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Office of Inspector General—Office of Audit 

EMPLOYEE BENEFITS SECURITY 

ADMINISTRATION 

FURTHER ACTION BY EBSA COULD HELP 

ENSURE PPACA IMPLEMENTATION AND 

COMPLIANCE 

Date Issued: September 30, 2011 

Report Number: 09-11-003-12-121 
 

U.S. Department of Labor 

Office of Inspector General 

Office of Audit 

BRIEFLY... 

Highlights of Report Number 09-11-003-12-121, issued 

to the Assistant Secretary for Employee Benefits 

Security. 

WHY READ THE REPORT 

The Patient Protection and Affordable Care Act (PPACA) was 

enacted on March 23, 2010, and amended by the Health Care 

and Education Reconciliation Act (HCERA) on 

March 30, 2010. As amended, PPACA is the most significant 

health care reform bill in decades. It expands health care 

coverage to an estimated 31 million uninsured Americans 

through a combination of cost controls, subsidies, and 

mandates. PPACA is estimated to cost $848 billion over a 

10-year period. 

PPACA will affect nearly every element of our health care 

system including employers, both large and small. According 

to employee benefits industry sources, PPACA will have the 

most significant impact on employer-sponsored health plans 

since the enactment of the Employee Retirement Income 

Security Act of 1974 (ERISA) more than 30 years ago. 

PPACA would impose requirements on the type of health care 

coverage employers must offer including: 

(a) Covering most adult children up to age 26. 

(b) Elimination of lifetime limits and restrictive annual 

limits. 

(c) Elimination of pre-existing condition exclusions. 

(d) Required coverage of certain preventative services 

(e.g., immunizations and infant screenings). 

The Employee Benefits Security Administration (EBSA) is 

responsible for oversight of health coverage provided by 

employers through the administration and enforcement of the 

civil and criminal provisions of Title I of ERISA and related 

criminal statutes. EBSA oversees approximately 2.6 million 

employer-sponsored health plans covering approximately 

150 million participants and beneficiaries. This includes single 

employer plans, multi-employer plans and Multiple Employer 

Welfare Arrangements (MEWA) 

EBSA, in conjunction with the Departments of Treasury 

(Treasury) and Health and Human Services (HHS), has been 

working to implement PPACA. 

WHY OIG CONDUCTED THE AUDIT 

We conducted the audit to determine if EBSA has taken 

action to implement PPACA. 

READ THE FULL REPORT 

To view the report, including the scope, methodology, and full 

agency response, go to: 

http://www.oig.dol.gov/public/reports/oa/2011/09-11-003-12-

121.pdf 

September 2011 

FURTHER ACTION BY EBSA COULD HELP ENSURE PPACA 

IMPLEMENTATION AND COMPLIANCE 

WHAT OIG FOUND 

EBSA has taken significant actions toward implementing 

PPACA requirements by issuing regulations, conducting 

research, and providing compliance assistance and outreach. 

However, further action by EBSA could help ensure PPACA 

implementation and compliance. Specifically, EBSA could 

work with Treasury and HHS to establish a public timeline for 

addressing the public comments received on interim-final 

PPACA regulations and issuing final regulations. 

In addition, EBSA could better leverage enforcement 

resources to assist plans in complying with the new 

regulations. Including compliance with PPACA requirements 

in its health plan investigations could have resulted in 

identifying areas where plans, sponsors, and insurers needed 

technical assistance. 

Furthermore, as required by PPACA, EBSA should provide 

HHS with the results of a survey of benefits typically 

covered by employers that is sufficiently broad to enable 

HHS to determine benefits provided under a typical 

employer plan. EBSA was unable to state that the report it 

provided HHS was broad enough to encompass all 

benefits EBSA considered to be typically covered by 

employers. Moreover, EBSA did not address all benefits 

HHS requested. Without this, HHS may not be able to 

ensure that State Insurance Exchanges offer the 

appropriate essential health benefits required by PPACA. 

Lastly, EBSA should develop a regulation concerning 

MEWAs under PPACA Section 6604, regarding the 

applicability of State law as a means to combat fraud and 

abuse. 

WHAT OIG RECOMMENDED 

We made four recommendations to the Assistant Secretary 

for Employee Benefits Security: 

1. Work with the Departments of HHS, Treasury, and the 

Office of Management and Budget to establish specific 

timetables to respond to public comments and issue final 

regulations; 

2. Incorporate PPACA requirements immediately into the 

enforcement program to assist plans in complying with 

PPACA; 

3. Provide HHS with the results of a survey of benefits 

typically covered by employers that is sufficiently broad to 

enable HHS to determine benefits provided under a 

typical employer plan; and 

4. Proceed with rulemaking relative to PPACA section 6604. 

The Assistant Secretary for Employee Benefits Security 

agreed with recommendations 1 and 4. The Assistant 

Secretary, however, did not fully agree to incorporate PPACA 

requirements into the enforcement program to help plans with 

compliance assistance or take further action to report the 

results of a survey conducted to determine benefits typically 

covered by employers. 
 

U.S. Department of Labor – Office of Inspector General 

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EBSA PPACA Implementation 

Report No. 09-11-003-12-121 
 

U.S. Department of Labor – Office of Inspector General 

Table of Contents 

Assistant Inspector General’s Report ......................................................................... 1
 

Results In Brief.............................................................................................................. 2
 

Objective — Has EBSA taken action to implement PPACA? .................................... 5
 

Further Action By EBSA Could Help Ensure Implementation and 

Compliance........................................................................................................... 5
 

Finding 1 — EBSA could take additional action to help ensure PPACA 

implementation and compliance....................................................... 5
 

Recommendations ...................................................................................................... 13
 

Appendices 

Appendix A Background ..................................................................................... 17
 

Appendix B Objective, Scope, Methodology, and Criteria .................................. 19
 

Appendix C Acronyms and Abbreviations .......................................................... 21
 

Appendix D EBSA Response to Draft Report..................................................... 23
 

Appendix E Acknowledgements ......................................................................... 27
 

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EBSA PPACA Implementation 

Report No. 09-11-003-12-121 
 

 

U.S. Department of Labor – Office of Inspector General 

U.S. Department of Labor Office of Inspector General 

Washington, D.C. 20210 

September 30, 2011 

Assistant Inspector General’s Report 

Phyllis C. Borzi 

Assistant Secretary for Employee Benefits Security 

U.S. Department of Labor 

200 Constitution Avenue, NW 

Washington, D.C. 20210 

The Patient Protection and Affordable Care Act (PPACA) was enacted on 

March 23, 2010, and amended by the Health Care and Education Reconciliation Act 

(HCERA) on March 30, 2010. As amended, PPACA is the most significant health care 

reform bill in decades. It expands health care coverage to an estimated 31 million 

uninsured Americans through a combination of cost controls, subsidies, and 

mandates. PPACA is estimated to cost $848 billion over a 10-year period. 

