In this episode of ShiftShapers, host David A. Saltzman welcomes compliance expert Carol Taylor, JM, of BenefitMall, for a deep dive into the rapidly evolving world of employer compliance. From court rulings and legislative penalties to HIPAA security updates and AI-driven benefit denials, Carol offers critical insights for anyone navigating today’s tangled regulatory landscape.

She unpacks the latest on ERISA preemption battles, mental health parity lawsuits, and the real-world impact of complex compliance rules on small agencies and employers. With rising penalties and tech-driven claim denials making headlines, Carol arms listeners with strategies to stay compliant—and stay out of court.

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🔑 Key Takeaways from This Episode

📌 Penalties Are Rising—And Enforcement Is Too
Missing a CHIP notice or 5500 filing? That could cost thousands per day. Carol outlines the latest penalty increases and why the IRS is stepping up enforcement.

📌 HIPAA Security Changes Are Coming
From encryption rules to breach simulations, the proposed HIPAA security updates raise the bar—especially for small agencies who now face enterprise-level expectations.

📌 Compliance Risks from AI-Powered Claim Denials
Carol explains how AI is being used inappropriately by some carriers—and why plan sponsors need to examine how these tools align with ERISA.

📌 ERISA, MIA, and Legal Landmines
With court cases mounting over PBM regulation and mental health parity, Carol breaks down what’s at stake and how employers can avoid becoming the next headline.

📌 Future-Proofing Your Compliance Strategy
From updated plan docs to tighter internal protocols, Carol shares best practices that can help advisors and agencies stay ahead of evolving rules.

⏱️ In This Episode

00:00 – Introduction to Compliance Challenges
02:01 – Legislative Updates and Penalties
09:25 – HIPAA Security Rule Changes
18:11 – Court Cases and Legal Battles
23:20 – Mental Health Parity and Addiction Equity Act
27:00 – Future of Compliance and Final Thoughts