There has been discussion on PIX and one of our employees attended Larry Deutsch's seminar last month regarding what to do if the xtesting does not pass. Can someone please clarify if we have a xtested document with Group One as owners and Group Two as staff, can we use straight integration if one of the employees receiving an integrated benefit is a NHCE and in the staff group. Do we still need to pass the general test? Thanks.

Employer was on a volume submitter money purchase plan document prior to 7/1/01. Employer then adopted a pre-GUST prototype non-standardized money purchase plan document on 7/1/01 effective for the plan year beginning 1/1/01. Since the remedial amendment period for GUST was extended until September 2003, wouldn't the employer have until then to amend their document for GUST?

I am needing clarification on testing for control groups. Is it true that if each separate entity covered by the control group passes coverage testing separately then they can process all other nondiscrimination tests separately as well?

We have received a Section 125 plan from a tpa. Pursuant to the terms of the plan, participants may be reimbursed for non-employer sponsored premiums paid for other insurance (health, disability, cancer and term life). 1.125-2 Q&A7(B)(4) states that a health FSA may not treat participants' premium payments for other health coverage as reimbursable expenses. Therefore, a health FSA may not reimburse participants for premiums paid for other health plan coverage. Am I missing something? Q&A5(a) provides the rule that a cafeteria plan cannot defer the receipt of compensation. This section goes on to state that a plan operates to permit the deferral of comp if the plan includes a health plan that is an FSA arrangement and such health plan may reimburse participants' premium payments for other accident or health coverage beyond the end of the plan year. Could this be read to mean that as long as the premium payments do not reimburse for insurance coverage beyond the end of the plan year, it is OK? I have always had the understanding that premiums are not reimburseable under a health FSA.

Can the 5500 filing plan year be different than you contract year with the carrier?

We have always filed our 5500s based on a 1/1 -12/31 plan year, but started coverage with a new carrier on 4/1/02. The carrier is refusing to provide the Schedule A information for 4/1/02-12/31/02, saying that we must file the 5500 off-cycle.

Thanks.

HIPAA privacy rules apply to group health plans, not to employers, per se.

Therefore, it would seem to make sense that an employer should enter into the terms of a business associate agreement only in its capacity as plan administrator of its group health plan.

Any comments appreciated.

We have a benefit coordination (order of payment/order of turn) situation that would at first read appear to be very simple, yet has proven to be incredibly problematic. CMS/Medicare both live person(s) and website, NAIC through Thompsons, Trilogy, and various other sources have all been tapped to no avail.

COB Scenario:

Employee (under 65) holds group health coverage that is paying secondary to Medicare due to disability (not ESRD) and is not in current employment status.

Spouse has no group coverage but is entitled to Medicare as is over the age of 65.

Question: Who pays prime for spouse?

Our thinking would be Medicare prime due to spouse's individual entitlement and the Employee's inactive status.

Problem: I despirately need regulatory back-up for the correct determination! Any guidance would be greatly appreciated.

A client maintains a 403(B) plan. An HCE maxes out and and the client is looking to offer this HCE a means to shelter more of her income. Would a Top-Hat be the best route? The HCE is 54 years old and earns approximately $130,000 annually. The plan is exempt under 501©(3).

Surviving spouse is considerably younger than 59 1/2. Surviving spouse is designated beneficiary on decedent's acct. balance in PSP. Surviving spouse needs to be able to take advantage of 72(t)(2)(A)(ii) exception to 10% penalty tax. Would it be possible for the surviving spouse to open an IRA in the name of the decedent and roll over the qual plan benefits? Anyone know of financial institutions which will allow for the opening of an IRA in the name of the decedent?

Surviving spouse is considerably younger than 59 1/2. Surviving spouse is designated beneficiary on decedent's acct. balance in PSP. Surviving spouse needs to be able to take advantage of 72(t)(2)(A)(ii) exception to 10% penalty tax. Would it be possible for the surviving spouse to open an IRA in the name of the decedent and roll over the qual plan benefits? If so, anyone know of financial institutions which will allow for the opening of an IRA in the name of the decedent? I remember PLR's allowing for a rollover of a decedent's IRA to a new decedent's IRA, but I don't recall anything addressing the ability to open a decedent's IRA... Also, I guess the plan document may constrain the ability to do this as well..

Is there a specific statutory duty on HR Department personnel to respond to employee requests? Employees at one company are having trouble getting responses, forms, help of any kind about a range of issues...FMLA, worker's comp, health insurance, etc.

Would one file a complaint with the DOL on the federal law issues and with the appropriate state agency for state law issues? Thanks for your help.

Is there some generally accepted notice period considered "reasonable" that an employer might require a retiring employee to give prior to the date of retirement. An employer is claiming that 90 days is necessary and is consistent with other plans. The other plans are DB plans. The plan in question is DC plan. 90 days seems long to me. Thanks.

Can anyone help with my questions in this thread?

http://benefitslink.com/boards/index.php?showtopic=18840

There doesn't seem to be anyone in that other forum lately.