The Employee Benefits Security Administration (EBSA) is responsible for the 

administration and enforcement of the civil and criminal provisions of Title I of the 

Employee Retirement Income Security Act of 1974 (ERISA) and related criminal 

statutes. ERISA covers pension plans and welfare benefit plans 

(e.g., employment-based medical and hospitalization benefits, and other plans 

described in section 3(1) of Title I). To receive favorable tax treatment, plan sponsors 

must design and administer their plans in accordance with ERISA. EBSA oversees 

more than 718,000 private retirement plans, 2.6 million employer-sponsored health 

plans, and similar numbers of other welfare benefit plans covering approximately 

150 million participants and beneficiaries. 

PPACA had significant impact on ERISA covered employer-sponsored group health 

plans. In accordance with PPACA, EBSA, in conjunction with the Department of the 

Treasury (Treasury) and its Internal Revenue Service (IRS) and the Department of 

Health and Human Services (HHS), issued eight interim-final regulations applicable to 

employer-sponsored health coverage: 

(1) Extension of Coverage for Adult Children 

(2) Grandfathered Health Plans 

(3) Pre-existing Condition Exclusions 

(4) Lifetime and Annual Limits 

(5) Rescissions 

(6) Patient Protections 

(7) Coverage of Preventive Services 

(8) Internal Claims and Appeals and External Review. 

EBSA PPACA Implementation 

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U.S. Department of Labor – Office of Inspector General 

We conducted the audit to answer the question: Has EBSA taken action to implement 

PPACA? 

To accomplish our audit, we reviewed applicable EBSA policies, procedures, studies, 

and surveys from March 23, 2010, (the enactment of PPACA) through 

August 31, 2011. We obtained information on enforcement actions taken from 

January 1, 2011, the beginning of the plan year PPACA was effective for most plans, 

through August 3, 2011. We interviewed officials at EBSA, HHS, the Government 

Accountability Office, and the Congressional Research Service to gain an 

understanding of PPACA regulations and rulemaking. We also interviewed officials 

from the U.S. Chamber of Commerce, the American Federation of Labor and 

Congress of Industrial Organizations (AFL-CIO), and various trade organizations. We 

reviewed EBSA’s procedures for addressing public comments submitted on EBSA’s 

interim-final PPACA regulations and met with interested parties to discuss their 

concerns about implementation and compliance. 

We conducted this performance audit in accordance with generally accepted 

government auditing standards. Those standards require that we plan and perform 

the audit to obtain sufficient, appropriate evidence to provide a reasonable basis for 

our findings and conclusions based on our audit objectives. We believe that the 

evidence obtained provides a reasonable basis for our findings and conclusions 

based on our audit objective. 

RESULTS IN BRIEF 

EBSA has taken significant actions toward implementing PPACA requirements by 

issuing regulations and sub-regulatory guidance, conducting research studies and 

surveys, and providing compliance assistance and outreach to employers and 

plan participants. However, further action by EBSA could help ensure PPACA 

implementation and compliance. 

Specifically, for interim-final PPACA regulations, EBSA could improve transparency 

and better demonstrate its intentions to address the more than 1,900 public comments 

submitted on these regulations by working with Treasury and HHS to establish a public 

timeline for addressing the public comments and issuing final regulations. DOL, HHS, 

and Treasury have the authority to promulgate interim-final rules that they determine 

are necessary or appropriate to carry out PPACA provisions. Using this authority due 

to time constraints, EBSA issued PPACA interim-final regulations, and did not engage 

in a full notice and comment rulemaking normally required by the Administrative 

Procedure Act (APA). While EBSA requested and obtained public comments on issued 

interim-final PPACA regulations, and intends to address the comments before 

finalizing the regulations, EBSA had not worked with HHS and Treasury to establish a 

timeline to address the more than 1,900 public comments received. EBSA could 

improve transparency and enlighten the public by providing at least an estimated 

timeline. EBSA officials stated that they would respond to public comments 

appropriately when EBSA finalizes the interim-final regulations. However, EBSA 

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U.S. Department of Labor – Office of Inspector General 

officials stated they could not provide an estimated date to release final regulations 

because EBSA issues these regulations jointly with HHS and Treasury, and EBSA 

could not commit for the other agencies.1 Furthermore, EBSA stated that the Office of 

Management and Budget. (OMB) would also have to clear the final regulations. 

In addition, while EBSA has made significant efforts in providing compliance 

assistance, EBSA could better leverage its enforcement resources to assist plans in 

implementing PPACA requirements. EBSA has not included reviews of compliance 

with PPACA requirements in its health plan investigations. Doing so could have 

resulted in identifying areas where plans, sponsors, and health insurers needed 

technical assistance. Since January 1, 2011, EBSA initiated 236 health plan 

investigations; however, according to EBSA, none of these cases included reviews of 

PPACA requirements. 

EBSA officials stated they wanted to use an initial compliance assistance approach, 

including enforcement grace periods, for PPACA while developing a coordinated, 

deliberate approach to PPACA enforcement. EBSA officials also stated that PPACA 

compliance reviews would be part of its Fiscal Year 2012 Health Benefits Security 

Project. 

Furthermore, as required by PPACA, EBSA should provide HHS with a report on 

benefits typically covered by employers that is sufficiently broad to enable HHS to 

determine benefits provided under a typical employer plan. Specifically, PPACA 

requires plans offered under the new State Insurance Exchanges (Exchanges) to 

provide benefits equal to those benefits “typically” provided by employer plans. 

PPACA requires EBSA to perform a survey to determine the benefits “typically” 

covered by employers and provide this information to HHS to help it determine the 

medical benefits the Exchanges must provide. To meet this requirement, EBSA used 

data from the National Compensation Survey (NCS) conducted annually by the 

Bureau of Labor Statistics (BLS). The NCS, a comprehensive survey of employer 

information, provides data on employment-based health care benefits. However, 

EBSA could not state that the survey was broad enough to cover all benefits EBSA 

might consider “typically” covered by employers. Moreover, the survey did not 

address all benefits for which HHS requested information. Without complete survey 

information from EBSA, HHS may not be able to ensure that the essential health 

benefits provided by the Exchanges under PPACA are equal to the benefits provided 

under a typical employer plan as required by PPACA. Furthermore, the lack of 

information from EBSA regarding benefits employers typically cover may also affect 

parties’ opportunity for public comment on HHS’ required proposed rule defining 

essential health benefits. 

