Greg Judd

Bzorc, I have a hunch that David Shipp's extraordinary clear-sightedness on this topic helps answer your question & explain what I was on about. My post refers to the North American Industrial Classification codes; those consume pages 17-19 of the form 5500 instructions available here: Form 5500 Instructions -Acrobat format - As for the National Association of Insurance Commissioners' codes needed for Schedule A....David, can you pull another rabbit out of your hat? If the codes are available on the NAIC's own site, they're well-hidden.... [This message has been edited by Greg Judd (edited 06-08-2000).]

Hi all, I'd be happy to send any of you a file of NAIC code info (BTW, the info IS available in the form 5500 instructions at the IRS site--it makes up the last couple pages of the instructions). We use it as part of our data products. No charge. Let me know the file format you prefer, or whether an HTML formatted reference page would do the trick.

If you operate under the assumption that nothing's really free, you might try contacting us-- info@biginsights.com or visiting benefits information group--for the same information. Different technique, same potential results. [This message has been edited by Greg Judd (edited 06-06-2000).]

Kip's points sure sound right on this one again, as usual. I'd only add that the stability of your group may influence the impact of his suggestions. If your 850 is a predictable crowd--growing as your business does, & you have a good idea (backed by data for the last 1-3 years) of how many will be leaving & coming in over the course of a year--the market's response should be more favorable than if you're changing size via buying/selling operations in less-predictable fashion.

Kip's suggestions are right on the mark. I can only add a question or two: has UHC forecast the new plan design will save the firm $$$? If so, what % over(under) projected costs with existing design? My gut reaction is the new design is likely to mildly increase costs other than Rx, assuming there's little change in the share of employees who can/will use in-network providers.

Larry's nailed this one. Non-dup COB is less a matter of self-insured vs insured than the sponsor's goals/philosophy regarding what the benefit plan is for (state laws may mandate particular COB terms, but I don't know of any state that prohibits non-dup provisions). Greg Judd CEBS CLU ChFC

I don't represent Financial Engines, & have no clients who currently use their services, but I've long admired their particular wedding of internet technologies to economic modelling. While Prof. Sharpe can lay claim to the economic modeling underlying Financial Engines 'engine', the firm's work isn't that of one man; FE has recruited some high-powered talent, including former DOL officials, to serve its client list, which is still in fact quite brief. The feature that distinguishes FE's modeling approach from its competitors is the attention it pays to the RANGE of possible investment outcomes for any given set of holdings--a nod to reality that in my judgment no one else addresses nearly as effectively. [This message has been edited by Greg Judd (edited 05-31-2000).]

I too lean toward the view that the program described isn't an ERISA plan, but would point out a) a welfare plan may be an ERISA plan regardless the funding mechanism--the presence or absence of insurance has nothing to do with it; b) I'm not sure that a program whose only eligibility requirement is employment would for that reason alone NOT be an ERISA plan. For what it's worth, Here's the CFR section pertaining to the definition of employee welfare benefit plan

I believe this may be what you're looking for (at the SSA site): Tax Rate Table & Maximum Taxable Earnings. [This message has been edited by Greg Judd (edited 05-18-2000).]

For the purpose of responding to these headcount questions, a "participant" is essentially anyone eligible for the plan in question. For example, in the case of a 401(k) plan with no automatic enrollment feature, there's no need to exclude those eligible who aren't currently contributing.

Here's some stuff that may help: FEHBP is often cited as a 'model' DC healthplan (nice piece on it in 1/18/00 WSJ "Why Health Insurance That Works Still Fails To Catch On Broadly". WSJ seems to have gotten interested in the DC concept due to dust thrown up by Bradley during the primaries; another piece appeared there 2/8/00 on the concept ("Companies Consider Letting Employees Handle Their Health Benefits Decisions"). Info available on FEHBP at GovExec.com , among other places. Xerox's name gets linked with DC health benefits, tho they've publicly backed off on the concept. eBenX is one dotcom associated with it. Booz-Allen Hamilton has boldly proclaimed DC healthplans will 'inevitably' remake the health benefits map. Business & Health magazine's latest issue features an article that's somewhat skeptical of the concept. [This message has been edited by Greg Judd (edited 03-27-2000).]

