GBurns

I thought that the issue was having the FSA reimburse an expense for a procedure that was NOT covered by insurance, so the deductible should not be an issue since nothing would have been submitted to the insurance company in the first place. I think of this as being no different from an employee whose insurance coverage does not include maternity, and who submits a claim for reimbursement for maternity care expenses. Maternity is not covered by the health insurance but the expenses of medical care for maternity are certainly eligible medical expenses under 105 and 125. Or you could think about prosthetic devices. Or eyeglasses if no vision coverage. Would you reimburse from the FSA?

Any particular type of Wefare Plan? Any particular aspect or issue? Try Thompson, BNA Portfolio Series and CCH. I am not sure what EBIA has other than a good Cafeteria Plan Manual.

Can you name a few products that are actually called "Institutional Life Insurance"? Can you name a few of these that have been "filed specifically for ownership by a business. Others for owners or employees." ? What states allow this? Can you name a few companies that use the term "Corporate Benefits Administrator" to describe the agents? I am not saying that these things do not exist as you state, it is just that I have never heard of these and I cannot find anything that explains or coroborates what you state.

I do not understand what you mean by "not available to the general public". I thought that insurance products were available to anyone who qualified. I also do not understand "though normal agent channels". I thought products were available only through agents. However, I am aware that there are some products that are used in the Advanced Market and other specialized areas, that some "regular" agents might not service. But that does not mean that the product is not available to every licensed agent. I am also aware that there are some "proprietary" products which are restricted to "special" agents. Are you saying that these particular insurance policies are restricted to certain agents or agencies? I also was not aware that anyone other than licensed insurance agents could sell insurance products. A lawyer who has an insurance license and who sells an insurance policy does so as a licensed insurance agent not as a lawyer. So a CBA, whatever that is, would also be selling the insurance policy as an insurannce agent not as a CBA. Which, to me, means that it is the insurance agent who has access to these products not the CBA. COLI and BOLI are not insurance products or policies. They are just the designation used to describe the ownership of the insurance policies. The underlying insurance policies could be Whole Life, Universal Life or Term Life in any of their various forms. In other words you cannot buy a COLI policy but a Corporaton/Company/Bank can buy an insurance policy and if it retains the ownership the insurance policy is regarded as Corporate/company/Bank Owned Life Insurance (COLI/BOLI). I cannot see what ILI has to do with COLI or BOLI. I have never before seen or heard of Institutional Life Insurance and a Google search did not bring up much. Is it that "Institutional" does not refer the product but to the target market. I know of Private Placement Life Insurance and other "Investment" life insurance products that have the characteristics that you describe. I also know of certain very high cash value/low death benefit policies that can be structured to do almost as well. None of these are referred to as Institutional Life Insurance. But all can and are sold to institutions.

mjb The real reason why you no longer respond to my posts is not related to "irrelevancy". It was because you were challenged to explain why you think that any post is/was irrelevant or wrong etc so that other posters could then either agree or disagree with you. When you could not do so successfully, you then took the postion of not responding to my posts especially those that question your posts. I notice that there are now others who do question the accuracy and relevancy of some of your posts.

What do you mean by "limited scope" ? What is it limited to? An item does not have to be covered by the health insurance policy in order to be reimburseable by an FSA. An item only has to be a covered (by the FSA) item and be an eligible expense for medical care.

Mark What is "institutional life insurance" ? Who sells it ?

yanfan A previous poster in responding to another poster stated that " You are also ignorant of the economic issue in govt plans- employees are covered by a state sponsored DB retirement plan that usually requires employee contributions of 5% of comp or so which means that employees have less discretionary funds to invest in a DC type plan." Yet here you are another NJ public school employee investing discretionary funds in a 403(b). And in a no load/low load fund at that, something that the same poster mjb thinks is not readily available. As far as I know Vanguard and other low cost providers are available in NJ and public school employees do somehow have money that they invest with such providers, and apparently in sufficient numbers to make it worthwhile. Am I correct as far as you know ?

