Increased Civil Penalty Amounts for Certain Violations
Effective November 15, 2021, the U.S. Department of Health and Human Services (HHS) has increased the following key penalties affecting group health plans:
Summary of Benefits and Coverage (SBC): up to $1,190 per participant or beneficiary.
Medicare Secondary Payer (MSP): up to $9,753.
HIPAA privacy and security rules: Penalties depend on the type of violation involved, and are broken down into “tiers” that reflect increasing levels of knowledge of the violation, as follows:
Tier one: Minimum $120, maximum $60,226, annual cap $1,806,757
Tier two: Minimum $1,205, maximum $60,226, annual cap $1,806,757
Tier three: Minimum $12,045, maximum $60,226, annual cap $1,806,757
Tier four: Minimum $60,226, maximum and annual cap $1,806,757
Employers should become familiar with the new penalty amounts and review their benefit plan administration protocols to ensure full compliance.