Page 3 of the 1999 edition of the Form 5500 instructions makes it sound like most employers with fewer than 100 employees should file Form 5500, unless the plan in question is "associated with a fringe benefit plan under Code Section 125", and meets the requirements of IRS Technical Release 92-01. So, it would seem the mere fact of employee contributions wouldn't of itself exempt the self-funded ("unfunded") plan.

It looks like I'm the only NON-attorney chiming in here, but we deal with the reporting requirements a lot.... JWK's nailed this one, but may have left unclear just what documents you need to fill in to let IRS know you've got a pretax contribution arrangement going. Basically, you do need to complete just a few parts of a 5500 form (sponsor name/address, plan name/number, & a checkbox (8c on the 1999 form) indicating the plan is a fringe benefits plan are about it)to satisfy the 6039D reporting requirement--at least, I'm unaware of any other 'official' format for satisfying the requirement. Based on the data, while a lot of firms DO manage to report info on their pretax contribution arrangements, a lot do not.

Paul Service bridging in its broadest sense is a company culture issue, not governed by any body of law or even any well-documented industry standards. So, for example, how a firm defines 'prior service' and/or counts all or part of that service toward current entitlements to vacation, etc, is basically a matter of company policy/culture. Re-establishment of vesting status in qualified retirement plans is another matter. Federal law (complex federal law, to be sure) covers the requirements plans must comply with here. Based on your summary alone, it's hard for me to say whether you're entitled to any re-establishment of your vesting status in any retirement plans of your current employer. My initial take is the Company A plan in which you originally participated now 'lives' at Company C, so you wouldn't have standing with any current Company A plans. Here's hoping better informed BenefitsLink correspondents chime in with their thoughts.

You're better off matching reimbursement eligibility with information you can manage, like the source of the reimbursement claim & its general purposes, rather than attempting to impose an ad hoc formulary. For example, you might ask questions like these about the claims: Does the care it contributes to fit the definition provided by IRS Publication 502 (click the Medical Care subtopic)? Was the Rx ordered by a physician or other credentialled medical practitioner authorised to write scripts, for treatment of an identified medical condition? Does the provider attest that the treatment is "primarily to alleviate or prevent a physical or mental defect or illness" (quote from Pub 502 definition of Medical Care)? There's no one correct way to reach determinations of what claims qualify or not--that's the beauty, & for some the aggravation, of spending accounts. If you work in a way that's consistent, sensible, fair, and that doesn't require you to be a pharmacist, who can find fault with that?

Kind of surprising that coalitions would be new to a firm in Oleen's business, but it's a big world.... Coalitions exist to serve a variety of healthcare provision/healthcare financing/healthcare information purposes, so it's tough to generalize, but one function they frequently perform is to provide purchasing leverage for smaller firms in regional markets. A reasonable way to begin your research is to start with the National Business Coalition on Health. As a would-be service provider (I'm just guessing), you'll be in fast company...but it doesn't look like firms in your field are involved yet. [This message has been edited by Greg Judd (edited 02-19-2000).]

Your best source will be one who resonates with your target publications' readership. While Dallas Salisbury's tops, & the consulting firms mentioned are first-rate, neither may mean anything to your audience(s). Are you writing for a general or special interest publication? For business generalists or specialists? Audience demographics? Fill us in on some of those particulars & you'll have a) better subjects to interview & b) better stories.

BLS's 1996 small business survey is here. I'm not sure why the time lag from survey to release date. [This message has been edited by Greg Judd (edited 02-02-2000).]

Tim, Only BenefitsLink could get you the skinny so efficiently on this & other matters statutory/regulatory. Dave's library section on ERISA is a great resource. I found the listing below using the "Search Title 29 by Keyword" link. Here's a f'erinstance: Here's the section where ERISA spells out what's required re: reporting a participant's benefits info: United States Code TITLE 29 - LABOR CHAPTER 18 - EMPLOYEE RETIREMENT INCOME SECURITY PROGRAM SUBCHAPTER I - PROTECTION OF EMPLOYEE BENEFIT RIGHTS Subtitle B -Regulatory Provisions part 1 - reporting and disclosure Section 1025 Click below to go to it directly: Reporting of participant's benefit rights This citation's tantalizing in that it refers to statement requirements for "benefits" information, but it may not be the ONLY reference re: provision of account status. But hey, I don't have time to do ALL the work.... [This message has been edited by Greg Judd (edited 01-23-2000).]

