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    Annual Appeals for Prescription Coverage

    Guest SSS909
    By Guest SSS909,

    Every year my mother reaches the limit of her prescription drug coverage. The costs above what is covered in the plan, are denied. She does file an appeal (hoping that someone might change their mind) each year. This year a plan rep says her appeal won't be reviewed since its the same issue that was denied last year. I say it is a new claim for this year and that she should go ahead and file an appeal.

    I'm searching cases right now to support the above, but it seems as though I'm just spinning my wheels. Does anyone have any experience with situations like this and can point me in the right direction?


    Qualified Defined Benefit Plan, not 412(i), but no Trust

    John Feldt ERPA CPC QPA
    By John Feldt ERPA CPC QPA,

    We are taking over a DB plan and they claim that they have no trustees (it's true their plan document has no trust provisions). This is not a 412(i) plan. They are a normal for-profit C-Corp. All of their plan assets are invested with an insurance company. They state that because of this, they are not required to have trustees. They say then that they don't want to name a trustee because of the fiduciary liability that would then be placed upon that individual.

    Is it possible for a qualified defined benefit plan to not have a trust and thus not have trustees?

    Don't they already have fiduciary liability anyway, even if they appear to not have a named trustee?


    Quarterly Contributions

    Guest D450
    By Guest D450,

    Have a calendar year plan required to make quarterlies. We estimated 4/15 contribution of $50,000, based on 100% of EOY min funding requirements for prior plan year. We've finished calculations for the current year; minimum quarterly turns out to be $45,000. Is it correct that the 7/15 contribution will be $45,000 and that I will not be able to use the extra $5,000 paid on 4/15 to reduce any quarterly (not until 9/15/09 contribution)? I seem to recall hearing something to this effect, but I can't find anything now to substantiate it. This plan has no COB or PFB.

    Thanks.


    Two years no claim for 401K

    Guest dulan
    By Guest dulan,

    It has been almost two years since my brother died.

    I am his only survivor and the Administrator of his estate.

    He was divorced in 1993 from wife #2 and again in 2003 from wife #3.

    I have written the company twice claiming the 401K plus called the DOL and they also told me who to write.

    The company will not respond to me and I have paid three different attorneys that don't do anything except take money.

    Fidelity said that they didn't have a beneficary listed and I talked with one of there supervisors every few days back in 06 .

    I then went to a attorney that was a distant relative and he wrote the company and then one of the company attorneys called him to say that my brothe never got wife # 2 removed as beneficary.

    They never sent any documents to him as he requested and both ex spouses waived any rights to his 401K in the divorce decree.

    After 6 months I was not getting any answers from the first attorney and then I went to attorney #2 gave him 3K up front he wrote probate judge and that was useless. Then told me we needed to find a attorney in GA and left that up to me.

    After 6 months of calls and even spending $250 for a on line attorney that advertisted as ERISA specialists but could not answer one question I went back to the first attorney that was a relative of my husband.

    Here is what the benefit plan summary says about beneficary and claims.

    After giving a defination of the beneficary the plan says it is the last known persons designated in writing by Participant on a form submitted to the Plan Recordkeeper and satisfactory to the Administrative Committee or, in the even no such designatin is made or if no person so designated survives the Participant, or if after ckecking his last known mailing address the whereabouts of a person is unknown and no death benefit claim is submitted to the Administrative Committee by such person within one year after the date of death, the personal representative or such Participant, if any has qualified within fifteen months from the date of his death or, if no personal representative has so qualified, and heirs at law of the Participant whose whereabouts are known by the Administrative Committee. Provided, however if the Participant is Married, then during the such marriage the Participant's Spouse shall automaticallly be the Beneficary unless the Participant waives sthe spousal designation and indicates another person or persons as Beneficary on the same form and the Spouse gives written consent to such waiver and the naming of such person as Beneficary on such form.

    If no Beneficaryis identified and located pursuant to the procedure described above by the end of the two year period beginning on the date of death of the Participant, his Participant's Accounts, upon Administrative Committee direction, shall be forfeited as the last day of the Plan Year which icludes the end of such two year period.( Such forfeiture shall then be used to reduce Matching Contributions or Nonelective Contributions for the Plan Year in which forfeited.) However if a Beneficary subsequently is located and he files a written claim with the Administrative Committee for the death benefit which was payable to him and if such person demonstrates to the Administrative Committee's full satisafaction, through a court order or otherwise, that he in fact is such Beneficary, the the Company shall contribute an amount equal dollar for dollar to the forfeiture of such Participant's Accounts and shall credit such amount to a new Accounts established for the deceased Participant and the new Accounts shall be paid to such Beneficary.

    The company went into bankruptcy and all the 401K was matched with company stock and after the bankruptcy all the match was taken from the employees so all the money my brother has at Fidelity was what he put into the account.

