Bill Presson

Well, we are denying the claim for lack of documentation but also saying it is too late to resubmit because of the deadline. The question is, is the deadline for the initial submission. for the complete claim or is it up to the Administrator? The Accudraft document that we use says the date is "to submit". So if you deny, then you are under the appeal process just like oriecat says. If you don't want the runout to be that long, then amend the plan and make it 30 days.

I did a search and it looks like my part of the question was discussed a few years ago on here: jvanheydeApr 19 2006, 04:16 PM I'm having a discussion with our new HR director and we have a difference of opinion on the amount to which a participant in a Section 125 Plan FSA is entitled to if and when the participant terminates employment. Don't worry about COBRA for these purposes. Assume Participant ("P") elects $2,400 of coverage on day one (January 1) of the plan year and will have $200 of compensation withheld from his paycheck on the last day of each month. As of March 31, P has had $600 of compensation withheld, and incurred no claims. On April 17, P got very ill because he owed so much in taxes, and incurred the full $2,400 of medical claims. Assume the claims will not be submitted until May. Now, here is where I'm having a dispute or difference of opinion. My HR director agrees that if P continues to work for the employer and submits the claims for the April 17 services in May, the employer must reimburse the full $2,400 even though at the time of the claims submission in May, only $800 has been withheld. However, the HR director says that if P terminates employment on April 20 and then submits the claim in May, the employer "must" only reimburse the sum total of the year to date withholding ($600 - 3 months @ $200). Her position is that you can treat a terminated participant different than an active participant with respect to a claim that was clearly incurred while P was an active participant, if the claim is submitted after the termination of employment. Her position draws a distinction as to when the claim is presented (i.e., while employed or after termination), even though the claim was incurred while P was an active participant in the plan. This evidently is the position of a national section 125 administrator. To me, it guts out the concept of a risk shift if the employer's potential liability is mitigated in this manner when the employee terminates. To me, it seems that all that matters is when the claim was incurred, and it does not matter if P was an active participant or terminated participant when the claim is submitted. QDROphileApr 19 2006, 05:18 PM If you are reporting correctly and I am reading you correctly, your HR director is wrong. You are correct that it would make mincemeat of the uniform coverage rule. I would say something unkind about the national administrator, but I have doubts that it agrees with your HR director. oriecatApr 19 2006, 05:30 PM I agree with you and QDROphile. GBurnsApr 19 2006, 11:34 PM I also agree. As long as the eligible expense in incurred while covered it cannot be treated differently and must be reimbursed to the full $2400 regardless of how much was contributed by the employee. jgarberJul 6 2007, 03:14 PM I hate to resurrect this issue, but in this case where the employee terminated, would you withhold the remaining election ($1,800) from the employee's final paycheck? GBurnsJul 6 2007, 04:25 PM No. What would give the employer the right to withhold an amount in excess of the "per pay period" amount stated on the Salary Reduction Agreement? LRDGJul 6 2007, 05:01 PM The PD can be written in such a way as to allow the ER to minimize the risk of loss by withholding the remaining balance due for COBRA from the final paycheck. Assuming no conflict with state/local laws with respect to payroll withholdings. It is impossible for the ER to eliminate 100% the risk of loss in the Medical FSA. It is the intent of the regs for the ER/plan to bare some risk of loss. If the risk is eliminated, the plan does not comply. The size of the organization administering the plan bares no relationship to compliance. Some of the big players administer 125's in a way that eliminates the risk referred to in the regs and are never the less out of compliance. Not everyone plays by the rules. Some believe they're above the rules. GBurnsJul 8 2007, 04:12 PM How can the employer withhold for COBRA if the employee has not elected COBRA? LRDGJul 9 2007, 01:55 AM When the cobra election is made the 3 payment options for Medical FSA are 1. withhold from the final paycheck 2. allow cobra participant to issue a personal check or a combination of 1 & 2 the two 3. pay monthly FSA cobra payments Without the option to withhold from the final paycheck, the tax savings benefit is lost, which is the sole benefit participation in the FSA provides. It provides incentive to continue participation on a post employment basis while maintaining tax savings. The option reduces the incentive to spend the annual elected amount before termination, helps avoid forfeiture for those with expenses after termination, while maintaining the tax savings benefit. How can the employer withhold for COBRA if the employee has not elected COBRA? Cobra election by the participant/EE is voluntary. Participant/EE can waive coverage under COBRA. Cobra compliance by the plan/ER is mandatory. It must be offered to terminating participants/EEs. GBurnsJul 10 2007, 03:47 PM I know very well the procedures involved. The OP clearly stated " Don't worry about COBRA for these purposes.". In any case, outlining the options is irrelevant to this thread. The issue is not withholding for post termination participation in the FSA. The issues are : 1. The applicable cut off date for filing claims. 2. Recovering any amount over reimbursed by deducting from the final paycheck.

