We are a large employer (not in the healthcare industry) in 50 states that self-insures it medical plan and also has about a dozen HMO's in some states. We outsource the administration to UHC for the self-insured part of our medical plan.

The problem I am having is trying to determine what is considered PHI (protected health information) internally that falls outside of TPO (treatment, payment or healthcare operations)

Would anyone have a good list?

Also in our HR dept. we separate our health benefits administration group from the group that handles FMLA and other employment based issues. Our workers comp(although headquartered in a separate state reports into headquarters) & LTD functions are part of benefits health admin in corporate

We have employees(HR reps) in the field who may come into play with PHI on a day-to-day basis

It seems to me at first glance that this may be monumental companywide

I read that workers' comp is exempt from the privacy rules? What about disability plan administration and FMLA? I also understand that "firewalls " must be in place between anyone who handles PHI for the health plan and other benefits/employment administration. Does anyone have any good recommendations here?

Our FMLA group from time to time may have interaction with our helath benefits admin group and the same for our disability administrators (they actually report into Benefits Admin as well)

We get involve dquite a bit in helping ees try to resolve claims/payment issues -does this fall under the "payment" exclusion?

Thanks for any and all insights

What is the maximum dollar amount that our 17 year old can contribute to a Roth IRA? He only works part time in the summers ( gets $1000 each Christmas from Grandparents also for investing). Is it dollar for dollar in regards to his earned income with a max of $2000? Would the same hold true for his 18 year old brother with same history? I am new at investing so I hope that this makes sense.

I do not see many articles on the use of Roth IRAs as a savings vehicle for kid's college education. With Education IRAs and 529 plans, you are locked into using this money for one purpose only. What if your kid decides not to go to college or receives a full scholarship? What happens to that money? What do you do with it and how does the IRS penalize you?

In addition, the returns in the NYS 529 plan are dismal. I know you get tax break on state returns, but I question how good these 529 plans really are. Now you are not taxed on earnings, but that does not matter if the plan is losing value.

With a Roth IRA, you have more flexibility in that if all the money is not needed for college education, then this becomes additional retirement savings. I know you are taxed on earnings only when a withdrawal is made for higher education. This is a disadvantage.

I don't believe my kids would receive any financial aid.

I would welcome comments/suggestions.

Describe the essential differences between strategic plans and operational plans for employee benefits. Provide examples of typical items included in each type of plan. Are there any planning aids that can be used to help in this process?

Describe the essential differences between strategic plans and operational plans for employee benefits. Provide examples of typical items included in each type of plan. Are there any planning aids that can be used to help in this process?

For a qualified distribution, do participants still pay taxes based on ten year averaging?

401(k) Plan... 2001 passes ADP with NHCEs, but by 12/31/01 they are all terminated (small tech co.).

2002 only the HCEs (2). As I understand it, 401(k) with no HCEs is deemed to pass ADP. But is there an implicit current year election in this case. Or is there just no test, current or prior.

Employer has union plan for union employees. For several years union has allowed non-union employees to participate as non-voting members receiving all benefits (pension, annuity, health insurance, etc.) Union has now decided that this arrangement is not proper and will not allow new employees to join their plan. Employer is now concerned as to propriety of non-union in union plan. Also what to do about new non-union employees, who would have joined the union plan,and how to provide benefits for them. The union has agreed to allow present non-union participants to remain in the union plan.

I have a governmental client who has a 457 plan for employee deferrals. One of the 457 providers requires that upon the death of a participant the account balance must be paid to the City instead of a named beneficiary. The service provider is quoting IRC 457(g) as the authority for this. When I review 457(g) it indicates the requirement of a trust, custodial account, or annuity for the exclusive benefit of plan participants. Paying the account balance to the City seems to violate this requirement. Is the service provider correct? If not, is there any additional guidance you can direct me to?

Thanks for your help and I look forward to receiving the Govt Answer book that I have on order!

Employer is considering setting up a 401k. Plan will be employee only contributions. They want to take a survey of employees to determine potential participation level. Does anyone have a sample form that can be used for this survey? Employer is not willing to consider automatic eenrollment option. Still insists on doing survey of employees. Need help with form, if possible.

We administer a governmental defined benefit plan that does not contain any QDRO language. We received a final judgement of dissolution that awards a wife of a plan participant that has not reached early or normal retirement age, but is vested in the plan. The judgement simply states the wife is given "one-half of the husband's retirement from the date of acquiring said retirement until the date of filing the Petition." When does the wife begin collecting the benefit? Do we require a QDRO & who prepares it? How do we calculate the 50%?

Please see http://www.treas.gov/press/releases/po2002.htm. The Treasuray issued new Regs that killed the concept of the hedging accounting for deferred compensation plans. As many of you know, the accounting firms where pushing this concept.

A union welfare fund is charging COBRA beneficiaries a composite rate. The composite rate has not changed since June 1, 1999.

Does anyone see problems here? I don't know if the plan is self insured but I believe individual and family rate tiers should be standard in any event. Also, for the rate not to have changed in 3 years given the 102% rule is virtually impossible. What do you think is going on here and what recourse does the individual on COBRA have?

Thanks

I am interested in obtaining information from our associates regarding their impressions of healthcare benefits, i.e preferences, satisfaction with existing plans, willingness or desire for plan changes, etc.

Would anyone be willing and able to share a template or list of questions which you might have used when conducting such a survey? OR can you direct me to any literature that would assist me in this effort? Thanks!

If a government employer maintains a qualified defined contribution plan, a 457 plan and a 403(B) plan is there a connection among the three as to the amount that can be contributed to each plan? In particular, we are concerned about whether contributions to the qualified DC plan will cause the amount which can be contributed on a tax favorable basis to the 457 or 403(B) to be decreased, or vice versa. Are the respective contribution limits interrelated or are they all independent of each other?

Have an individual whose husband recently died. She converted his IRA to hers. She is under 59 1/2 and he was early 60's. No distributions taken until recently after she converted, she took some funds out. All assets are now in her IRA. Problem is, she has two stepdauthers (His from a previous marriage) that she wanted to give $50k each to by using a disclaimer (She found out about this after converting the assets to her IRA). Her question,

is there any way she can put assets back into his IRA and let the stepdaughters have it by using the disclaimer. In effect, reversing the IRA conversion in her name for a portion of the assets to go to the stepdaughters, allowing the mom to avoid taxes and penalties if she were to gift the assets to them. Can anyone shed light on this or provide any resources on where I can find a definitive answer? My understanding is the IRA she has now is irreversible, she is stuck with the assets in her name and can't move them back in the decedant's account. Any help anyone can provide would be greatly appreciated.

Randy Braidfoot

Could a TPA receiving a check on behalf of a retirement plan participant from a custodian or trustee deposit it in the TPA's account, with the TPA then handling the payment process and actually writing a check to the participant? What about the TPA being given checkwriting authority by a trustee over a trust account?

Has anyone ever heard of a TPA receiving a check on behalf of a retirement plan participant from a custodian or trustee for deposit in the TPA's account, with the TPA then handling the payment process and actually writing a check to the participant?

Under the mid-year election change rules, could coverage that a self-employed spouse obtains (e.g., through an individual policy) constitute "coverage under another employer plan"? See 1.125-4(f)(4).

If there is a change in Plan Year for a safe harbor 401(k) plan, does the plan automatically have to do ADP/ACP testing for the short plan year created, and then automatically resume non having to do ADP/ACP testing for the next full 12 month plan year?

Is the plan automatically exempt from the safe harbor notice and contribuiton requriements for the short plan year created by the plan year change?