Health and Wellness Penalties
 |
Health & Wellness Penalties
2024 |
2023 |
2022 |
|
CHIPRAFailure to inform an employee of CHIP coverage opportunities |
Up to $141 per day per employee | Up to $137 per day per employee | Up to $127 per day per employee |
COBRAFailure to provide compliant COBRA notices |
Not Yet Available | $110 per day from the date of compliance failure | $110 per day per violation; in addition, ERISA provide notice penalties of up to $110 per day from the date of compliance failure |
DOLFailure to furnish to the DOL any requested information relating to the employee benefit plan |
Up to $190 per day not to exceed $1,906 per request | Up to $184 per day not to exceed $1,846 per request | Up to $171 per day not to exceed $1,613 per request |
FMLAWillful failure to post FMLA general notice |
Up to $211 for each separate violation | Up to $204 for each separate violation | Up to $189 for each separate violation |
(ACA) 4980H(a)ALEs that fail to offer coverage to at least 95 percent of full-time employees (and their dependents) |
$2,970 times ALE’s full-time employees (minus up to 30)  Assessed and calculated monthly using monthly employee count (minus 30) times 1/12 of penalty above |
$2,880 times ALE’s full-time employees (minus up to 30) Assessed and calculated monthly using monthly employee count (minus 30) times 1/12 of penalty above |
$2,750 times ALE’s full-time employees (minus up to 30) Assessed and calculated monthly using monthly employee count (minus 30) times 1/12 of penalty above |
(ACA) 4980H(b)ALEs that offer coverage to at least 95 percent of full-time employees (and their dependents), but the coverage is either unaffordable or does not offer minimum value |
$4,460 times the number of ALEs full-time employees who receive a premium tax credit Assessed and calculated monthly using employees receiving a tax credit for a month times 1/12 of penalty above and capped at the 4980H(a) assessment (if it were applicable) |
$4,320 times the number of ALEs full-time employees who receive a premium tax credit Assessed and calculated monthly using employees receiving a tax credit for a month times 1/12 of penalty above and capped at the 4980H(a) assessment (if it were applicable) |
$4,120 times the number of ALEs full-time employees who receive a premium tax credit Assessed and calculated monthly using employees receiving a tax credit for a month times 1/12 of penalty above and capped at the 4980H(a) assessment (if it were applicable) |
Form 1095-BFailure to file a correct information return and failure to provide a correct payee statement |
$310 per return/statement with a max penalty of $3,783,000 per year | $290 per return/statement with a max penalty of $3,532,000 per year | $280 per return/statement with a max penalty of $3,426,000 per year |
Form 1095-CFailure to file a correct information return and failure to provide a correct payee statement |
$310 per return/statement with a max penalty of $3,783,000 per year | $290 per return/statement with a max penalty of $3,532,500 per year | $280 per return/statement with a max penalty of $3,426,000 per year |
Form 5500Fail to file a properly completed annual report |
Up to $2,670 per day that the filing is late | Up to $2,586 per day that the filing is late | Up to $2,400 per day that the filing is late |
GINAFailure of a plan sponsor of group health plan that fails to meet requirements with respect to genetic information |
$141 per day per employee | $137 per day per employee | $127 per day per employee |
M-1Failure of MEWA to file annual MEWA Report |
Up to $1,942 per day for each failure | Up to $1,881 per day for each failure | Up to $1,746 per day for each failure |
MedicareFailure of an insurer, TPA, or fiduciary for a group health plan to provide information identifying whether the plan is a primary plan to Medicare to HHS |
Not Yet Available | Up to $1,428 per day for each failure | Up to $1,325 per day for each failure |
SBCFailure to furnish required documents to a requesting participant, such as an SBC |
Up to $1,406 per failure | Up to $1,362 per failure | Up to $1,264 per failure |
SPD and SARFailure to provide an SPD, SAR, or plan document within 30 days of receiving a request from a plan participant or beneficiary |
$110 per day per employee | $110 per day per employee | $110 per day per employee |
HIPAA Penalty Chart for 2022
Culpability/State of Mind |
Minimum Penalty/Violation |
Maximum Penalty/Violation |
Annual Limit |
|
Tier 1 |
Violations involving no knowledge | $127 | $63,973 | $1,919,173 |
Tier 2 |
Reasonable cause violations | $1,280 | $63,973 | $1,919,173 |
Tier 3 |
Willful neglect violations that are corrected | $12,794 | $63,973 | $1,919,173 |
Tier 4 |
Willful neglect violations that are not corrected | $63,973 | $1,919,173 | $1,919,173 |
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