EBSA officials believed they used the best information available and what they 

provided to HHS met the PPACA legislative requirements, particularly since HHS 

1

 The three Departments are required to coordinate interpretations and enforcement activities under Part 7 of ERISA, pursuant to an 

Inter-Agency Memorandum of Understanding. See 64 FR 70164 (December 15, 1999). 

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U.S. Department of Labor – Office of Inspector General 

would use the EBSA report as only one of many sources to determine essential 

medical benefits the Exchanges would provide. 

Lastly, PPACA enables DOL to promulgate regulations addressing fraudulent multiple 

employer welfare arrangements (MEWA). Historically, MEWAs have been a difficult 

enforcement issue for EBSA, and issuing regulations under these provisions may 

alleviate the difficulties. To implement these provisions, EBSA has drafted and 

cleared proposed regulations (1) allowing it to issue cease and desist, and summary 

seizure orders with respect to abusive MEWAs, and (2) requiring registration of 

MEWAs. However, it has not yet drafted a proposed rule under section 6604 of 

PPACA, which authorizes the Department to determine standards, or issue orders, 

regarding when persons providing insurance through MEWAs are subject to State law 

as a means to prevent fraud and abuse. EBSA states that it took up the other two 

rulemaking first because EBSA viewed them as having a higher priority. 

We made four recommendations to the Assistant Secretary for Employee Benefits 

Security as follows: (1) Work with the Departments of HHS, Treasury, and OMB to 

establish specific timetables to respond to public comments and issue final regulations; 

(2) Incorporate PPACA requirements immediately into the enforcement program to 

assist plans in complying with PPACA; (3) Provide HHS with the results of a survey of 

benefits typically covered by employers that is sufficiently broad to enable HHS to 

determine benefits provided under a typical employer plan; and 4) Proceed with 

rulemaking relative to PPACA section 6604. 

EBSA RESPONSE 

In response, the Assistant Secretary for Employee Benefits Security agreed to engage 

in discussions with the other two Departments and OMB regarding timetables to 

respond to public comments and issuing final regulations. EBSA did not fully agree to 

incorporate PPACA requirements immediately into the enforcement program to assist 

plans in complying with PPACA. EBSA believed its approach to enforcing operative 

provisions of the PPACA was appropriate, and stated it would phase in PPACA 

enforcement as a component part of its FY 2012 Health Benefits Security Project. EBSA 

did not agree that EBSA should provide more survey results showing benefits typically 

covered by employer plans to HHS. EBSA stated that the April 2011 report to HHS 

together with its associated supporting material fully satisfies the requirements of 

PPACA. Finally, EBSA agreed to set a reasonable timeline for PPACA section 6604 

regulations, taking into account all PPACA priorities. The Assistant Secretary’s entire 

response is contained in Appendix D. 

OIG CONCLUSION 

We accept EBSA’s response to recommendations 1 and 4. However, we continue to 

disagree with EBSA’s positions on recommendations 2 and 3. We believe EBSA 

misunderstood the OIG’s position regarding its enforcement resources. The OIG did not 

question EBSA’s approach to enforcing operative provisions of the PPACA. Instead, it 

was the OIG’s position that EBSA could have used enforcement resources already 

EBSA PPACA Implementation 

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U.S. Department of Labor – Office of Inspector General 

directed at investigating health plans to identify compliance assistance needs rather 

than not reviewing compliance with PPACA requirements at all. We are not advocating 

additional enforcement actions. EBSA’s response does not state specifically when in 

FY 2012 all health plan investigations will include reviews of PPACA requirements. We 

continue to believe that generally all reviews of health plans should include compliance 

with PPACA requirements as a means to assist plans, sponsors, and insurers with 

compliance regardless of whether EBSA intends to take enforcement action or not. 

We also continue to believe EBSA should provide HHS with a report on benefits 

typically covered by employers that is sufficiently broad to enable HHS to determine 

benefits provided under a typical employer plan. 

The fact that the ultimate determination is to be made by HHS, potentially using other 

sources of information in addition to the DOL survey, perhaps gained from different 

perspectives and/or different agencies, has no bearing on the scope of the survey that 

EBSA is required to perform under the statute. Since PPACA specifically requires EBSA 

to submit to HHS to "inform" its decision on what benefits are typically covered by 

employers. If the EBSA survey is not broad enough to cover what EBSA is prepared to 

say is the full scope of benefits "typically" provided by employers, then we believe EBSA 

has not fulfilled its statutory obligation to assist and inform HHS. 

To ensure the understanding of our position, we clarified our discussion of EBSA’s 

report and modified recommendation 3 from the draft version of this report. 

RESULTS AND FINDINGS 

Objective — Has EBSA taken action to implement PPACA? 

Further Action By EBSA Could Help Ensure Implementation and Compliance 

Finding 1 — EBSA could take additional action to help ensure PPACA 

implementation and compliance 

EBSA has taken significant actions toward implementing PPACA requirements 

through issuing eight regulations and sub-regulatory guidance, conducting research 

studies and surveys, and providing compliance assistance and outreach to employers 

and plan participants. Additionally, EBSA has issued sub-regulatory guidance issued, 

including four technical releases, seven model notices, and six sets of Frequently 

Asked Questions. 

While EBSA has taken significant actions to implement PPACA, further action could 

mitigate potential challenges that may affect implementing and complying with PPACA 

requirements. 

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5 Report No. 09-11-003-12-121 
 

 

U.S. Department of Labor – Office of Inspector General 

EBSA Could Improve Transparency in Response to Public Comments 

Received on Interim-Final PPACA Regulations 

EBSA could improve transparency and better demonstrate its intentions to address 

the more than 1,900 public comments submitted on PPACA regulations by working 

with HHS, Treasury, and OMB in an effort to establish a public timeline for reviewing 

the public comments and issuing final regulations. 

PPACA contained major new requirements for group health plans. To implement these 

requirements, EBSA had to develop new regulations dealing with complex issues in a 

short amount of time. EBSA also had to develop these regulations jointly with the 

Treasury and HHS. Normally, under the APA (5 U.S.C. Subchapter II), issuing new 

regulations involves publishing proposed regulations in the Federal Register, obtaining 

and reviewing public comments, making changes where necessary, and ultimately 

issuing final regulations. This process frequently takes more than a year to complete. 

