Achieving Compliance Confidence: The Role of a Benefits Advisor in Navigating Regulatory Changes

In today’s dynamic and quickly evolving regulatory landscape, employers and HR professionals face a persistent and growing challenge: staying on top of ever-changing federal, state, and local compliance requirements. From shifting healthcare regulations to emerging employment laws, ensuring compliance is no easy task.  

This can be especially challenging during transitions in presidential administrations or significant shifts in legislative representation, for example, when new regulations can seemingly pop up overnight and existing regulations can be either modified or terminated with the stroke of a pen.

However, the employer and HR team should not feel as though they need to navigate these waters alone. This is where a reliable benefits broker becomes an invaluable partner, providing timely regulatory guidance, proactive updates, and strategic planning to keep businesses compliant and penalty-free.

Filtering the Firehose: A Trusted Source of Critical Compliance Updates

Given the sheer volume of legislative changes these days, having a single, reliable source of information is crucial. For our part, we rely heavily on platforms like Zywave, continuously monitoring legal updates and distilling them into actionable insights for our clients. While we encourage our clients to do the same, they can rest assured that we are doing this on their behalf at all times. They can also be confident that we will keep them apprised and informed, not of every minute change or adjustment, but of what they need to know most, when they need to know it, and what actions might be necessary as a result of key developments.

Employment laws, healthcare requirements, and tax codes are constantly shifting, and missing even a minor update can result in hefty fines or legal consequences. Those with full-time obligations elsewhere cannot be expected to stay on top of everything. Work with a broker who proactively monitors changes at the federal, state, and local levels, and who has a proven process in place for keeping clients informed and prepared for any necessary adjustments.

Reducing Risk and Avoiding Penalties

The cost of non-compliance can be steep. Whether it’s misreporting employee benefits, failing to meet Affordable Care Act (ACA) mandates, or overlooking state-specific requirements, non-compliance can result in significant financial penalties. For example, failing to maintain an up-to-date Summary Plan Document (SPD) can result in a fine of $110 per plan participant per day.  

Other key compliance obligations include:

• RxDC Reporting (prescription drug cost reporting)

• Gag Clause Attestation (required for transparency in coverage)

• PCORI Fees for self-funded groups (required per ACA to fund research and improve healthcare for patients)

• Form 5500 Filings (to ensure compliance with the IRS)

• State-Specific Laws (such as the recent Michigan Earned Sick Time Act)

These tasks require careful monitoring and timely execution, underscoring the necessity of a knowledgeable and “plugged-in” benefits broker. Businesses should rely on a benefits advisor as a strategic partner who identifies potential risks and provides guidance on maintaining compliance. We help organizations implement best practices, review policies, and ensure they are aligned with current regulations.

In fact, we’ve developed thorough checklists that quantify the compliance risks our clients are avoiding by working with us, so that they understand the value of proactive benefits consulting. Many HR teams may not even realize they are avoiding penalties, simply because we have taken the right preventive measures.  

Seamless Collaboration Between Legal and HR Teams

Compliance isn’t a one-person job. It requires coordination across HR, legal, and finance teams. We act as a bridge between these departments or external service providers, offering expert insights and resources to keep everything running smoothly.  

But while we are experts in employee benefits, we are not ERISA attorneys. This is why we collaborate closely with legal professionals to dictate and validate compliance strategies. We have carefully vetted partnerships and external expertise to ensure our guidance is accurate. This collaboration extends to state-specific and even city-specific regulations, which can be especially complex.  

From policy documentation to employee communication, we help businesses create a structured approach to compliance that minimizes risk and maximizes efficiency.

Staying Proactive, Predictive, and Proscriptive

Rather than reacting to compliance issues only as they arise, we recommend that employers and HR teams take a proactive stance. Through ongoing education, regular audits, and strategic planning, employers must stay ahead of potential challenges to ensure that compliance is not just a checkbox on a to-do list, but an overarching part of a company’s overall benefits strategy.

Ensuring compliance is not just about reacting to new laws—it’s also about proactive planning. We like to work with clients to create an annual compliance calendar, mapping out key deadlines and responsibilities for the year ahead. Such a tool should forecast all significant milestones and anticipated required actions, from RxDC reporting to filing your 5500 .Your company’s compliance calendar should be reviewed and modified throughout the year as developments warrant.  

This structured approach allows employers to anticipate upcoming compliance obligations and allocate resources accordingly. Instead of scrambling to meet last-minute deadlines, HR teams can stay ahead with a clear roadmap.

“Continuing Education”

Beyond one-on-one consultations, we highly value periodic educational initiatives such as webinars and seminars that we’ll conduct throughout the year and on an as-needed basis. We have both dedicated learning modules exclusive to existing clients as well as educational opportunities open to any HR professional or employer who wishes to attend.

In these sessions, our team brings in experts, including ERISA attorneys to discuss common compliance mistakes, late-breaking priorities, and overall best practices. These educational resources reinforce our intended role as a trusted advisor, ensuring that HR professionals have the knowledge and tools they need to stay compliant.

Your Benefits Broker as a Compliance Ally

Regulatory compliance is a critical yet complex aspect of benefits administration. Employers and HR professionals should not have to navigate this landscape alone. A knowledgeable and proactive benefits broker provides the guidance, resources, and strategic planning necessary to achieve confidence. 

By staying informed, mitigating risks, and offering expert-backed insights, our goal is to help businesses avoid costly penalties and maintain a strong compliance posture in an ever-evolving legal environment that isn’t always linear nor easily predictable.