That run out likely began 1/1/2009 even though his employment ended 5/20/08, at least most of the documents I've seen don't specify the run out to begin on a mid-year termination at that time. March 31 was the 90th day, if that is what the plan specifies. The plan documents do need to be checked to make sure Bill's concerns are vetted. I agree that the run out likely started 1/1/09, even though I didn't say it. So let's assume it was timely submitted. I still don't think anyone has actually addressed the question. QDRO and Burns continue to act like children, so I'm just going to ignore them. Please assume the deductions happened like they were supposed to and the participant actually had $418 withheld before he quit. If he submits the claim AFTER he terminates, is the plan still obligated to pay him the full $988?

I'm a bit confused about a couple of things, so please bear with me. 1. Participant elects to have $38 per pay period withheld for 2008. 2. Participant quits 5/20/08 so he has probably completed 11 of the 26 pay periods and had $418 withheld. 3. I think we are all in agreement that if he turns in $988 of claims on March 31, 2008, the company/plan would have to pay the full amount. 4. The OP says that he comes in and submits the claim on March 31 and I am assuming it is 2009. Questions: 1. With this scenario now laid out (assuming I'm accurate), does everyone still agree that he is eligible to receive the full $988? 2. What is the "run out" period? I'm guessing 3 months/90 days, but just want to make sure he didn't miss a deadline.

The only test is how many people were eligible to participate on January 1. That includes any employees that became eligible on January 1, so it's not the same number as December 31, 2007. It also includes terminated participants with account balances. Now, assuming the plan was effective in a year before 2008, that number would have to be more than 120 to be required to have an audit.

The majority of our plans are cross tested physician plans. We have almost every plan set to have forfeitures to reduce. When we're trying to target the contributions for various groups, I don't want to have to worry that we need to consider $47.53 for each person as a forfeiture to get them to the needed number. We just do the calculation and then subtract the forfeitures from the amount that gets ACH'd. Seems much cleaner to me.

Sorry I missed part of the rules. I should have known better than to comment on IRA's.

That's where you are wrong. To be tax free they still have to be a "qualified distribution".

Guess I need to just sit here and hush then. Sorry about snapping off an answer without thinking it through.

If it wasn't eligible for rollover, then Plan B should send the money back to Plan A and let them deal with it.

And since you're refunding deferrals because of a 415 violation, I don't think you have a deduction issue. Deferrals don't count against an employer's deductible limit anyway. So no 10% penalty.

Rules about what? Who owns it? How much can be spent? What income is reported?? You need to be more specific.

Can you Pick and Chose which Otherwise Excludable Employees to exclude and which to excluded? For example, exclude only the Otheriwse Excludable Employees who did not defer, and include the ones who did defer? The easist way to make that determination (I've found) is to ask yourself: If I do "X" will it help me/my client? If the answer is "yes" then it's not allowed.

1. I agree 2. line 28 is correct for the owner's amount. Schedule C is for any employee contributions 3. I assume you mean a penalty for nondeductible contributions, which is correct if 1 is accurate.

I would guess you need the cooperation of the DOL investigator. That's who you should call.

This whole thing seems very odd to me. The person receives no paycheck, complains and the sponsor says sorry? I have never worked for or with any sponsor that wouldn't immediately act to correct the issue. I'm leaning towards calling BS on this one.

S Corp dividends are not considered earned income.

FWIW, we always recommend using the money market account and we always recommend using forfeitures to reduce the employer contribution.

See if you can find something titled "Compensation while a Participant." Or similar.

This is what we would do.

I believe that what Tom is trying to say is that your testing compensation does not have to be the same as the allocation compensation defined in your document. You are able to use another definition as long as it satisfies 414(s).

We haven't had any Relius speed issues. Microsoft Office 2007 is much slower however, which might be the case with your spreadsheet.

1. you can look at the events link on the front page of benefitslink.com 2. you can call NIPA and find out about approved seminars 3. you can search the ASPPA web site. Those seminars generally qualify for APA credit as well 4. you can search the Relius and McKay Hochman web sites 5. you can search the DOL website for seminars

If disability insurance is paid for on a pre-tax basis, then the proceeds are taxable. So, they are likely correct on the additional W-2. Someone else will have to help on the allocation compensation.

Here is a number you can call to confirm receipt of 5500's :EFAST Help Line 1-866-463-3278 . All you need is tax ID and plan number. Not sure about checking a specific year or not.