Due to time constraints in implementing PPACA, EBSA took advantage of existing 

provisions in Part 7 of ERISA, which grants the authority to issue interim-final 

regulations for group health plan coverage where necessary or appropriate. These 

interim-final regulations became effective without the consideration of public comment 

and compliance is generally required shortly after their issuance. However, EBSA and 

the other Departments may make changes in final regulations, as the result of public 

comments submitted in response to the interim-final regulations. 

EBSA, in conjunction with Treasury and HHS, issued eight interim-final regulations 

applicable to employer-sponsored health coverage: 

(1) Extension of Coverage for Adult Children 

(2) Grandfathered Health Plans 

(3) Pre-existing Condition Exclusions 

(4) Lifetime and Annual Limits 

(5) Rescissions 

(6) Patient Protections 

(7) Coverage of Preventive Services, and 

(8) Internal Claims and Appeals and External Review. 

While EBSA, in conjunction with Treasury and HHS, requested and obtained public 

comments on all of these regulations, EBSA has not yet worked with the other 

Departments to establish a timeline to address and respond to the more than 1,900 

public comments received. EBSA officials stated that they have reviewed the public 

comments and have addressed many public comments through the issuance of 

amendments to the interim-final rules for Grandfathered Health Plans, Internal Claims 

and Appeals and External Review, and Preventive Services. In addition, EBSA has 

issued sub-regulatory guidance addressing many questions. 

However, EBSA officials could not provide a firm date for when they would respond to 

other comments through tri-Department final regulations. They stated they must jointly 

EBSA PPACA Implementation 

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U.S. Department of Labor – Office of Inspector General 

issue the final regulations with HHS and Treasury and clear the regulations with OMB 

and this makes estimating a date difficult. 

The APA generally requires agencies to publish proposed regulations in the Federal 

Register, allow the public and affected organizations an opportunity to comment on 

the proposed rule, and then consider those comments in developing and publishing 

final regulations. However, section 734 of ERISA authorizes the promulgation of any 

interim-final rules the Secretary determines are appropriate to carry out the provisions 

of Part 7 of ERISA. Additionally, section 553(b) of the APA states that a general notice 

of proposed rulemaking is not required when an agency, for good cause, finds that 

notice and public comment thereon are impracticable, unnecessary, or contrary to the 

public interest. EBSA and the other Departments determined that the provisions of the 

APA that ordinarily require a notice of proposed rulemaking did not apply because of 

the specific authority granted by section 734 of ERISA. The agencies also found that, 

even if the APA were applicable, it would be impracticable and contrary to the public 

interest to delay putting these regulatory provisions in place until the agencies 

completed a full public notice and comment process. 

Following the issuance of PPACA regulations, EBSA received more than 1,900 

comments from the public. EBSA organized the comments into seven categories. 

The following table illustrates the amount of public comments EBSA received after 

promulgating interim-final regulations on PPACA. 

Table 1: Summary of Public Comments Received on PPACA Interim-Final
 

Regulations 

No. of PPACA Interim-Final Regulations Date Issued Comments 

Extension of Coverage For Adult Children 5/13/2010 82 

Grandfathered Health Plans 6/17/2010 1,199 

Amendment to Interim-final Rule- Grandfathered 

Health Plans 11/17/2010 16 

Internal Claims and Appeals and External Review 

Processes 7/23/2010 89 

Amendment to Interim-final Rule- Internal Claims 

and Appeals and External Review Processes 6/24/2011 123 

Preexisting Condition Exclusions, Lifetime and 

Annual Limits, Rescissions, and Patient 

Protections 6/28/2010 145 

Coverage of Preventive Services 7/19/2010 261 

Total 1,915 

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U.S. Department of Labor – Office of Inspector General 

Commenters on these regulations include organizations such as The National 

Association of Health Underwriters, American Benefits Council, U.S. Chamber of 

Commerce, ERISA Industry Committee, AFL-CIO, New York State Insurance 

Department, New York City Department of Health and Mental Hygiene, and national 

health insurance companies. 

EBSA indicated it plans to respond to these comments, in conjunction with 

Treasury and HHS, and fully consider them in the final regulations; however, it has 

not established a timeline for this or informed the public of when to expect the 

agencies to complete the process. 

Though not required, establishing a timeline and informing the public of expected 

final regulations would help improve transparency in PPACA rulemaking. The 

Administrative Conference of the United States (ACUS), an independent Federal 

agency designed to improve Federal administrative procedures, issued some 

guidance on this matter. The ACUS stated2 that when using post-promulgation 

comment procedures, agencies should consider whether to include in the Federal 

Register notice a commitment to act on any significant adverse comments within a 

fixed period of time or to provide for a sunset date for the rule. 

While we acknowledge EBSA’s cited time constraints in promulgating PPACA 

interim-final regulations and efforts to address specific public comments, EBSA could 

better demonstrate its progress to address the more than 1,900 public and industry 

comments submitted on these regulations. EBSA could provide a specific timetable to 

address all public comments. This would increase transparency in the agency’s 

response to public comments and mitigate potential challenges for implementation. 

EBSA Could Better Leverage Its Office of Enforcement to Assist Plans in 

Implementing and Complying with PPACA Requirements 

EBSA could better leverage its enforcement resources to assist plans in implementing 

PPACA requirements. EBSA’s Office of Enforcement has not actively monitored plans’ 

compliance with PPACA requirements. Such monitoring could have resulted in 

identifying areas where plans, employers and health insurers needed technical 

assistance. Changes by health insurers could potentially impact numerous 

employer-sponsored health plans. PPACA requirements were effective for most plans 

on January 1, 2011. EBSA, however, did not immediately incorporate PPACA 

requirements into all enforcement investigations. This was because EBSA was 

developing an approach to PPACA enforcement that initially focused on compliance 

assistance. As a result, EBSA did not immediately issue PPACA enforcement 

checklists or train investigators on PPACA requirements. 

EBSA’s enforcement program detects and corrects ERISA violations and restores 

losses to employee benefit plans, including health plans. Since January 1, 2011, 

2 1 CFR s 305.95‐4

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8 Report No. 09-11-003-12-121 
 

U.S. Department of Labor – Office of Inspector General 

EBSA initiated 236 health plan investigations; however, according to EBSA, none of 

these cases included reviews of PPACA requirements. 

