Sarah Borders, CEBS February 3, 2025 6 min read

2025 Adjusted Penalty Amounts Released

The Department of Labor (DOL) issued the 2025 annual adjustments to penalties applicable to group health plan benefits. The 2025 amounts are effective for penalties assessed after January 15, 2025 for violations occurring after November 2, 2015.

Applies To:

  • All employers with a fully insured, level-funded or self-funded group medical plan or an ICHRA.
  • All employers with ERISA health or welfare plans subject to the jurisdiction of the DOL.

Go Deeper:

Following are the revised penalties for 2025 applicable to health benefit plans:

 

2024

2025

Form 5500

per day late

$2,670

$2,739

Form M-1

per day late

$1,942

$1,992

Summary of Benefits and Coverage (SBC)

per failure

$1,406

$1,443

GINA Violations

per person per day

$141

$145

Medicaid/CHIP Disclosures

per person per day

$141

$145

DOL Information Request

$190 per day, up to $1,906 per request

$195 per day, up to $1,956 per request

Employers sponsoring group benefits need to be aware of potential penalties for various failures, and make necessary changes to avoid such penalties.

Federal Civil Penalties Inflation Adjustment Act Annual Adjustments for 2025 can be found here.

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Sarah Borders, CEBS

Principal, Benefits Compliance Solutions. Sarah has spent the last 15 years in the employee benefits industry, has numerous designations and serves on NAHU’s Employer Working Group Subcommittee and is an active board member of Austin AHU. She recently stepped down as Vice President of Benefits Compliance at one of the nation's largest brokerage firms to start her own compliance consulting practice. Her designations include an active license with the Texas Department of Insurance, CEBS (Certified Employee Benefits Specialist), Certified Health Care Reform Professional, HIPAA certification and Health Care Service Associate. She holds an MBA from Texas A&M Corpus Christi and a BA from University of Incarnate Word. Her consulting firm, Benefits Compliance Solutions, partners with employers to identify unknown risks and avoid hundreds of thousands of dollars in fines and lawsuits from failure to comply with their healthplan obligations.

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