oriecat

I'm curious how it was misrepresented? Isn't a POP a POP, if you know what I mean? In what way you would change it when canceling and restarting it? Can't you just do an amendment if something isn't right?

I stated that for a covered employee, the QEs are... which is true. Look at the QE's outlined in the regs. (1) The death of a covered employee; - doesn't apply to the employee, as the employee is dead (2) The termination (other than by reason of the employee's gross misconduct), or reduction of hours, of a covered employee's employment; - this is what applies and what I mentioned (3) The divorce or legal separation of a covered employee from the employee's spouse; - this doesn't apply to the employee, only to the spouse, as the employee would not lose coverage due to this event, only the spouse would, and lose of coverage is required for something to qualify as a qualifying event. (4) A covered employee's becoming entitled to Medicare benefits under Title XVIII of the Social Security Act (42 U.S.C. 1395-1395ggg); - again, same as above. (5) A dependent child's ceasing to be a dependent child of a covered employee under the generally applicable requirements of the plan; or - applies only to the child, not the employee. (6) A proceeding in bankruptcy under Title 11 of the United States Code with respect to an employer from whose employment a covered employee retired at any time. - I didn't mention this one, as it is not really on an employee level, but the group level. If that doesn't help, perhaps this webpage from the DOL will help: http://www.dol.gov/ebsa/faqs/faq_consumer_cobra.html The only family status change mentioned is divorce, so I'm not really sure what you mean by "includes the family status changes", when there is nothing about marriage, birth/adoption, death of spouse/dependent, etc.

Here's a link to the COBRA regulation if you would like to review it. 26CFR54.4980B-4 What is a qualifying event?

The COBRA regs specify the qualifying events, which for a covered employee are only termination of employment and reduction in hours. Would becoming a partner equate to one of those? If not, then there is no qualifying event and I don't think COBRA would apply. There are no tax implications for being reimbursed.

Did he actually enroll in Medicare? Was he enrolled in Medicare prior to electing COBRA? If he was not enrolled in Medicare prior to electing COBRA, his Medicare entitlement and enrollment would be an allowable reason for the COBRA to be terminated. So under the facts as you put them, I am thinking he shouldn't have had any months on COBRA. He definitely would not have 36 months, all of the 36 month qualifying events apply only to dependents. Edit to add: I am wondering if you can expound any on the MSP provision you talked about, because I am not familiar with it at all, and I don't understand how it could add time that isn't listed in the COBRA regs themselves.

Wouldn't this negligence first depend upon whether the former or the latter of the first quote is true?

I also use Firefox and the My Assistant and My Friends link pop up just fine for me.

Thank you, Tom!

Thank you! Do you know the source of this rule change?

On another board I am on someone posted that their recordkeeper said that starting this year, the refunds to HCEs due to failing non-discrim would be taxable in the year refunded instead of the plan year so the HCEs would not need to wait to file taxes. Is this true? Has anyone heard anything about this? Thanks

2 questions: What does your plan document say about the procedure for requesting a hardship distribution? Is there some reason these people can't come into the office and fill out the form? How far away are they?

Why wouldn't this be HIPAA special enrollment? From the DOL website: Under HIPAA, individuals who are otherwise eligible, but had declined health coverage because they had other group health plan or health insurance coverage, must be permitted to enroll in the plan (regardless of any late enrollment provisions) upon “loss of eligibility” for the other coverage or if employer contributions toward the other coverage cease.

To my understanding, there is no spend down for Health FSA, the participant needs to elect COBRA to continue participation past the termination date.

The Regulations themselves won't disallow this, but what you need to doublecheck is that your group health plan contract will allow it. If you are keeping someone on the books as an active employee when they are not, that can be insurance fraud.

EBIA Weekly? http://www.ebia.com/WeeklyArchives/COBRA/CourtCases

My understanding is that it is neither of those, but it is the Plan's money, is that not right?

Yup I would agree with that.

Are you asking like if the ex elects cobra, whose funds pay for the reimbursements? Or what really are you asking?

I don't see why you would need to do that. The cobra notice should just say that the initial payment is due within 45 days of the election and needs to bring all retro premiums up to date. You can't set out the schedule, because you don't know what day of the 60 the person will make their election.

Technically he would have until 11/29 to elect COBRA, since October has 31 days. And then payment is due on 1/13/08. Payment would be due for October, November and December premiums since the initial premium needs to bring you current with all past due premiums.

Agreed, but if you are only doing premiums and not other cafeteria benefits, then a Premium Only Plan (POP) document should be pretty small and inexpensive to get.

So I'm confused... what happens at the end of the 90 days? Are they transitioned to regular employees on a different health plan?

Well the companies are related, in the way I wrote, in that they are all owned by the same person, and they share management personnel. I am not familiar with MEWAs, other than having heard the term. Is it something that is easy to set up and administer? Can anyone do it? Would that be a good option in this instance?

3 separate employers - Corporation 1 - 300+ employees, 100% of stock owned by John Corporation 2 - 5 employees, 100% of stock owned by John John's Sole Proprietorship - 4 employees In the past the two corporations have shared benefit plans. For example, on the self-insured dental plan, Corp 2 is listed as a Participating Employer. Same with the 401(k) plan. I am not sure how the insured medical plan was set up, since it has been in place for like 25 years, so perhaps it was not done properly at the time, but I believe it was, and that the insurer was aware that there were 2 separate corps involved in the plan. Now we are asking about adding the 3rd company to the plans and being told we cannot do that, they would have to have their own small plan. Is this correct? Is there any way to have these 3 plans all together for all benefit purposes? Do we have any options?

We don't have anything currently, but will probably be looking into it soon, due to a new Oregon law requiring breaks for pumping. I would make sure to check what laws you might have in your states. http://www.ncsl.org/programs/health/breast50.htm http://www.lalecheleague.org/Law/LawBills.html