EBSA officials stated they implemented an initial compliance assistance approach, 

including enforcement grace periods, for PPACA requirements. EBSA officials stated 

enforcement checklists were not necessary immediately since EBSA was 

concentrating on compliance assistance, not enforcement. They also stated the 

enforcement checklists were completed and circulated to investigators at an 

August 10, 2011 training program. 

However, EBSA could have leveraged this compliance assistance if it had 

incorporated PPACA requirements into its enforcement investigations. If the 

investigations found non-compliance with PPACA requirements, EBSA could have 

provided technical assistance to plans and health insurers to achieve compliance. 

Enforcement investigations also may have been able to provide feedback on areas 

plans were having difficulties in complying with PPACA requirements. EBSA could 

have added resources and leveraged its compliance assistance efforts by actively 

reviewing employer-sponsored health plans compliance with PPACA. 

EBSA Should Provide HHS With a Report on Benefits Typically Covered by 

Employers as Required by PPACA 

EBSA’s report to HHS regarding employer-sponsored coverage was not sufficiently 

broad for HHS to determine benefits provided under a typical employer plan. The report 

primarily presented health benefit data from the National Compensation Survey (NCS), 

conducted annually by BLS. EBSA officials could not confirm that the data in the report 

represented benefits typically covered by employers. Moreover, the report did not 

include information on all the types of benefits HHS asked EBSA address. 

PPACA requires each State to establish an American Health Benefit Exchange 

(Exchange) to offer non-group health insurance beginning in calendar year (CY) 2014. 

PPACA requires the benefits the Exchanges offer to meet minimum coverage 

requirements, including being equal to the scope of benefits provided under a typical 

employer plan. While HHS must make the actual determination of benefits each 

Exchange must offer, PPACA requires EBSA to conduct a survey of 

employer-sponsored coverage to determine the benefits typically covered by employers 

and provide a report on the survey to HHS. 

To meet this requirement, EBSA used data from the annual NCS. The NCS, a voluntary 

survey of employers, provides comprehensive measures of occupational wages, 

employment cost trends, and benefit incidence and detailed plan provisions. Annually, 

BLS releases data from this survey on the percent of employees offered employmentbased health care benefits and the percent of employees who are actually covered by 

such benefits. The NCS also provides details on the provisions of those health care 

plans, including what services are covered and what cost-sharing is required by plan 

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U.S. Department of Labor – Office of Inspector General 

participants. Benefits presented include such services as hospital room and board, 

surgical procedures, physician office visits, and skilled nursing facility care. 

While the NCS currently captures data from about 36,000 employers, including those in 

private industry and State and local government across all industries and all 

establishment sizes, information on the detailed provisions of employment-based health 

care benefits is from a representative sample of about 3,900 private sector employers 

annually. From each of these employers, BLS identifies available health plans and 

requests copies of written documents describing plan benefits. BLS extracted the 

detailed plan provisions presented in the NCS report from approximately 3,200 plan 

documents. 

To expand on the NCS published benefits, HHS requested coverage and cost sharing 

data on 24 additional benefits. 

In April 2011, EBSA issued a report to HHS. The report contained detailed data on 

selected health benefits coverage by employer-sponsored health plans in the private 

sector. The report also presented new data from an analysis of additional health 

benefits requested by HHS. 

However, EBSA could not state that the survey information it provided to HHS was 

sufficiently broad to cover what it considered to be benefits typically covered by 

employers as required by PPACA Section 1302(b)(2)(A), which states: 

The Secretary of Labor shall conduct a survey of employer-sponsored 

coverage to determine the benefits typically covered by employers, 

including multiemployer plans, and provide a report on such survey to . . . 

[HHS] 

Furthermore, the report did not provide all the information HHS had requested. HHS 

specifically requested data on 24 benefits. EBSA requested the data from BLS but, 

while BLS did do additional survey work, data on only 12 of the 24 benefits could be 

developed under BLS’s survey methodology. 

EBSA officials stated that the NCS was very comprehensive and using the data 

satisfied the legislative requirement in the PPACA and met HHS’s needs. EBSA further 

stated that the report would be only one of many sources HHS would use to determine 

benefits under a typical employer plan. Despite these claims, we concluded that to 

completely fulfill its statutory obligation under PPACA, EBSA must provide HHS with 

survey information that it believes encompasses those benefits typically covered by 

employers. 

Without this information from EBSA, HHS may not be able to ensure that the scope of 

the essential health benefits provided by state exchanges is equal to the scope of 

benefits provided under a typical employer plan as required by PPACA. This could 

potentially impact millions of Americans and the cost of their insurance. Any benefits not 

included as typically offered in an employer-sponsored plan may not be included in 

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essential medical benefits offered through the Exchanges. Any benefit actually included, 

although perhaps not typically provided in an employer-sponsored plan will nevertheless 

be required in essential benefits and could drive the cost of insurance up. The 

Congressional Budget Office (CBO) estimates 8.9 million people will buy insurance on 

the Exchanges in 2014, with the number growing to 24 million people in 2021. 

In addition, public commenters on the proposed regulation may lack sufficient 

information on what benefits are typically covered by employer plans or may incorrectly 

assume that EBSA provided HHS with information from a survey that was broad enough 

for HHS to determine benefits provided under a typical employer plan. 

Even sophisticated employee benefit specialists may misinterpret or imprecisely 

describe what EBSA provided to HHS. For example, the May 2, 2011, issue of Deloitte's 

Washington Bulletin, a periodic update of legal and regulatory developments relating to 

employee benefits stated: 

The Labor Department released a report on the health benefits provided 

under a typical employer plan. The typical benefits will provide a baseline 

for the Department of Health and Human Services in defining "essential 

health benefits" under the Patient Protection and Affordable Care Act 

(PPACA). The PPACA requires that the scope of "essential health 

benefits" be equal to the scope of benefits provided under a typical 

employer plan. 

Under PPACA, essential health benefits are to be used as the minimum coverage of the 

qualified health care plans in the Exchanges established by each State by CY 2014. 

These Exchanges provide the opportunities for health coverage for millions of people 

who currently have no health insurance. Without sufficiently broad survey information 

from EBSA concerning the benefits typically covered by employers, HHS may not be 

able to ensure that the scope of the essential health benefits provided by state 

exchanges is equal to the scope of benefits provided under a typical employer plan as 

required by PPACA. Furthermore, this could impact affected parties’ opportunity for 

public comment on HHS’s required proposed regulation defining essential benefits. 

