JCJD

If an employee is not eligible for an employer-provided ACA compliant group health plan, the FSA becomes subject to the ACA market reforms.

See IRS Notice 2014-55

Associates cannot enroll in DCFSA while on leave.

You cannot contribute to an HSA in the same year in which you participated in the FSA...and, it does not matter whether or not your FSA funds have been depleted. You may sign up for a HDHP, you will just be unable to contribute to an HSA.

As long as you properly communicate how the HSA works, deductions can remain in place year to year.

Check your plan documents for enrollment deadlines. Our associates are given 30 days to enroll once they provide notification. If they do not enroll during the 30 days, they have to wait until AE to enroll the child. Also, another point to consider...if you let this enrollment proceed, you will be setting a precedent and will have to provide others the same ability to enroll late.

Is Tri Care considered group health care coverage for purposes of enrolling in an employer's section 125 plan?

I know that a covered entity can be a business associate of another covered entity. In that situation, what things do you consider when determining whether or not to require a business associate agreement from the covered entity with whom you do business?

I realize the agencies have asked for comments on stand alone HRAs - has anyone heard of any forthcoming guidance? And, withouht any subsequent guidance, are any companies adding this kind of HRA now despite the possible issues?

Under PPACA, a group health plan cannot rescind coverage under the plan with respect to an individual once the individual is covered under the plan unless the individual performs an act, practice, or omission that constitutes fraud, or unless the individual makes an intentional misrepresentation of material fact. In addition, a group health plan is allowed to cancel coverage retroactively for non-payment of premiums. The Interim Final Rules set forth an example which states that an employer who sponsors a group health plan provides coverage for employees who work at least 30 hours per week. Individual A has coverage under the plan as a full-time employee. The employer reassigns A to a part-time position. Under the terms of the plan, A is no longer eligible for coverage. The plan mistakenly continues to provide health coverage, collecting premiums from A and paying claims submitted. If the plan discovers that A no longer works at least 30 hours per week, the plan cannot rescind A's coverage because there was no fraud or intentional misrepresentation of material fact. The plan may only cancel A's coverage prospectively. I am wondering how other employers, who use automated benefits systems, are planning to comply? Also, does anyone know if these rescission rules are intended to "trump" HIPAA's special enrollement rules?

Is there a voluntary correction program available for employers who inadvetently fail to submit employer contributions for all eligible associates?

One of the elements of the DOL safe harbor exemption is that "The employer receives no consideration in the form of cash or otherwise in connection with the program, other than reasonable compensation, excluding any profit, for administrative services actually rendered in connection with payroll deductions or dues check-offs." I believe the safe harbor exemptions are very strict, however, just because an employer is barred from using the safe harbor rules, does not mean that the policy is necessarily part of an ERISA plan. Rather, if the plan fails to meet the safe harbor exemption, the employer’s involvement will be evaluated on a case-by-case basis to determine whether the employer’s level of involvement is deemed to rise to the level of plan establishment and maintenance.

What if the company provides company-paid COBRA coverage?

As an employer, we give all former employees access to COBRA continuation coverage (even "gross misconduct" terminations) rather than take the chance that we may be second-guessed later. Under that logic, if we offered COBRA to someone involuntarily terminated for gross misconduct after September 1, would that individual be eligible for the subsidy and would the employer be able to recoup the subsidy for that person?