Who is responsible for employee benefits compliance?

The employer, as plan sponsor, retains legal responsibility for benefit compliance even when brokers, TPAs, payroll providers, or ERISA counsel handle day-to-day work. Those vendors act as agents, while the fiduciary duty stays with you. This is why written service agreements, regular oversight, documented vendor due diligence and periodic file reviews all matter.

How often should we audit our benefits compliance?

A full compliance audit annually is the minimum for most mid- to large-sized organizations, with quarterly check-ins on filing deadlines, notice distributions, and any regulatory changes issued mid-year. Plan design changes, acquisitions, workforce shifts or jurisdictional expansions should always trigger an interim review.

Do compliance requirements differ for self-funded versus fully insured plans?

Yes, significantly. Self-funded plans (including level-funded arrangements) carry greater direct responsibility for items like machine-readable file posting, mental health parity comparative analyses, Form 1094-B and 1095-B reporting, and ongoing fiduciary oversight. Fully insured plans can often rely on the carrier for some of these items, but only with a written agreement in place confirming that the carrier will perform them.

July 10, 2026

Tobacco Surcharges

Many employers provide incentives to employees (and sometimes their family members) for not smoking or using tobacco or nicotine products to encourage them to adopt healthier lifestyles and to potentially cut down on medical costs. However, some employers fail to realize that putting such incentives in place often creates a wellness program subject to HIPAA wellness rules (as well as ADA/EEOC wellness rules in some cases). Employers choosing to implement a tobacco-related incentive/penalty must be mindful of requirements such as incentive limits and reasonable alternative standards (RAS), as well as confidentiality notices if medical testing is involved.

Protect Your Organization From Costly Compliance Penalties With a Dedicated Benefits Partner

Get In Touch

Looking for a partner to audit your current practices and build a sustainable employee benefits compliance program? Apex Benefits helps Indiana’s HR leaders stay ahead of federal and state requirements while keeping plans competitive and cost-effective. Reach out to get started.

Tobacco Surcharges

July 10, 2026

Tobacco Surcharges

Protect Your Organization From Costly Compliance Penalties With a Dedicated Benefits Partner

Related Articles

Required Reporting of Creditable Status to CMS

ACA Employer Reporting Guide

IRS Provides Guidance on the OBBBA’s Expansion of HSAs