EBSA Should Determine if MEWA regulations are Necessary 

PPACA added the following three provisions to ERISA relating to the prevention of fraud 

and abuse by multiple employer welfare arrangements: (1) Section 6604 authorizes the 

Secretary of Labor to issue regulations to determine when persons engaged in offering 

insurance through MEWAs are subject to State law, (2) Section 6605 authorizes the 

Secretary to issue cease and desist orders and summary seizure orders with respect to 

abusive or financially hazardous MEWAs, and (3) Section 6606 provides for the 

registration of MEWAs with the Department of Labor. Although EBSA has submitted to 

draft proposed regulations to OMB for implementation of sections 6605 and 6606, as of 

the end of the audit, 18 months after enactment of PPACA, it has not begun drafting a 

proposal under section 6604. EBSA has stated that it considered the 6605 and 6606 

regulations to be a higher priority. 

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11 Report No. 09-11-003-12-121 
 

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MEWAs historically have been a difficult enforcement issue for EBSA. In fact, EBSA 

has, for many years, had a National Enforcement Project directed at MEWAs. According 

to EBSA, although legitimate organizations can provide MEWAs, they are sometimes 

marketed using attractive but actuarially unsound premium structures, which generate 

large administrative fees for the MEWAs. In addition, certain promoters will set up 

arrangements, which they claim are established pursuant to a collective bargaining 

agreement; and therefore, are not MEWAs but legitimate benefit plans free from state 

insurance regulations. Often, however, these collective bargaining agreements are 

nothing more than shams designed to avoid state insurance regulation. 

The impact of MEWAs can be significant. The General Accounting Office has estimated 

there were more than 2.5 million participants and beneficiaries in 46 states enrolled in 

MEWAs. 

EBSA could help alleviate the MEWA issue by proceeding with a rulemaking action 

under PPACA section 6604. 

Conclusion 

Overall, EBSA could take further action in its rulemaking, enforcement, reporting on 

benefits typically covered by employers, and MEWA regulations to mitigate potential 

challenges that may affect implementation and compliance with PPACA requirements. 

Taking the recommended actions could help improve transparency to the public; 

provide additional compliance assistance to employer, plans and insurers; help enable 

HHS to determine essential medical benefits; and help strengthen enforcement over 

MEWAs. 

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RECOMMENDATIONS 

We recommend that the Assistant Secretary for Employee Benefits Security: 

(1) Work with the Departments of HHS, Treasury, and OMB to establish specific 

timetables to respond to public comments and issue final regulations. 

(2) Incorporate PPACA requirements immediately into the enforcement program 

to assist plans in complying with PPACA. 

(3) Provide HHS with the results of a survey of benefits typically covered by employers 

that is sufficiently broad to enable HHS to determine benefits provided under a typical 

employer plan; and 

(4) Proceed with a rulemaking to implement PPACA section 6604. 

We appreciate the cooperation and courtesies that EBSA personnel extended to the 

Office of Inspector General during this audit. OIG personnel who made major 

contributions to this report are listed in Appendix E. 

Elliot P. Lewis 

Assistant Inspector General for Audit 

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Appendices 

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Appendix A 

Background 

The Patient Protection and Affordable Care Act (PPACA) was enacted on 

March 23, 2010, and amended by the Health Care and Education Reconciliation Act 

(HCERA) on March 30, 2010. As amended, PPACA is the most significant health care 

reform bill in decades. It expands health care coverage to an estimated 31 million 

uninsured Americans through a combination of cost controls, subsidies, and mandates. 

PPACA is estimated to cost $848 billion over a 10-year period. 

PPACA will affect nearly every element of our health care system including employers, 

both large and small. According to employee benefits industry sources, PPACA will have 

the most significant impact on employer-sponsored health plans since the enactment of 

ERISA over 30 years ago. PPACA would impose requirements on the type of health care 

coverage that employers must offer including: 

(a) Covering most adult children up to age 26; 

(b) Elimination of lifetime limits and restrictive annual limits; 

(c) Elimination of preexisting condition exclusions; and 

(d) Required coverage of certain preventative services (e.g., immunizations and infant 

screenings). 

PPACA reorganizes, amends, and adds to the provisions of the Public Health Service Act 

(PHS Act) and ERISA relating to group health plans and health insurance issuers in the 

group and individual markets. The Departments of Labor (DOL), Health and Human 

Services (HHS), and the Treasury (the Departments) are issuing regulations in several 

phases to implement the revisions. 

EBSA is responsible for the administration and enforcement of the civil and criminal 

provisions of Title I of the Employee Retirement Income Security Act of 1974 (ERISA) 

and related criminal statutes. ERISA covers pension plans and welfare benefit plans 

(e.g., employment based medical and hospitalization benefits, and other plans 

described in section 3(1) of Title I). Plan sponsors must design and administer their 

plans in accordance with ERISA. EBSA oversees more than 718,000 private retirement 

plans, 2.6 million employer-sponsored health plans, and similar numbers of other 

welfare benefit plans covering approximately 150 million participants and beneficiaries. 

In accordance with PPACA, the Employee Benefits Security Administration (EBSA), in 

conjunction with the Department of the Treasury (Treasury), the Internal Revenue Service 

(IRS) and the Department of Health and Human Services (HHS), has issued eight interimfinal regulations applicable to employer-sponsored health coverage for (1) Extension of 

Coverage for Adult Children, (2) Grandfathered Health Plans, (3) Pre-existing Condition 

Exclusions, (4) Lifetime and Annual Limits, (5) Rescissions, (6) Patient Protections, (7) 

Coverage of Preventive Services, and (8) Internal Claims and Appeals and External 

Review. 

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Appendix B 

Objective, Scope, Methodology, and Criteria 

Objective 

The objective of this audit was to determine if EBSA has taken action to implement 

the Patient Protection and Affordable Care Act (PPACA). 

Scope 

Our scope included all EBSA policies and procedures pertaining to PPACA activities for 

March 23, 2010 through August 31, 2011. Additionally, we reviewed prior GAO and CRS 

reports on federal rulemaking, and EBSA required research studies and surveys. We 

conducted fieldwork at EBSA headquarters in Washington, D.C. 

We conducted this performance audit in accordance with generally accepted 

government auditing standards. Those standards require that we plan and perform the 

audit to obtain sufficient, appropriate evidence to provide a reasonable basis for our 

findings and conclusions based on our audit objective. We believe that the evidence 

obtained provides a reasonable basis for our findings and conclusions based on our 

audit objective. 