Thanks.

Suppose a company is large enough that it has a Benefit Department and there is very little overlap with Human Resources.

The Benefit Staff are clearly regarded as in receipt of PHI and have been trained and are obviously involved as to payment and operations - and assisting in obtaining treatment at times.

Human Resources at office locations could be asked some general questions - "is this a covered procedure" or "what is the basic percentage of reimbursement";" am I eligible to drop/add coverage if ...";"where do we file";etc.

They may also get specific questions such as "How do I fill out this form"; or "can you interpret this EOB I just got"; or "Is Dr. Jones in the network; etc.

Finally, they might get infomation on "fitness for duty" or requests for medical leave, etc.

But the key is about the only thing an HR representative has clear access to that is PHI is payroll information related to deductions. All other dealings with an employee are because they were asked by the employee for assistance.

After all that build-up, the short question is whether the fact that the "employer" is not subject to HIPAA Privacy means the HR's are not "agents of the plan" and so HIPAA Privacy does not apply to them - notwithstanding that company policies on privacy of employee information certainly does and notwithstanding that the Benefits Dept employees are "in the box."

I'm currently involved with a municipal DB plan that calls for mandatory ee contributions.

With limited understanding of 414(h)(2) my impression is that the plan can be amended to replace or augment the mandatories with a "pick-up" arrangement.

We're currently funding the plan under the Projected Unit Credit method and the annual suggested Town contribution is comprised of net service cost ( i.e total service cost net of mandatories) plus an amortization of the unfunded.

Since the "pick-ups" are employer contributions, they would just go towards the suggested Town contribution described above, correct ??

And lastly, if the "pick-up" arrangement augments the current mandatory arrangement & if the mandatories are a % of base pay, then base pay would include the "pick-up" amounts, correct ??

I'm currently involved with a municipal DB plan that calls for mandatory ee contributions.

With limited understanding of 414(h)(2) my impression is that the plan can be amended to replace or augment the mandatories with a "pick-up" arrangement.

We're currently funding the plan under the Projected Unit Credit method and the annual suggested Town contribution is comprised of net service cost ( i.e total service cost net of mandatories) plus an amortization of the unfunded.

Since the "pick-ups" are employer contributions, they would just go towards the suggested Town contribution described above, correct ??

And lastly, if the "pick-up" arrangement augments the current mandatory arrangement & if the mandatories are a % of base pay, then base pay would include the "pick-up" amounts, correct ??

Hello -

I have made the necessary refunds recommended by our TPA with regards to a failing ADP test. When you make these adjustments the net change to our HCE ADP % doesn't equal the corrective % action recommended. It is my understanding this situation exists because the refunds are distrusted to the highly compensated with the highest contribution amounts. I am concerned about being in compliance with IRS standards relative to passing the test? According to our TPA as long as the corrective action is taken we have met our requirements. Is this true??

After receiving notification that their provider would be getting out of the (SIMPLE IRA) business on 12-31-02 my client sent the contributions to the custodian for the fourth quarter of 2002. They sent them in on 12-15 but they were returned by the custodian after 1-1-03 with a note stating that they had been received too late. They now have a check representing contributions that were withheld from employee pay during the fourth quarter and don't know what to do with them. The account balances were distributed to the employees and will be rolled over into the new 401(k) but what can they do with the funds that were returned?

In setting up an HRA with a health plan ($2000 deductible) we want to know if the following two scenarios are acceptable.

1. Set up the HRA for $1000 but it can only begin paying after the employee has expensed THEIR $1000 toward the $2000 deductible. The ee would have to show proof of the first $1000 being applied to their deductible then, claims after that could be submitted for reimbursement up to the $1000 HRA amount.

2. Set up the HRA to pay 50% of the employee's deductible which would again be $1000 but pay it out 50% at a time meaning... ee sends a claim for $300 the HRA reimburses $150 of that and the HRA keeps reimbursing 50% of all claims submitted until it pays out a total of $1000.

Can an HRA be set up with these stipulations? Is it violating anything? Seems that in both cases the HRA is still making available the $1000 it is designed to provide (in this case).

:confused: :confused: :confused: :confused: :confused:

In setting up an HRA with a health plan ($2000 deductible) we want to know if the following two scenarios are acceptable.

1. Set up the HRA for $1000 but it can only begin paying after the employee has expensed THEIR $1000 toward the $2000 deductible. The ee would have to show proof of the first $1000 being applied to their deductible then, claims after that could be submitted for reimbursement up to the $1000 HRA amount.

2. Set up the HRA to pay 50% of the employee's deductible which would again be $1000 but pay it out 50% at a time meaning... ee sends a claim for $300 the HRA reimburses $150 of that and the HRA keeps reimbursing 50% of all claims submitted until it pays out a total of $1000.

Can an HRA be set up with these stipulations? Is it violating anything? Seems that in both cases the HRA is still making available the $1000 it is designed to provide (in this case).

:confused: :confused: :confused: :confused: :confused: