How would a Health Spending Arrangement work for a self-insured plan as opposed to a fully-insured plan and has anyone implemented this on a self-insured basis? Is this type of plan only for a fully-insured plan?

I have a controlled group where each Corporation wants to sponsor its own plan. Company A wants to provide a match contribution, and Company B does not. The remainder of the plan provisions are the same.

The plans will pass ADP/ACP when tested as one group.

The group also passes 410(B) ratio percentage test for the match contribution with the participants from Company B not benefitting.

Here is my question:

Does the testing group need to pass the general test, 401(a)(4), since there are effectively different benefit accrual rates within the testing group because Company B participants are not eligible to receive a match contribution? Or, does the fact that the 410(B) ratio percentage test pass preclude the need for the 401(a)(4) test?

Thank you for any assistance.

(Note: the testing group also passes the average benefits percentage test)

Supposd that a self-insured group health plan has been informed by Medicare that Medicare paid primary on a claim when the plan should have paid primary. Medicare is seeking to recover the amount of the claim plus interest and the plan has decided not to contest it.

The plan is funded through a VEBA.

Now the question is whether the interest may be paid out of plan assets from the VEBA or must the employer/sponsor pay for it out of employer assets? I am assuming that the principal (the claim amount) may be paid out of the trust because it would have been in the first place.

The only remotely analogous authority I've found concerns payment of penalties for failure to file Form 5500 or penalties under the DOL's Delinquent Filer Voluntary Correction program, where the DOL has concluded that the plan administrator, not the plan, is required to pay the penalties.

I also reviewed the DOL's guidance from last year about use of plan assets (settlor v. plan functions), but found none of those hypotheticals useful.

Another potentially relevant fact is that the Medicare secondary payer statute and regulations gives the government the ability to sue either the employer or the plan to recover the mispaid claim.

Any thoughts would be greatly appreciated. Thanks in advance.

I am putting together a direct reimbursement dental plan. The employer will reimburse dental expenses subject to a deductible and annual maximum limits. Is this a kind of health plan to which COBRA applies? If so, how does it work?

A formerly qualified money purchase Severance (welfare benefit plan) is in the process of being terminated and has liquidated all participant balances. A tax refund is expected and there are additional funds remaining after paying off all balances. This plan is to be construed under the laws of New Jersey.

What, if anything, can be done with the remaining funds? Can the trustees do anything with these funds such as CLE seminars? Is the money forfeited and does it revert to the State? Or something else?

Any help is appreciated!

Hello again!

Seem to have misplaced my website addy for IRS Private Letter Rulings...can anyone help me out here? Am specifically looking for info on "otc meds" and reimbursement with letter of medical necessity from doctor.

Thanks in advance.

JM

Are discount vision programs (offering discounts on exams, hardware and laser sugery) offered only to employees of certain employers "plans" under ERISA (i.e. such "discount" programs are medical benefits). Would they also be subject to COBRA?

I am trying to locate the full text of the Treasury Decision/Announcement (??) that withdrew the old 414(o), et. seq. regulations. Any ideas or cites?? Thanks.

New SRO rule - obligation of investment analyst to disclose 1% ownership positions implemented and effective on 11/10/2002. Article says that "in order to support compliance with the new disclosure requirement, trust departments of banks that are ffiliated with investment banking firms will be required to track beneficial ownership interests and report them to affiliated firms" so that the affiliate/Investment bank can disclose.

arent the beneficial ownership interests of the stocks in an EB trust held in trust departments FBO the trust. Is the bank the beneficial owner. i think the plan is the beneficial owner, and therefore think this rule is ignoreable.

thoughts?

thanks.

We have an employee who has had a court order issued to him to add on a dependant who was not previously covered on his medical insurance plan. We have added on his dependant per this court order and now the employee would like to start contributing to a section 125 Medical Flexible Spending Account also. This would be a mid-year enrollment as he did not sign up/enroll at the beginning of the plan year. There was no Qualified Family status change (i.e birth, loss of other coverage, divorce), the enrollment was strictly by court order.

My question is: Do we have to allow him to enroll in our section 125 Medical Flexible spending account to pay for things like deductibles and co-pays even though it is mid-year? and there was no "qualifying life event"?

I have read all the advantages of contracting with a TPA to perform COBRA administrative functions.

What are the disadvantages, if any?

A participant dies. There is not a surviving spouse. The adult child, trustee of the estate, has been told that the qualified plan money can be rolled into a Inheritance IRA. The IRA is fbo the participant's revocable living trust.

Can this be done? My thinking is that it cannot be.

Thoughts?

Has anyone heard of Entrust Administration? Would you recommend them?

The AICPA audit guide classifies these plans under Welfare Benefit plans. Generally they are 501© plans. Question: Is a 5500 required to be filed if the plans are Unfunded (paid from the general assets of the plan sponsor) and have less than 100 participants. Cannot locate specific guidance on these plans.

Your assistance is appreciated

I'm not believing my eyes.

I have only ever used the Characteristic Code 2K (Line 8a of 5500) if the employer provides a Match.

Someone who was unfamiliar with 5500s, and who was asked to review my work said, "But look at the instructions. 2K is also designated for a Plan in which employee contributions are allocated to separate accounts, and this plan does that . . . "

Oh my gosh . . . have I been missing something? Should I be coding any 401(k) plan which provides for individual participant accounts the 401(m) code 2K as well?!?

Member wants to withdraw all of the money in his annuity fund and close the account. He is legally married but he has not seen his wife since 1997 and says she is missing. Can the fund allow him to receive all of the monies in the account? What about his wife?

This is a defined contribution plan and is a collectively bargained plan.

Any help would be greatly appreciated!

The AICPA audit guide classifies these plans under Welfare Benefit plans. Generally they are 501© plans. Question: Is a 5500 required to be filed if the plans are Unfunded (paid from the general assets of the plan sponsor) and have less than 100 participants. Cannot locate specific guidance on these plans.

Reg. section 1.401(a)-13(e)(1) provides that a participant may assign all or part of his benefit to a third party,including the employer,provided that certain conditions are met. One of those conditions is that the third party must file a written acknowledgement with the plan administrator stating that the third party has no enforceable right to the benefit. If assidgnment is being made to the employer,and the employer is also the plan administrator,is the employer truly a third party,or is the assignment invalidated?

If a participant that has been taking the required minimum distributions dies, can his beneficiary who is his spouse and not age 70 1/2 defer taking the required minimum distributions until she reaches age 70 1/2?

Thank you!

Assume employer does not file a 5558 - what is the fine for filing 5500 late? Is it a 'set' fine or is it on a daily basis? I'm sure the info in on the web somewhere, but what is the address? Thanks in advance!