Methodology 

To accomplish our audit, we reviewed applicable EBSA policies and procedures, 

research studies and surveys, and enforcement actions. We interviewed officials at 

EBSA, HHS, the Government Accountability Office, and the Congressional Research 

Service to gain an understanding of PPACA regulations and rulemaking. We reviewed 

public comments submitted on EBSA regulations and met with interested parties to 

discuss their concerns about implementation and compliance. 

In planning and performing our audit, we considered EBSA’s internal controls that were 

relevant to our audit objective. We confirmed our understanding of these controls through 

interviews, obtaining, and reviewing PPACA studies, policies, procedures, and 

enforcement actions. Our consideration of internal controls relevant to our audit objective 

would not necessarily disclose all matters that might be significant deficiencies. Because 

of inherent limitations in internal controls, misstatements or noncompliance may 

nevertheless occur and not be detected. 

In conducting our audit, we did not rely on computer-processed data; therefore, the 

sufficiency and reliability of data was not applicable in meeting the audit’s objective. 

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19 Report No. 09-11-003-12-121 
 

U.S. Department of Labor – Office of Inspector General 

Criteria 

We used the following criteria to accomplish our audit: 

• Title I of the Employee Retirement Income Security Act of 1974 

• The Patient Protection and Affordable Care Act of 2010 

• The Health Care and Education Reconciliation Act of 2010 

• The Administrative Procedure Act of 1946 

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U.S. Department of Labor – Office of Inspector General 

Appendix C 

Acronyms and Abbreviations 

APA Administrative Procedure Act 

ACUS Administrative Conference of the United States 

BLS Bureau of Labor Statistics 

CBO Congressional Budget Office 

CRS Congressional Research Service 

CY Calendar Year 

DOL Department of Labor 

EBSA Employee Benefits Security Administration 

ERISA Employee Retirement Income Security Act of 1974 

GAO Government Accountability Office 

HCERA Health Care and Education Reconciliation Act 

HHS Department of Health and Human Services 

IRS Internal Revenue Service 

MEWA Multiple Employer Welfare Arrangement 

NCS National Compensation Survey 

NPRM Notice of Proposed Rulemaking 

OIG Office of Inspector General 

OMB Office of Management and Budget 

PHS Public Health Service 

PPACA Patient Protection and Affordable Care Act 

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22 Report No. 09-11-003-12-121 
 

U.S. Department of Labor 

DATE: 

MEMORANDUM FOR: 

FROM: 

SUBJECT: 

Assistant Sectetary for 

Employee Benerits Security Administretlon 

Washlr.gtoo. D.C. 202tO 

SEP 29 2011 

ELLIOT P. LEWIS 

Assistant Inspector General for Audit 

PHYLLIS C. BORZI ~ ( I;""" 

Assistant Secretary for Employee Benefits Security 

EBSA Response to OIG Performance Audit 

Draft Audit Report Number 09-11-003-12- 121 

Thank you for the opportunity to comment on the recommendations in your above 

referenced Performance Audit Repol1 on our implementation of the Patient Protection 

and Affordable Care Act of2010 (PPACA). 

The Employee Benefits Security Administration (EBSA) is responsible for the 

administration and enforcement of the civil and criminal provisions of Title I of the 

Employee Retirement Income Security Act of 1974 (ERISA) and related criminal 

statutes. EBSA oversees approximately 718,000 private retirement plans, 2.6 million 

health plans, and similar numbers of other welfare benefit plans, such as those providing 

life or disability insurance. The employee benefit plans under our jurisdiction hold 

approximately $6.5 trill ion in assets and cover approximately 150 million participants 

and beneficiaries. 

When President Barack Obama signed the PPACA, P.L. 111-148 on March 23, 2010, this 

historic health care reform legislation gave more than 32 million Americans access 10 

medical coverage. The PPACA assigned significant new regulatory, enforcement, and 

outreach responsibilities to the Department and more specifically, EBSA. To implement 

the PP ACA, the Department is required to develop and implement over 25 regulations in 

conjunction with the Departments of Health and Human Services (HHS) and Treasury; 

implement Multiple Employer Welfare Arrangements (MEWA) reporting and oversight 

requirements; and design and conduct several health benefit studies, as well as develop 

and implement education, outrcach, and assistance programs and new enforcement 

strategies. Your audit focused on the Department's responsibi lities under the PPACA 

and your objective was to determine whether EBSA has taken action toward the 

implementation of the PPACA. 

U.S. Department of Labor – Office of Inspector General 

Appendix D 

EBSA Response to Draft Report 

EBSA PPACA Implementation 

23 Report No. 09-11-003-12-121 
 

As you know, parallel statlllory provisions implementing tbe PPACA market refonn 

provisions were added to ERISA, the Public Health Service Act, and the Internal 

Revenue Codc. Accordi ngly, EBSA shares interpretive jurisdiction over the PPACA 

market refonns with the Dcpartment of Health and Human Services and the Department 

ofthc Treasury (including its Internal Revcnue Service). I Regulations are developed and 

issued jointly by the three Departments. 

OIG's RECOMMEN I>ATIONS 

Rceommendalion 1: \Vork with th e Depa rtmcnts of HHS, Treasury, and the Offi ce 

of Managcmcnt and Bnd gct (OMB) to establish specific timetables to respond to 

public comments and issue fin al regulations. 

EBSA will engagc in discussions with the other two Departments and OMB regarding 

timetables. These discussions typically take place through the semi-annual regulatory 

agenda decision-making process. 

Recommend ation 2. Incorporate I'PACA requirements inHnediately into the 

enforcement program 10 assist plans in complying with PI'ACA. 

EBSA believes its approach to enforcing operative provisions ofthc PPACA is 

appropriate. EBSA officials expla ined to the Inspector General (0 10) auditors that the 

three Departmcnts' initial approach to ACA implementation, as stated in Question I of 

the September 20, 2010 "Affordable Care Act Implementation FAQs Part I," is to assist 

plans, issuers, and others in understanding the new rules and achieving compliance rather 

than to immediately begin imposing penalties for violations of thc ACA. 2 EBSA 

officials explained that the agcncy's initial focus was on developing regulations and 

related sub-regnlatory guidance. The agency had also engagcd in substantial compliance 

I The Ihree DcpanmcnlS are required 10 eoordiMle inlerprelalions and enforcement aCli~ilies under Pan 7 

of ERISA, title XXVII of the Public Health Service Act, and Chapler I 00 of the Internal Re~enue Code 

(including the PPACA health n:form provis s, which wen: added 10 Ihose seelions) pursuant to an InterAgency Memorandum of Understanding. See 64 FR 70164 (December 15, 1999). 

