GBurns

I doubt that you will see anything other than what is offered by the Supplemental providers such as Allstate WSD, Aflac and Colonial etc. Don't these have what you are asking for?

You never could reimburse 213(d) medical expenses through an FSA or an HRA. For FSAs and HRAs 213(d) provides the definition only. Expenses are reimbursable under 105. 213(d) appears under the section of the IRC for Deductions from Income whereas 105 appears under Exclusions from Income. FSAs and HRAs are related to Exclusions and not to Deductions. Take a hard copy of the Regs and look at the section and chapter headings.

What do you mean by "deduct premiums"? Deduct where and when?

Why not? Is there a difference between paying rent so as to have their own building and paying rent for hotel meeting rooms? They are still paying rent so as to have facilities in either case. On the other hand, you could have these charges included in the fee paid to the enrollment company.

I was not aware that an employee could waive or forfeit prevailing wage contributions. If they waive or forfeit, how does the prevailing wage be met?

The problem is really not paying into 2 plan deductibles as much as it is most likely violating the section 125 rules by changing the employee salary reduction election absent an eligible event. Have a look at the permitted changes at www.changeofstatus.com Then there is the issue of the changing the salary reduction amount without the explicit signature of the employee. How and when are the authorizations signed? You also did not indicate the plan sponsor of this section 125 plan.

I do not think it is wise to guess at what the client might mean. I suggest that you get them to be more definite and to explain what they mean and what they understand. It is possible to have an HSA/HDHP along with reimbursement of the out-of-pocket eligible expenses including deductible. BUT, the devil is in the details and what the client means might not be what you opine on.

I have a problem with your statement that your medical plan is through another company. Is this a PEO arrangement or is it a controlled group? If it is a PEO, is the arrangement a MEWA and did your company adopt this arrangement with Board Resolution etc? Aside from trying to understand if you have a legitimate arrangement in the first place, I have some other questions. How do you pay your premiums? Is it done on a pre-tax basis? If it is done on a pre-tax basis, Who is the sponsor of the section 125 cafeteria plan under which this is done? If your premiums are paid pre-tax through a section 125 plan, changes such as you out line are not usually allowed. You did not indicate whether or not there was any change in premium (either employer or employee share). Is there a change in premiums?

Is this for purposes of checking the quality or consumer reaction?

FlyboyJohn. Where did you get the information that an FSA will be limited? This is an FSA under a section 125 cafeteria plan, not an HRA.

It could be that they misunderstood what you mean. Do you mean Certificate of Coverage, which you would have received after enrolling in your employer's group plan? Ask for a duplicate or even ask your Benefits Dept. Do you mean Certificate of Creditable Coverage, which is given after termination? If you mean Certificate of Creditable Coverage, then the question is why? It serves no purpose before termination.

Your concerns should be more directed towards your state small group/employer health insurance laws.

If the Employee Benefits Plan has wording such as " This XYZ EBP will provide the following benefits: " Then it lists all of the various items Why is there need for a "wrap" document if the EBP has them listed and incorporated ?

I did not understand what you mean by "only offer affordable coverage". Affordable to whom? If the current coverage has been or is being paid, it must be affordable. In some states, under their small group/employer health insurance laws if the employer pays or any premium, coverage must be offered to all. However, there is no requirement for any employer to offer or provide health insurance.

I think that we need a definition of a "wrap" document. Is it a document for the employee welfare plan or is it a document for the cafeteria plan? What does it "wrap" etc?

Multiple welfare plans are not the same as multiple insurance providers/choices/programs/policies etc. Insurance coverage is not a welfare plan.

I just took another look at a few companies who I know do not have a wrap document. They all had multiple Schedule As, one for each insurance company, and for those large enough, multiple Schedule Cs, one for each service provider. I also do not know why you feel that a wrap document is required, but that is your choice. I do not know where you even see mention of either "wrap document" or "plan document" in the Instructions or why you feel that that is of some relevance, but that is your choice.

I have never seen anyone file a separate F5500 for each insurance company. Every F5500 that I see have multiple insurance companies and multiple products. I suggest that you browse through a few at www.freeerisa.com The filing of a 5500 has no bearing or relevance to there being a Plan Document or SPD.

Yes, for employees but not for 2% or more shareholders. A fairly good explanation can be found here, if you follow all the links: http://www.benefitplans.com/Employee_Benefits/Sec_105/Sec_105_overview.asp

I suggest that you seek legal counsel. Your current ineligibility standards might even be questionable.

And if this is a small group/employer, then state insurance laws and the individual policy terms most likely will restrict.

Remember that just because you saw it on the internet does not mean that it is true. As Chaz advises speak with competent counsel. Disregard the article. Health FSAs have nothing to do with HRAs. A number of articles and alerts etc have been put out by many credible sources including many law firms. The meaning to be drawn from the unfortunate and unexplained reference to section 106 © (2) is agreed on by seemingly everyone except the publishers of that article, and who needs a definition to support its products. I suggest that as a first step you take a look at section 106 then go to 106© and read the section title then see 106©(2) which falls under 106©. Then look up some of the many other readily available articles from many credible sources who have addressed the issue of "stand alone HRAs" and "integrated HRAs".

It seems that you might be taking 106©(2) out of context. Look at the subject matter of 106©. It clearly pertains to "long-term care benefits": © Inclusion of long-term care benefits provided through flexible spending arrangements (1) In general Effective on and after January 1, 1997, gross income of an employee shall include employer-provided coverage for qualified long-term care services (as defined in section 7702B ©) to the extent that such coverage is provided through a flexible spending or similar arrangement. (2) Flexible spending arrangement For purposes of this subsection, a flexible spending arrangement is a benefit program which provides employees with coverage under which— (A) specified incurred expenses may be reimbursed (subject to reimbursement maximums and other reasonable conditions), and (B) the maximum amount of reimbursement which is reasonably available to a participant for such coverage is less than 500 percent of the value of such coverage. In the case of an insured plan, the maximum amount reasonably available shall be determined on the basis of the underlying coverage. ************************ There have been many opinions published on this same issue and the overwhelming consensus is that what you are proposing will not work. Here is 1 which I picked because it is a collection of other opinions with cites and links: http://www.shrm.org/hrdisciplines/benefits/Articles/Pages/HRAs-Exchanges.aspx

I thought that that was what "integrated" meant.

But disclosing does not mean providing documentary proof.