I guess this case shows that it is not the amount of money involved that counts, it is the principle, and it applies to both issues, the segregation and the deposit. . I also wonder whether the use of a non-interest bearing account really mattered. http://www.mhco.com/Commentary/2006/DOL_De...eded_060806.htm Does anyone know which case this was?

When I saw this item I remembered this and another thread where this issue was discussed. I particulary noted the comment about DOL agents in various parts of the country (implied widespread ocurrence) and the very small amount of money involved (implying that it is the principle that counts). http://www.mhco.com/Commentary/2006/DOL_De...eded_060806.htm

I assumed that it was from a plan checking account. If it was from a Trust, Custodian, Brokerage etc then it would be very unlikely that the OP would have known factually that the check was not cashed.

How could the Trust bank account or any account be zeroed out if there are uncashed checks? The uncashed checks would be outstanding and the amounts would still be in the account. With a remaining balance in the account it could not have been closed and therefore there should be no need to "re-open". I do not have an authority to cite, but logic dictates that until a recipient cashes the check how can the money be anything but still plan assets. A payroll check is not paid if the employee never receives it. Your mortgage is not paid if the servicer does not receive the check. Drawing and mailing a check has never been proof of payment for anything, So why would it be otherwise just because it comes from a QP?

AlanB I always advise my clients to use qualified competent help whenever possible. I advise you to do the same for a few reasons. There are things that you might miss and the consequences will cost more than if you had used a TPA. Plus you can blame etc the TPA for errors. It is more profitable to work on building your business than working in your business. For example if you are currently making $84,000 per year ($1,600 per week) that equates with an hourly rate of about $40 per hour. It makes no sense to answer your own telephone, type your own letters, do your own payroll, take deposits to the bank, go to the Post Office, do filing etc etc or any other clerical function if you can easily hire competent clerical help for $20 per hour. And it is possible that you might only need this clerical help on a part time basis. Why do $20 oer hour work when you can do work worth $40 per hour? How much more valuable would your time be if it was instead spent on getting more business, or getting the jobs done faster or better? Let someone else sweat the little stuff for you.

Maybe Tony will let us preview his review of the book.

Since a party does not have to be a "named fiduciary" but can very easily become a fiduciary by means of actions taken, whether services rendered or advice given etc, the cited DOL Reg 2509.75-5 seems irrelevant. There have been numerous cases, reports, articles and I even think that there was a fairly recent DOL release or opinion on the issue of parties, including professionals, becoming liable fiduciaries because of services rendered. There was even a thread on this Board about this a few months ago in which cites were given. It also does not matter whether this TPA is now or becomes a fiduciary. This does not have any bearing on either the subpoena or any action that might be taken by a participant etc. in the future. The TPA whether also an Actuary or not, IMHO, should seek competent legal advice regarding what might or might not be withheld or not complied with, and most importantly how to properly do it. To not comply would be foolhardy. The matter might be resolved either by compromise or counter filing etc but whatever action is taken, it needs to be with competent advice and needs to be proactive.

If any of these funds "left over" were derived from employee salary reductions that were the employee share of the "cost" of the self-funded coverage, I do not think that there is any authority that allows these funds to be used for other than the purpose intended and therefore could not be used as part of the employer cost of the new fully insured coverage. What is the source of these funds? What were you intending to label the contributions to the fully insured coverage as? Employer premium or employee premium contribution?

If the regulations were finalized way back in 1996 and effective 1997, it seems a stretch to claim not to know that this issue should have long ago been corrected. So while it seems hard to go back 10 years rather than just 3 years, I would look out for an auditor to claim plan failure etc. if you do not go back 10 years. The "technology change" date should not matter since it did not matter with the payroll tax deadline date. The needed technology was widely and readily available prior to 1996. But I guess a date has to be selected and should have some rational reason. While it could be that the DoL might only audit 3 years back on a "normal" basis, this might not be regarded as normal. How far back can they go if fraud, fiduciary failure etc is the claim? How far back can the IRS go especially if driven by employee complaints ? Isn't there some written guidance on self correcting this issue? Could there be an employee lawsuit for losses caused by the late deposits if they become aware of the issue especially because of this correction process?

