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105(h) - Application to Retired Employees and Premium Sharing Formula


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A self-insured medical plan provides that the portion of contributions required to be paid by retirees is dependent on service. (e.g., if normally a retiree who had longer service had to pay only 25% of the premiums, a shorter service retiree had to pay 50% of the premium). Is this provision discriminatory under 105(h)?

The Regs under 105(h) (1.105-11) provide that providing different contribution levels for employees in a cafeteria-plan can be discriminatory under 105(h). See 1.105-11©(3)(i) ("A plan that provides optional benefits to participants will be treated as providing a single benefit with respect to the benefits covered by the option provided that (A) all eligible participants may elect any of the benefits covered by the option and (B) ... the required employee contributions are the same amount.")

For retirees, the regulations merely require the "type, and the dollar limitations of benefits provided to retired employees who were highly compensated individuals" to be the same for all other retired participants. Reg. Sec. 1.105-11©(3)(iii). Thus it appears that the inclusion of such a provision would not be discriminatory.

Does anyone have a different opinion?

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  • 6 months later...

Did your research turn up anything on this count? I'm trying to find any IRS guidance about Reg. 1.105-1(e), i.e., at what point a self-insured plan is discriminatory when highly compensated employees pay lower contributions than do other employees? Did you uncover any formula to resolve this?

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