GBurns

Isn't it against the law to ask a job applicant their marital status? If this is so, then it seems that asking for the marriage certificate of an employee would also be unlawful. Signing an attestation might be okay.

I agree but I do think that you should run it by counsel. The bug is that the employee did decline coverage rather than not being eligible. If it was a change in coverage already elected I see no problem, but this has a twist.

There are different rules for different issues. There are some state laws that apply in some states. Did they say why? It could be that the medication was not effective. There are very few medications that are the only medication that works for a particular ailment. Have you looked to see what else is used? There are very few medications that are the best for everyone. Quite often what works or one person does not work for another Was the FDA warning about your particular medication? An FDA warning about one particular drug has nothing to do with any other drug.

I advise seeking competent experienced legal counsel. The PEO can claim anything, that does not make it so. I can recall PEOs claiming that they would take on tax liability for late deposits etc. The IRS did not agree and many clients learned the hard way that the liability was theirs. Just because the state or the WC insurer recognizes a co-employer relationship, that does not mean that anyone else does. I doubt that the employee who is almost always going to be the common law employee of the client, could ever be eligible for the PEO plan. The employee provides no service to, is not an employee of the PEO and the common law employer has not joined a MEWA for this purpose. There was no mention of a MEWA which would raise many other issues. Even if there was a MEWA, this should still leave questions regarding whether or not this alleviates PPACA liability.

I do not know the answer but the arrangement raises questions. If each college has its own plan document and contract with the insurance company, Why have the "consortium's" trust account? They each file a separate 5500 so in showing the assets and values they have to pro-rate to get the amount attributable to each particular college. Why have a common account?

So is the name etc of the insured. Was the information shared with an unauthorized person?

You gave a design. I do not understand what you are looking for.

What size group and What state? If it is a small group (usually under 50 lives) there could be the issues of state insurance laws and the insurance company's Individual Application.

No, changing will not help. If the excellent explanation given by registered user is not enough, this simple explanation from Bryan Cave should be: http://benefitsbryancave.com/renew-early-pay-later/

Bill, How will you check your lines and emails?

Aren't you jumping ahead? Have you yet determined what regulations you would fall under if the MEWA is a GIA and is not an ERISA welfare benefit plan? It is most likely that each employer would be deemed to have a separate single employer ERISA covered plan. Have you yet determined the extent of state jurisdiction?

There is a lot of confusion regarding the completion and filing of a 5500, so you will see a lot of different things even from similar companies with similar benefits. I would not advise using anyone's 5500 as a guide.

Agreed.

This is a significant change and would allow an election change, if the plan documents allow it. I like to run things like this through the Tool at www.changeofstatus.com You should also look at the examples given in thr Regulations. I recall 1 that was similar.

I am curious as to why an HRA rather than a MERP? Are they going to be accumulating funds which will rollover to the next year? What is it that the HRA can do that neither a MERP nor the FSA cannot do? It is unusual, for me, to see a section 125 plan and an HRA together.

Sorry it should have been A 8 on page 31 (if your format is the same as mine).

The final COBRA regs might be your answer. See Q6: http://www.irs.gov/pub/irs-regs/td8928.pdf

There is so much information available that my suggestion is to jut use Google and read until you are satisfied. You also need to search the HHS website for summaries etc because the final rules are in this 644 page document https://s3.amazonaws.com/public-inspection.federalregister.gov/2012-06125.pdf

So what is your conclusion?

The Summary does say: "Privacy Personnel. A covered entity must designate a privacy official responsible for developing and implementing its privacy policies and procedures, and a contact person or contact office responsible for receiving complaints and providing individuals with information on the covered entity’s privacy practices." I guess that the Security Officer could also be 1 of the 2 privacy personnel positions which, as I was advised, could be held by 1 person In other words 1 person 3 functions.You might want to read the actual wording of the statute at 45 CFR 164.530(a)..

If you look at the Sample Business Associates Agreements on the HHS website you will see that the Agreement must state that the BA is required to implement safeguards including the HIPAA Security Rules. The Security rules require a security official. See 45 CFR 164.308(a)(2).There are Summaries on the upper left.

I do not follow your logic. The employee's coverage under the group health plan allows that employee to be eligible to receive the benefits from the HRA which are the expenses for that employee and eligible dependents. What does this have to do with primary coverage for the dependents? Is this any different from the treatment of FSA reimbursements under a cafeteria plan?

I do not follow your logic. The employee's coverage under the group health plan allows that employee to be eligible to receive the benefits from the HRA which are the expenses for that employee and eligible dependents. What does this have to do with primary coverage for the dependents? Is this any different from the treatment of FSA reimbursements under a cafeteria plan?

I do not understand. You stated in your OP that you see them as failing discrimination tests. The first set of discrimination tests that they will have to satisfy are the section 125 tests, but, you do not know if they have a 125 plan. So again, I have to ask what test are you referring to in your OP?

Which are the 2 failed tests? Which is "test 3"? How are the plans funded? Employee contributions through a section 125 plan?