So where does that put BCBS and all the other not-for-profit providers? Where does that put many HMOs? They are not commercial insurers and they are not-for-profit entities. Also can you say MET or MEWA? Aren't most regulated under state insurance regulations pertaining to the business of insurance?

No! Don. Also if a plan provides insurance it IS in the business of insurance. Although "provides insurance" might not mean the same thing to both of us. I noticed that although the TOC was dated in late 2005, the list did not include ERISA, USERRA, FMLA, ADA, COBRA and Medicare. Of course Medicare Part D would have been since. There was also no mention of QMCSOs, HIPAA Privacy and HIPAA Security.

The May 18, 2006 EBIA weekly had a list of the major Federal mandates. Maybe someone has a copy they can let you have. The list of Federal laws that could be applicable is lengthy. There also are applicable state laws. I do not understand why you would be helping nor why the client would be negotiating something like this without first having the required knowledge. I suggest that you seek competent legal advice. I would not rely on an ERISA attorney, per se, since that attorney could very well only focus on ERISA. Seek an attorney that handles all laws related to health and welfare plans.

Isn't a divorce decree and divorce property settlement different and separate items from a DRO ?

Why would there be any higher marketing costs for selling to a SD as opposed to selling to any other employee group? How would any higher marketing cost be "passed" on to the employees of an SD? The sales loads etc are not variable at will, they are set with the product and product approval. As a result the sales charges for a particular product is the same regardless of purchaser. The marketing costs associated with selling to an employee is usually borne by the sales rep who is compensated from the sales charges. The sales charges do not differentiate by job description or location, so an employee of a SD pays the same as an employee of a hospital. It is the fact that there are no or little sales charges which which to reimburse or compensate the sales rep that leads to there being very few sales reps being willing to sell those products. Very few or no representation is what causes the low load providers to not have much presence in most SDs, not the inability to pass on any alleged higher marketing costs. There is also the reluctance to service SDs caused by the Hold Harmless requirement and the service fees charged by some SDs. The situation is even further aggravated by the requirement that some have for a minimum amount of new cases in order to get a payroll slot. No or little commission means that very few, if any, sales reps will make the initial thrust to get these "start up" enrollees. On top of all of this is the issue of endorsement and sponsorship. Without endorsemnt or sponsorship by an employee union, most sales reps in most districts have restricted access to employees of SDs. As a result the employees tend to see, on SD property, mainly the sales reps from the providers that are endorsed mainly by the teachers union and NEA. These unions endorse the providers for revenue. No or low sales charges means no or low revenue to the endorsing union. Sales reps whose providers are not endorsed have to try and canvass employees off premises during the employee's non working hours. This severly restricts sales. Sales reps generally are reluctant to work for no or little commission from fewer more difficult and restricted sales. The result is that the low cost providers get no representation and therefore very few sales.

I am assuming US Virgin Islands. Does the US Virgin Islands have any governing regulations? Does the US Virgin Islands require registration by the Mutual Fund? Does the client have a US residence also? Where? What is the citizenship etc status of the client? Does the client have a proper Social Security Number? Where did the solicitation and transaction take place? Does the Mutual Fund accept deposits etc from non-continental US residents? The Mutual Fund probably has already addressed such legal issues and should be the best source of information on the issues. I do not think that it matters since I have for many decades seen no-resident aliens (people from many other countries) open accounts with mutual funds etc with no problems, except distribution taxation and termination issues. But that does not mean that it is legal or problem free.

I know that this is not my area, but I do have the ability to read and understand posts and to find any cites given. However, this thread and the other thread seem to have something in common. There seems to be 2 interpretations for which sides have been taken, but those on 1 side seem to have no or very little actual audit experience, while the opposing side seems to have. In other words 1 side relies on their interpretation and theory whereas the other side relies on not only their interpretation but on field tested audit experience. An old adage comes to mind, "The proof of the pudding is in the eating".

But what is your determination as to the amount of compensation?