Compliance Fines & Penalties
Depending on the compliance violation the Department of Labor (DOL), Internal Revenue Service (IRS) or Department of Health & Human Services (HHS) may impose fines or penalties. Below are a few possible examples.
Violation | Possible Fines | Department |
ACA Reporting ALEs and Self-Funded Plans – 6055 and 6056 Reporting | $280 for each filing failure, amount cap of $3,392,000 | DOL |
ACA Notices (e.g., Patient Protections Notice, Rescission of Coverage Notice) | $100/day | IRS |
COBRA Notices | $110/day, per violation | DOL/ERISA |
Failure to provide written requested ERISA plan documents, Summary Plan Descriptions, Summary of material modifications, etc. | $110/day. Failure to furnish up to $161 per day, not to exceed $1,613 per request | DOL/IRS |
Late 5500 Report | up to $2,400 per day | DOL/IRS |
Failure to File annual 5500 Report | $2,400 per day | DOL |
FMLA Violations | $178 for each separate offense | DOL |
Failure to furnish statement of benefits or to maintain records. | $33 per employee | IRS |
Failure to notify plan participants of benefit restrictions and/or limitations. | $1,788/recipient | DOL |
Failure to furnish automatic contribution arrangement notice. | $1,788/recipient | DOL |
Failure to furnish employee benefit plan documents to DOL upon request. | $2400/day | DOL |
Failure to inform employees of Medicaid/CHIP coverage opportunities. | $127 per day per employee | DOL |
GINA Violation | $127 per participant per day | DOL |
Failure to provide Summary of Benefits Coverage (SBC). | Up to $1,264 per failure | DOL |
Failure to disclose certain documents upon request (ERISA 101(k) and (l)); failure to furnish notice under ERISA 101(j) and 514(3)(e) | $1,899 per statutory recipient | DOL |
FMLA Posting & Notice Violation | $189 for each offense | DOL |
HIPAA Violations – No Knowledge | $60,226 per violation and up to $1,806,757 per calendar year | DOL/HHS |
HIPAA Notice of Special Enrollment Rights | $100 per failure | CMS/HHS |
MEWA – Failure or refusal to file a complete or accurate Form M-1. | $1,746 a day | DOL |
Allowing premiums to be paid on a pre-tax basis for covered benefits without having either a Premium Only Plan (POP) document or Flexible Spending Account (FSA) document. | Penalty: Employer can lose the ability to allow premiums on a pre-tax basis. | IRS |
Other – This is only a partial list of possible fines and penalties. |