I Specifically, this FAQ slates: 

Ql : Unller the AffordHble Care Act, there a rc va rious provisions tllot ap ply to group hfalt h 

plans a nd llra lth insura nce issuers a nd va rious proteNions and bCllefits for cons umers tho t 

are bcginlling to take effect or Iha t will b«ome effective vn y soon. What is the 

Depa rtments' basic BIIllroaeh 10 implement ation? 

The Depanments are working together wilh employers, issuers, Slates, providers and other 

stakeholders 10 help them come into compliance wilh Ihe new law and arc working with families 

and individuals to help them understand the new law and benefit from it, as intended. Compliance 

assistance is a high priority for the Departmenls. Our approach to implementation is and will 

conlinue to be mar\(ed by an emphasis on assisting (rather Ihan imposing penalties on) plans, 

issuers and others Ihat are working diligently and in good fait h to understand and come into 

compliance with the new law. This approach includes, where appropriate, transilion pro~isions, 

grace periods, safe harbors, and other policies to ensure thalllle new provisions lake effect 

smoothly, minimizing any disruption to existing plans and prllctices. 

2 

U.S. Department of Labor – Office of Inspector General 

EBSA PPACA Implementation 

24 Report No. 09-11-003-12-121 
 

assistance and outreach Cff0l1S to the public, separatc from invcstigations.3 At the samc 

timc, investigative support tools wcre being developed and investigativc staff were 

undergoing training to enforce the new provisions in a consistent, informed manner. As 

requested by thc OlG, EBSA providcd the datcs PPACA field training was conducted. 

EBSA also developed a comprehensive PPACA enforcement chccklist to promote 

consistent invcstigations. The checklists drew in part from the Departments' expertise in 

the growing body of regulations and public guidance. After multiple rounds of training, 

refinement ofa PPACA enforcement checklist, and internal guidance, EBSA elected to 

phase in PPACA enforcement as a component pmt of its FY 2012 Health Benefits 

Security Project. Through this national enforcement project EBSA expects to investigate 

a large number ofhcalth plans. These investigations will provide meaningful feedback 

on PPACA compliance after plans and insurers have had the opportunity to proccss the 

implementing regulations and related guidance and benefit from EBSA's extensive 

outrcach. 

Recommendation 3. Delelomin e benefits typically covcred by employer-sponsored 

plans and pl'ovide this 10 HHSo 

The DOL's April2011 report to ]-[]-[S ("the report"), together with its associated 

suppol1ing material, fully satisfies the requirements of PI'ACA Section 1302(bX2)(A). 

This section provides as fo llows: 

The Secretary [onl1-IS] shall ensure that the scope of the essential health benefits 

under paragraph (I) is equal to the scope of benefits offered under a typical 

employer plan, as (Iefermined by the Secretary [of IlHS). To infonn this 

detennination, the Secrctary of Labor shall conduct a survcy of employersponsored covemge to determine the benefits typically covered by employcrs, 

induding multiemployer plans, and provide a report on such survey to the 

Secretary [ofHHS]. 

The italicized language clearly requires the Secretary of HHS, rathcr than the Secretary of 

Labor, to detennine the scope of benefits offered by a typical employer plan. Thc stated 

purpose of the Secretary of Labor's survey is to inform this determination. Congress' 

plain intent was for the Secretary of HHS to use the survey in deciding whether a given 

benefit is offered under a "typical employer plan." 

The survey is based on the National Compensation Survey. conducted regularly by the 

Department's Bureau of Labor Statistics. Using a large, nationally representative sample 

of employers, the NCS col lects detailed infonnation on whether particular benefits are 

induded in employcr health plans. fiy measuring the incidence of a broad range of 

diffcrent benefits, the Department's survey will al10w the Secretary of HHS to determine 

which are offercd by a typical employer plan. 

l Materials provided to OIG indicated that outrtach eVCnlS by EBSA National Office staff(not including 

Regional·Office·ted outreach by customer service stafT) exceeded IWO (2) evcnlS per week. 

3 

U.S. Department of Labor – Office of Inspector General 

EBSA PPACA Implementation 

25 Report No. 09-11-003-12-121 
 

The 010 faults the report for nOI expressly stating which benefits are "typical." 

However, the statute docs not require the DOL to determine a specified threshold of 

incidence above which (and only above which) the benefit should be considered "typical" 

by l-lHS. DOL's report, by providing detailed data on the incidence of different benefits, 

fu lfills the statutory purpose and requirements without taking on the function of the 

Secretary of HHS . DOL also disagrees with the OIO's assertion that DOL's approach to 

the report could impair the public comment process. The report and associated 

supporting materials are easily available to the public. Commcntcrs are free to provide 

their views on the survey and on what benefits arc offered by a typical employer plan. In 

addition, in her press release thanking the DOL following the transmittal of our report, 

Secretary Sebelius stated that HHS will be collecting public comments as they consider 

how to determine the scope of essential benefits. 4 

Recommendation 4. Proceed with rulcmaking relative to PPACA section 6604. 

EBSA will reevaluate its initial determination that regulations under PPACA section 

6604 were not immediately necessary to implement the requirements of PP ACA section 

6604 in light of other priorities. EBSA will set a reasonable timcline for such 

regulations, taking into account all PPACA priorities. 

We appreciate the opportunity to provide our comments 10 the draft report and hope that 

they wiJ1 be helpful to you in developing a final document. 

• See hUp:flwww.hhs.gov/news/press/201Ipresl041201104ISb.hlml. 

4 

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Appendix E 

Acknowledgements 

Key contributors to this report were Ralph McClane (Audit Director), Jason Jelen (Audit 

Manager), Chih “Steve” Chiang (Auditor-in-Charge), Richard Donna, Tim Kerschen, 

Angela Stewart, and Mary Lou Casazza. 

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TO REPORT FRAUD, WASTE OR ABUSE, PLEASE CONTACT: 

Online: http://www.oig.dol.gov/hotlineform.htm 

Email: hotline@oig.dol.gov 

Telephone: 1-800-347-3756 

202-693-6999 

Fax: 202-693-7020 

Address: Office of Inspector General 

U.S. Department of Labor 

200 Constitution Avenue, N.W. 

 Room S-5506 

Washington, D.C. 20210