One of the recent strategies more employers seem to be embracing is getting into the care delivery business. Whether a full onsite health clinic, resident psychologist or physical therapist, varying types of employers are exploring ways to reduce cost by getting into the service side of the healthcare business. And while we strongly encourage these solutions – along with other hybrid ones such as onsite telehealth and near-site clinics – compliance pitfalls abound.
In general, any ERISA-covered benefit sponsored by an employer will be subject to all ERISA requirements unless an exception applies (i.e. basic first aid). These requirements include plan documents, SPDs, SMMs (summary of material modifications when something is changed), 5500 filing if at least 100 participants are eligible to use the clinician, and COBRA continuation coverage.
Additionally, offering these services at no cost share to the member would prevent HSA eligibility. An employer’s onsite clinic could offer some limited free medical benefits without interfering with employees’ HSA eligibility; such as physicals, immunizations, and providing aspirin and other nonprescription pain relievers. But that’s because the IRS concluded that these are not “significant benefits in the nature of medical care.” Anything beyond that could jeopardize the entire population’s HSA eligibility.
If you want to start providing care to your employees – by all means! But make sure you’re working with a consultant that can ensure it’s done in a compliant manner.