    It has ranged anywhere from $165,00.00 to $210,00.00.

    How do I find a attorney that will do what they say when I have paid them money?

    Thank You,

    dulan


    Cash Balance Plan Accrued Benefit

    Gary
    By Gary,

    Pror to PPA my understanding of the way the AB needed to be calculated (for practical purposes) was:

    EE is age 50

    NRA is 65

    If account bal = 50,000 at age 50 it would be projected at the interest credit rate to 65 and then converted to a life annuity

    And for example if the interest credit were reduced from say 6% to 4%, the current balance (at the time of change) would need to be projected at 6% to preserve the AB since the AB is based on the balance to NRA, but future allocations could be credited at 4%.

    Bottom line is that the AB (annuity payable at NRA) must be preserved (which would likely entail the balance at the time of change being projected at 6%). At a minimum there could be substantial wearaway if the entire balance is projected at 4%.

    Post PPA

    It seems the above approach is still acceptable.

    However, as an alternative the AB can simply be the account balance, where the normal form of payout would be a QJSA.

    Are we in agreement on that?

    So the following could occur if the acct bal is the AB.

    1. No need to project balance to NRA except for informational purposes for providing the projected benefit.

    2. The plan can simply determine the benefit payable at the time of ddsitribution, where the payment can be a lump sum equal to the account balance or an equivalent immediate annuity, if the plan provides.

    3. If the interest credit were reduced from 6% to 4%, then the balance is simply projected at 4% per year from that point on and thus no need to preserve the 6% interest credit to preserve the AB.

    Are we in agreement?

    Any other views?

    Thanks.


    Rollover of Cash, Deemed Distribution of Loan - what to payout?

    Guest SuzieQNEC
    By Guest SuzieQNEC,

    Participant has a cash balance of $50,000

    Participant has an outstanding loan with a current payoff amount of $5,000

    Participant would like to rollover the cash only without paying back the loan.

    In that case, would the actual distribution be:

    50,000 less 20% of loan payoff, or $1,000, for a rollover of $49,000.

    The taxable amount would still be $5,000.


    In-Service Distribution and RMD

    Dougsbpc
    By Dougsbpc,

    Suppose you have a 1 participant DB where the owner/participant reached the NRA a few years ago (5 yrs of partic). He began taking RMD's in 2007.

    If the plan allows for in-service distributions at NRA could he take an in-service distribution even though he is taking RMDs?

    If this is possible, can his RMD go down based on the in-service withdrawal? We think not.


    Accounting Method

    RDY2RTR
    By RDY2RTR,

    I'm looking for the definition of cash basis, modified cash basis and accrual basis for 5500 reporting. The 5500 Form instructions say we can use either method, but the instructions don't define the methods. Any help would be greatly appreciated!


    Self Funded-Accountants-Privacy for internal reconciliation

    Guest Pecos
    By Guest Pecos,

    With alot of self funded plans, internal accountants reconcile the checks issued from the company's bank account to medical providers or in some cases employees (reimbursed). Do you have any sample forms or language that could be used and signed by an accountant, regarding the privacy of the employees, if they have access to view the medical checks (fraud prevention, etc)?


    Dependent Care Savings Account vs. Tax deductions?

    Guest Pecos
    By Guest Pecos,

    I am sure there are probably a lot of threads on this topic, but I am not very savvy with this website yet. Are there any online tools I can use to see if it is better to contribute to a Dependent Care Savings Account (FSA) vs. having the dependent credit/deduction for tax filing?


    Rollover for new loan to pay off prior loan

    Guest Pecos
    By Guest Pecos,

    I recently changed employers and have an oustanding loan on my former 401(k) plan. My former employer will allow me to keep my funds in their plan as long as I have over $5,000 balance.

    What I would like to do is rollover half of my funds from my prior 401(k) into my new employers 401(k). Than take a loan against my new 401(k) (rollover funds) and use those funds to pay off my outstanding loan with my prior employer's 401(k) plan? Can I do this to avoid the 10% distribution penaly + 20% in taxes? Or is there any easier way to pay back the prior loan?(I don't have enough cash on hand to pay it back within the 90 days).


    Match forfeiture different than nonelective forfeiture

    Jim Chad
    By Jim Chad,

    I am curious if I am missing something. The new EGTRRA document, just like the GUST document, makes it very clear that how match forfeitures will be handled is a separate question from how any other forfeitures will be handled.

    Are there times when they are required to be handled differently?


    415 Limits

    Gary
    By Gary,

    An EE is a participant of Co. A DB plan.

    EE works for Co. B and Co B. pays for the funding requirement to Co. A DB plan for the EE.

    CO. A and Co. B are unrelated w/r/t ASG and CG purposes.

    EE used to work for Co. A.

    While EE was an EE of CO. A , CO. A funded plan on behalf of EE.

