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.
ViolationPossible FinesDepartment
ACA Reporting ALEs and Self-Funded Plans – 6055 and 6056 Reporting$280 for each filing failure, amount cap of $3,392,000DOL
ACA Notices (e.g., Patient Protections Notice, Rescission of Coverage Notice)$100/dayIRS
COBRA Notices$110/day, per violationDOL/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 requestDOL/IRS
Late 5500 Reportup to $2,400 per dayDOL/IRS
Failure to File annual 5500 Report$2,400 per dayDOL
FMLA Violations$178 for each separate offenseDOL
Failure to furnish statement of benefits or to maintain records.$33 per employeeIRS
Failure to notify plan participants of benefit restrictions and/or limitations.$1,788/recipientDOL
Failure to furnish automatic contribution arrangement notice.$1,788/recipientDOL
Failure to furnish employee benefit plan documents to DOL upon request.$2400/dayDOL
Failure to inform employees of Medicaid/CHIP coverage opportunities.$127 per day per employeeDOL
GINA Violation$127 per participant per dayDOL
Failure to provide Summary of Benefits Coverage (SBC).Up to $1,264 per failureDOL
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 recipientDOL
FMLA Posting & Notice Violation$189 for each offenseDOL
HIPAA Violations – No Knowledge$60,226 per violation and up to $1,806,757 per calendar yearDOL/HHS
HIPAA Notice of Special Enrollment Rights$100 per failureCMS/HHS
MEWA – Failure or refusal to file a complete or accurate Form M-1.$1,746 a dayDOL
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.