GBurns

You seem to have complicated a simple issue, so it is likely that I do not understand what you have described. It seems that all you want is a group health insurance plan with a $5,000 deductible and Rx coverage. The employer will also fund a MERP to cover expenses after the first $500 up to a limit of $5,000. It should not be hard to find such coverage as long as you do not complicate the issue as you have done in your post.

Sections 125 and 105 explicitly require prospective election, so the election must preceed the date on which the income is earned. To answer your question, the dental election does not have to be turned in early, but, by not doing so, you are complicating the enrollment etc. Why create unnecessary problems?

After quite some consideration, I have to concede that @zbenefits is correct to some extent, He is correct regarding the exemption from ACA of a less than 2 participant plan. But, being exempt from ACA does not help because HIPAA, ERISA, state insurance law and the individual insurance contract prohibits the reimbursement of individual health insurance policy premiums, which is probably why there is the exemption cited by @zbenefits. First, I must address some errors made by @zbenefits 1. While an HRA is a section 105 self-insured medical reimbursement plan, it is not the same as a standard 105 MERP and is also different from what he refers to as a Healthcare Reimbursement Plan, HRAs are explained by the IRS in Notice 2002-45 etc. 2. The reference in section 105(b) to section 213(d) is solely for the definition of "the expenses of medical care" and is not for the listing of the items which comprise such expenses. You will have to read a number of IRS Written Determinations etc to really understand IRS wording. 3. Your citing of 42 USC 300gg regarding "a group health plan" does not support your interpretation and subsequent comments, because it states: (6) EmployerThe term “employer” has the meaning given such term under section 3(5) of the Employee Retirement Income Security Act of 1974 [29 U.S.C. 1002 (5)], except that such term shall include only employers of two or more employees. We are discussing a case with a single employee. 4. There is no explicit law that specifically allows the reimbursement of individual health insurance premiums. Since we are discussing an employer with a single employee, most of the cites are irrelevant. What is more relevant than the tax issues are the issues of state insurance laws and the insurance contract, neither of which are pre-empted by ACA etc Almost every Individual Application for Health Insurance has a certifying statement by the applicant that this is not an employer sponsored plan and that the premiums will not be reimbursed, directly or indirectly, through wage adjustment or otherwise. Almost every state prohibits a small employer from reimbursing individual premiums by any means and also state that if any part of the arrangement is treated under section 106, section 125 or section 162, the entire arrangement falls under state small group heath insurance laws. So regardless of Federal tax laws or ACA, the insurance policy and state law prohibits the reimbursement of individual health insurance premiums to employees.

@zbenefits Note that "the market reforms do not apply to a group health plan that has fewer than two participants who are current employees on the first day of the plan year.." (emphasis mine) Brett posted that the "employee who has purchased his own health insurance policy". This means that we are dealing with reimbursing and individual health insurance policy and not a group health plan. The exemption that you cited is not applicable. What is applicable and on point is the prohibition on "Employer Payment Plans".

Contributions to an HSA require coverage under an eligible HDHP. But, that is not an issue in this case. The employer will be paying the premium and the HRA will not be used for premiums, but will only be used for out-of-pocket expenses. In this case, there are no restrictions on using the funds in the HSA for eligible medical expenses even though she has an HRA for the same purpose. However, remember that you can only reimburse or pay for an eligible medical expense only once. No double dipping. She can start using the HRA as soon as she is not covered under the HDHP. There are no restrictions on the availability of the HSA funds for eligible medical expenses. However, I suggest that she clear this with her HSA Administrator.

Before the pay date from which the first salary reduction is made.. Not the date of the payroll but the date of the first earnings affected.

The query specified an individual health policy which would make the issue of "a non-group" moot. There is no way, that I know of, to either reimburse an employee on a tax free basis or to not report the reimbursement as taxable wages. This used to be possible under Revenue Ruling 61-146 but is no longer the case as outlined in recent IRS Notice 2013-54 http://www.irs.gov/pub/irs-drop/n-13-54.pdf If Brett does a search on Google using "IRS Notice 2013-54" he will see many items from many law firms and tax consultants explaining why it can no longer be done. The IRS has further advised that some employers who violate this rule might be subject to large fines: http://www.irs.gov/Affordable-Care-Act/Employer-Health-Care-Arrangements http://www.swlaw.com/blog/employee-benefits/2014/06/11/the-irs-meant-what-it-said-in-notice-2013-54-employers-who-pay-for-individual-health-insurance-policies-for-employees-on-a-pre-tax-basis-face-massive-penalties/

It is as it always was, the employee must be a bona-fide employee who may cover their spouse and dependents, including the owner. A self-employed person and a greater than 2% shareholder cannot be an employee. Here is an explanation: https://www.tasconline.com/products/bizplan/section-105-plan/

It would be best to ask that CPA for proof of his position, in case you misunderstood or he misspoke. I do not deal with small entities, but as far as I know, he is wrong.