    Once EE worked for CO. B (when it was first formed 10 years ago), Co. B funds plan for EE.

    Is the 415 limit still 185k (at 65) even though each Co has funded and taken deductions for a part of the pension? Or are they separately calculated 415 limits for each period of service for each employer.

    Co. A still sponsors the plan. I am not sure, but I think Co. B is taking deductions for these contributions to Co. A's plan.

    Now Co. B is going to implement a cash balance plan and there will be coordination of two benefits for 415 purposes.

    In the case of CB plan, 415 limit may be lesser of 1) 415 limit to CB plan alone and 2) 415 limit based on total participation in the other plan while Co. B was funding less the benefit accrued by the EE in the other plan while Co. B was funding.

    Another thought is to have the CB benefit = Gross CB benefit less the other plan benefit (funded by Co. B) where 415 limit is gross 415 limit in CB plan less benefit in other plan. Thisof course can result in an AB of $0 for several years until the 415 limit in the new plan exceeds the AB in the other plan.

    Thanks.


    governmental parent with 501(c)(3) sub

    waid10
    By waid10,

    A hospital authority is a political subdivision and has formed a 501©(3) to employ physicians. Can the hospital authority establish a governmental plan and make that plan available to both employees of the parent (hospital authority) as well as employees of the sub?


    Overpayment, Restitution & Recoupment: EPCRS or Great-West?

    Guest anygig
    By Guest anygig,

    The issue is that EPCRS allows for recoupment, in fact seems to require it, yet the Supremes have said legal restitution is not allowed for an ERISA 502(a)(3) claim by a plan fiduciary. My question is in the overpayment by plan operational failure category when the plan's language does not provide for recoupment of such, rather than recoupment by provisions provided for in a plan document.

    In 2002, the Supreme Court decided Great-West. It is a subrogation case, but its language and effects have been much broader. Ogden, in the 5th, specifically stated that there is no federal common law right to restitution as a legal remedy against plan participants after Great-West. Neither Great-West nor Ogden's holdings were limited. Thus, if the participant has dissipated the funds, and the plan does not provide for recoupment, the plan cannot recoup from future benefits as a self-help remedy. How does that square with a fiduciary duty to not pay out more funds than a plan should?

    That leaves a state law contracts claim, but Great-West refused to address whether such would be pre-empted by ERISA. Pre-emption may be colorable because recoupment does not appear to fall within the exemptions from pre-emption. If so, Great-West appears to eliminate a Plan's ability to recoup, unless funds have not been dissipated (or the provision is in the plan, which then is a contract or extra-judicial remedy according to Northcutt in the 7th Cir.).

    EPCRS, Rev. Proc. 2006-27, App. B 2.05, addresses recoupment (including overpayments other than 415 excess payments).

    Has anyone run into this situation, and/or found any legal authority specifically addressing either the Great-West v. EPCRS issue or the pre-emption issue? I know there are other posts about recoupment, but none seem to address these issues. Thanks in advance.


    401K and Roth IRA limits

    Guest stets
    By Guest stets,

    New member, first post. Looks like a great resource. I searched but did not find anything that deals with this.

    I understand it is allowed to contribute to both a 401K and a Roth IRA, but I can’t find anything specific on how the maximum annual Roth limit is affected by the 401K contribution, assuming AGI is under the limit.

    Assuming a 25 year old freshly minted engineer is contributing to, but not maxing out a 401K, and with gross income in the 40-50K range, is there a way to determine how much he could contribute to a Roth IRA?

    Thanks in advance.


    Employer withholding 401K info

    Guest mel63129
    By Guest mel63129,

    Long story short: I recently quit my job and called the company that the 401K is through to see how long it would take to get the check (paperwork was already turned in). I had the plan ID number (from my employer), but aparently that wasn't the info I needed. I called my employer back to get the correct info, but they wouldn't give it to me. They said that all I need is the plan ID and my SS#. I called the 401K company several times with this info, and each person I spoke with told me that I need more info.

    So, my question is: Does my previous employer legally have to give me that info?

    Thanks!


    Loans and RMDs

    CJS07
    By CJS07,

    Do you include an outstanding loan balance in the calcualtion of the Required Minimum Distribution?


    AFTAP elections

    AndyH
    By AndyH,

    Are actuaries generally requiring written elections from clients regarding PPA funding elections before signing AFTAPs for 2008?

    I'm referring to asset method, phase in election, lookback month, etc.

    Anybody willing to comment on how this process is generally being handled, i.e. formally or informally? Are there any advisories or published guidelines on this subject?

    We're requiring formal elections in advance and I'm wondering if others are doing the same. Thanks for any comments.


    ALL Index Funds in a 401(k)?

    Guest AmyHarle
    By Guest AmyHarle,

    Would a sponsor that decides to offer only Index funds in his 401(k) Plan be intending to comply with ERISA 404©?


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