Chaz

During open enrollment, each QB has the same rights as active employees with respect to election options.

A participating employer in a multiemployer welfare fund receives a request from CMS for participant enrollment/eligibility information to use in the Medicare Data Match program The participating employer forwards the request to the fund asking for the information. (The employer is required to provide the information under the Medicare rules so the disclosure would generally be "Required By Law" under the Privacy Rules.) Can the fund disclose the information to the employer? A single employer/plan sponsor can disclose the information to CMS if it has the information in its role as employer because the information is not PHI. If it doesn't, it can also get the information from the health plan it sponsors if, in its capacity as plan sponsor, has certified to the plan that it complies with HIPAA, etc. In my situation, the employer doesn't hold the information in its role as employer (the fund does) and the employer is not a plan sponsor so the certification rules are seemingly not applicable. I'm not sure the fund can disclose the information to the employer. Does anyone have any thoughts?

Under COBRA, you can only elect to continue the same coverage that you had before the qualifying event (i.e., turning 26). If your father's company offers an open enrollment period for employees (this is usually done before the beginning of the year), you will be able to change your plan at that time.

These types of state laws are generally preempted by ERISA for self-insured plans. That's why the Nebraska law only regulates insurance companies.

Hi Karen, You seem to be having a lot of problems with your QMCSO based on all your postings on these boards. I'm sure you have been told this many times before, but I think it bears repeating: You will have a MUCH better chance of success (and much less stress) if you hire a competent attorney to help you navigate the legal system instead of trying to do it all yourself. I'm sure your local bar association can recommend a number of attorneys who practice domestic relations law. Charlie

I'm not entirely sure what you mean, but there are no "grandfathered" FSAs. All FSAs, regardless of when first effective, must comply with the rules in 2013.

Yes. The opt-out provides the opportunity to choose between a taxable benefit (cash) and a non-taxable benefit (spousal coverage), hence the need for a cafeteria plan. The material terms of a cafeteria plan need to be in writing and the opt-out is likely a material term.

The bigger news in this notice is that the IRS in contemplating getting rid of the whole "use it or lose it" requirement.

You raise an interesting question. I don't think there is any guidance on whether an individual who is the sole owner and the sole employee of an S-Corp can participate in a standalone DCAP. I wouldn't want to bet that the IRS will give this arrangement its blessing. The conservative approach is to just take the tax credit.

All I can say is (and with a sigh) welcome to the world of welfare benefit and cafeteria plan compliance.

There is substantial uncertainty but I have taken the position that there is no statutory or regulatory support to apply the transition period to welfare plans.

The EEOC opinion was withdrawn NOT because it determined that this design is okay. In short, the EEOC withdrew the portion of the opinion where it said that a plan design that met HIPAA's requirements would not violate the ADA but it kept in place the portion where it said that conditioning coverage on completing an HRA was impermissible. The EEOC stated that it is not taking a position at this time on what wellness program plan design might meet the requirements of the ADA. There are a lot of pitfalls and open questions with wellness programs with respect to a wide variety of laws (not just HIPAA) so I definitely second GBurns's suggestion that competent counsel be consulted.

A wrap plan is the way to go. One clarification, if all the subsidiaries are in the same "control group," you already have to pass the various nondiscrimination tests, even before combining the plans under one plan number.

Sue your ex, not your lawyer, heaven forbid!

The circumstances were similar but not exactly the same. We scared the client enough so that he dropped the whole matter. I didn't have the opportunity to talk to a Benemax representative, which I definitely would have liked to do.

That raises an interesting question that I actually asked one of the drafters of the age 26 regulations: That is, who has the "right" to enroll an under age 26 child? Is it the parent or is it the child him or herself? The regs don't say. The drafter said she would get back to me but, alas, no response.

Spam

A company self-insures its medical plan. It wishes to provide coverage to a group of employees (predominately highly compensated) without requiring them to pay a portion of the premium (which it requires other employees to do). Can it require the group to pay the same premium co-pay but then gross up the premium co-pay and pay it as taxable compensation in the same pay check? What is the risk that the IRS will view this as evading the nondiscrimination tests?

I am not sure what your specific concerns are. This may be something to speak with your counsel about as you will only get general information on this forum.

I am pretty sure the Privacy Rule requires the designation of one person as the "privacy officer" but there is no reason that the duties cannot be delegated as long as one person is ultimately responsible for administering the policies and procedures. The Privacy Rule also requires the designation of a "contact person" who employees can contact with questions, etc. This contact person does not have to be the same individual as the Privacy Officer (but it can be) so that is another way to split up the HIPAA responsibilites.

Can any one point me in the direction of a discussion of how to "correct" a 409A operational violation that is outside of the formal correction program. An employee (insider) was awarded restricted stock units that vested and should have been paid no later than March 15, 2009, but were not paid until 2012. How does he pay the penalty/interest? Does he need to amend his 2009 tax return or does he just include the income/penalty/interest in his 2012 tax return? Thanks.

I agree. Consult with counsel on this.

I went down that road and that language seems to apply only in the case of repayment wages paid in "error." Here, there was no error. In any event, the IRS letter and revenue ruling say pretty much the same thing. Thanks for the help!

For posterity sake, there is good information to be found in IRS Rev. Ruling 79-311 and info letter 2005-0146.

Thanks for the quick replies! Do either of you have any authority for your position that the employer need not take any action for 2011? What about with respect to Medicare and SS withholding amounts? What "reporting" must be done for 2012?