to each compliance check to request that they log in to their member portals and provide an updated proof of coverage, dated within the last 30 days, to confirm that they are maintaining qualified coverage to receive their tax-free reimbursement. For companies following an annual compliance schedule, a single upload may suffice for the entire plan year.
How do I know who has completed a compliance check?
Multiple reminders will be sent out to employees to make sure they submit their insurance verification documents in time. Starting June 16, notices will go out advising them how and what to submit. Once we begin the compliance e-mails, we’ll update your dashboard to show that your employees’ proof of coverage “Will Expire.” Once they upload their new proof of coverage, their status will update to “Enrolled.”
After July 1, for anyone that hasn't sent in their updated Proof of Coverage, their status will show as “Expired” on the dashboard.
Here's a breakdown of what this looks like:
In this example, 35 employees' proof of coverage documents are set to expire on July 1st. Once they submit their insurance verification, they will be moved into the top "Enrolled" tab in the image above. Click "View" to see which employees fall into each category.
Anyone that “Will Expire” who does not provide updated proof by July 1st will automatically be updated to “Expired” on July 1st. They will need to submit their Proof of Coverage before they can receive any more reimbursements.
One thing to note-they will still be able to provide proof of coverage, even after the quarterly compliance deadline. However, they will not be eligible to be reimbursed until they do so. They can submit insurance verification for the month when compliance is due at a later date and get caught up on reimbursements, and you can retroactively reimburse them.
What can my employees provide for Quarterly compliance?
For quarterly compliance checks, with most insurance types, we’re looking for documentation that shows your name (the name of the HRA-eligible employee), your insurance company name and/or plan name, dated within the last 30 days, and if applicable, the premium amount clearly stated. If the person is not the primary insured (e.g., a dependent), evidence of dependent coverage is required as well. Here are the detailed criteria for documentation:
Name: The document must include the eligible person’s name, and if applicable, confirm dependent coverage.
Premium Amount: If claiming premium reimbursement, the premium amount must be clearly listed.
Date: The document should be dated within the last 30 days for compliance purposes.
Plan Name and Provider: Clearly state the plan name and carrier/provider, including the tier and insurer details. A monthly insurance bill, an "Election of Benefits" document, or other formal insurance documentation is preferable. If claiming premium reimbursements for past months, a statement of backdated coverage should be included. Here is a little more information about what to provide as proof of coverage based on your HRA and insurance plan type: