top of page

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.

3 views0 comments


bottom of page