4 Benefits Compliance Requirements

Although the legal cannabis industry is growing at an extremely fast pace, there are still quite a few impediments. While compliance with federal, state, and local laws is necessary, it can be stressful and diverge your attention and energy from successfully running your business.

Whether you’re running a legal marijuana company, or you belong to another industry, proper benefits management is an essential part of it. It’s not easy to completely follow up with the entire compliance strategy, and outsourcing it to a reliable company can help you focus on other aspects of your business. However, it’s good to be aware of the common requirements for benefit plans, so let’s have a look at what they are. 

What are the best compliance requirements for benefits plans?

There is a lot of pressure to have the benefit plans of your employees fully compliant with all benefit laws in order to avoid any issues. Here are the most important requirements to comply with:

Medical identification cards

An individual’s medical identification, or ID card, must comprise the following information:

• Any applicable out-of-pocket maximum
• Any applicable deductible
• An internet website and a telephone number that the person may use for obtaining consumer assistance information

Continuity of care

When there’s a change in the network status of a provider due to a termination of contract, it is required from group health plans to notify an individual considered to be a patient with continuing care. A patient with continuing care is a person who is:

• Undergoing a treatment for a complex and serious condition
• Undergoing inpatient or institutional care 
• Scheduled for non-elective surgery, comprising the postoperative care
• Pregnant and undergoing a pregnancy treatment
• Receiving treatment for terminal illness

The notice must give the patient an opportunity for transitional care during the following 90 days or until the person is no longer a patient requiring continuing care. 

Accurate provider directories

It’s necessary to have a process that enables updating and verifying the provider directory every 90 days at minimum and removing the ones that can’t be verified. It’s also required to respond to the inquiries of the network health provider within one business day, as well as keep records of the communication.

The plan also needs to possess a database, listing all health providers who are in indirect or direct contractual relationships. It must as well include a notification stating that the information was accurate.

Gag clauses

Gag clause refers to requirements that don’t allow plan provisions restricting information on quality and price. In fact, it’s not allowed for a group health plan to make an agreement with third-party administrators, a network of providers, a single provider, or any other vendors that either indirectly or directly restrict the plan from:

• Providing information on quality or cost of care 
• Electronically accessing claims and information for each plan enrollee, consistent with privacy regulations, Americans with Disabilities Act (ADA), and Genetic Information Nondiscrimination Act (GINA)
• Sharing data or information described in the previous bullets

Can my legal marijuana business get help with benefits management?

If you’re not sure how to keep your business fully compliant with regulations, or want to look out for potential issues, feel free to reach out to a reliable outsourcing company to take this load off your back. At Green Leaf Business Solutions, we are committed to providing our clients with the high-quality service they deserve. Our team of hard-working experts is dedicated to helping your business grow. 

While we provide the knowledge and expertise for all business types, our specialized niche is the industry of cannabis. We understand these are high-risk businesses, and we diligently make sure they comply with all federal, state, and local laws. Contact us today to schedule free consultation.