I suggest that you contact Concordia. They should have this already set up for Lutherans. http://www.concordiaplans.org/who-we-are/about-us.html

Your scenarios are based on market reform requirements and guidance. If non-compliance predates market reforms and the guidance on which your scenarios are based then logically your scenarios are based on a wrong assumption. You seem to be relying on "reading of the more recent guidance" and coming to the conclusion that a "non-integrated HRA" is something new. It is not. If your arrangement was never ever compliant, then your start date for correction is Day 1 of the arrangement.

I suggest that you first consider that this is not new law and that non-compliance might have existed long before the guidance to which you refer was issued. The guidance clarified existing law and therefore would make your scenarios incorrect.

In this case, it is integrated because the Minister is covered under his wife's employer sponsored group health plan. In IRS Notice 2013-54 etc the prohibition is against the reimbursement of premiums related to individual health policies. http://www.irs.gov/pub/irs-drop/n-13-54.pdf See III. GUIDANCE. Question 4 and the sections on Integration Methods.

Chaz raises some good points. I think that your easiest solution is to have a benefits lawyer set up a section 105 MERP for you. You would vet the expenses when submitted then reimburse. There would be no pre-funding and your commitment would be for eligible expenses (if any) up to whatever limit that you set. The lawyer should not cost more than $200. I do not know your denomination, but the larger denominations seem to have this already set up for the smaller congregations, but you have to ask for it.

I have not heard of Intuit having been hacked, but I have been getting some very authentic looking emails. However, if you look at the address of the link that it wants you to use, you will see that you will be taken to what seems like a very suspicious website that does not have Intuit in its name. I have hear that the State of Minnesota is not accepting tax returns done with TurboTax. I wonder if there is any connection?

Clarifying Health. I suggest that you get some competent legal advice regarding these Zane items that you often link.

I understand sex and age but I have not seen "but rather are based upon Number of children, their ages, age of the employee and age of spouse, and the sex of all."

You have a unique interpretation of Delta. How did you get ADEA into it or into Title VII?

ERISA preemption is not absolute, it depends on the facts and circumstances of each case. There is always an "If". "If a claim can be brought under ERISA § 502(a), then the state law action is completely preempted by ERISA § 514(a). See Ingersoll-Rand Co. v. McClendon, 498 U.S. 133 (1990) (a common law wrongful discharge claim that an employer terminated or otherwise discriminated against an employee to prevent the employee from vesting in a benefit or to prevent accrual or receipt of a benefit is preempted by ERISA § 510);" Why di you pick on ADEA as being the only thing applicable?

I gave the EEOC link not for ADEA but for its reference to state law. State labor and employment laws are not pre-empted by ERISA. "The Age Discrimination in Employment Act (ADEA) only forbids age discrimination against people who are age 40 or older. It does not protect workers under the age of 40, although some states do have laws that protect younger workers from age discrimination."

One law does not necessarily negate another.

The problem is the building permit and the inspectors (IRS)..

I doubt that age discrimination would be allowed under either 105 or 125, but truthfully, I have not looked because I think that HIPAA, ERISA, FLSA, EEOC and even state law that would prohibit it in a few states. Also for public entities and certain other employers there is the Age Act. From EEOC: http://www.eeoc.gov/laws/types/age.cfm This article cover some of the main issues, but unfortunately does not give cites or links: http://www.shrm.org/templatestools/hrqa/pages/offeringdifferentbenefitsfordifferentemployees.aspx Age is not an acceptable classification under 105, 125 or HIPAA. While age is not specifically addressed, the issue of similarly situated employees is prominent: http://www.dol.gov/ebsa/faqs/faq_hipaa_ND.html Then there is ERISA 510 and FLSA 18C which both prohibit interference, denial or restricting an employees right to a benefit. Then there is ACA. If your client plans to go ahead, I suggest that they do so only after seeking competent legal advice.

And the same to you If you "offer" to match the under-cut prices, those posters should have to reduce their prices. Then they will discover that they are not generating enough cash flow to meet expenses and will have to raise their prices. Remember that the services are less for the lower prices. It is not an apples to apples situation, so be sure that you also cut services . It should only be a short lived problem.

I do not think that you will find any. In general, there is nothing that can exist or be done prior to date of incorporation simply because the entity did not exist and there was no one with authority to adopt etc. There might be some actions possible if it was a conversion from a sole prop but only if the sole prop was eligible to have such a plan, which is doubtful.