I'm sure Rick meant no subterfuge with his post, but it seems only sporting for posters to understand that his firm, browsable at www.corporatebenefitsplus.com,is in the business of providing--what else?--MBPs. My $0.02 on Rick's question--as attracters & retainers, MBPs are not very valuable. As potential differentiators, they may be valuable.

Let's step out of the courthouse for a moment to examine the situation: Terminated employee submits specious healthcare FSA claim a few days into a new plan year. Based on the available facts, there's no way the work was done when indicated. If employer, who happens to be the FSA claims processor, gives the person the benefit of the doubt, it is out the amount paid, because the terminated employee obviously isn't making further contributions. If employer doesn't pay, saying the claim is n.g. based on the evidence, the former employee may a) provide more conclusive evidence the claim is good, b) drop the matter, seeing their ruse won't fly, or c)take some kind of legal action which will cost the person money with no certainty of recouping the cost. Employee contributions to the FSA aren't at stake - certainly not significant amounts; on the other hand, significant employer funds may be at stake. So, claimant may merely be trying for a benefits windfall, & if the 'hurdle' to getting it is too high, they merely move on to a new job, plan, etc. Former employee has little to risk pressing the claim-unless employer makes him/her prove it, within reason; employer may have real $$$ at stake in paying without demanding further evidence - like some kind of record from the dental insurer/claims processor that it has received a claim & taken some action with it (there's going to be SOME kind of transaction record on their side that they give the participant, so why not ask for a copy?). Now the employer's action decision is down to particulars: employer's assessment of the claimant's integrity, claimant's potential tenacity in pressing this questionable claim, employer's interest in taking a firm stand, etc. No particular course of action entirely insulates you from a legal challenge; a person's right to his/her day in court (regardless the surface merits of his/her case) is part of what makes this a great country. So, making a rational business decision is about the best you can accomplish. Obviously this is not legal advice in any way shape or form. File under 'business advice'. In my view, this situation is a great example of 'real world' benefits management - "it's not the law, it's just the way it is."

Big, messy,ugly subject -which you may be able to boil down this way: avg budget: 33% of payroll made up of: statutory benefits (8.5%) health (8%) retirement/capital accumulation (7%) pay for time not worked (8%)[a category often left out - the US Chamber of Commerce numbers count it, but lots of sources, & employers, don't] other (1.5%) Be sure to adjust for items like organization size (# employees), industry, ownership, date of origin, geographical dispersion of employees, and numerous other factors.

GBurns is right (as usual)in pointing out that, correctly done, the only person taxed on a cashout is the "cashee"--the person opting out. Re: "the cash payout was always less than the employer's share of the premium": Here's where many self-funding entities really miss the boat, by equating an underwriter's 'premium equivalent' for what they really would be spending for "opt-outers". Where the plan's insured, the employer saves a "hard" premium cost. Where self-funded, the employer's only going to save whatever 'real' expenses the opt-outer might generate--and that's normally a LOT less than the 'premium equivalent'. It's sort of like the COBRA situation in reverse. I've seen several self-funded plans pay a over $1,000 to employees opting out, when had they examined their claims data more carefully, they would have found their actual spending on the 'opt out class' was under $300/yr. Net result: plan spends MORE, not less money, gaining nothing from the opt out. Only winners: those reaping the 'opt out' cash windfall. In my experience, self-funded plans are much better off putting together targeted communications on the subject of dual coverage -- many two-earner families still assume, often mistakenly, that their 'overlapping' coverage is beneficial to them. A good communications campaign may result in the behavior 'opt out strategists' are hoping for, for much less cash outlay.

Regarding Scuba's comment, while 'for hire' advisors may add to the fiduciary crowd around a plan, complicating the task of sorting out which fiduciaries are most culpable for what category of fiduciary responsibility(s), it seems doubtful that employers shed all, or even the most critical, fiduciary responsibilities with regard to their plans. What bringing in advisory entities MAY do is support any defense that the sponsor is acting in 'good fiduciary faith'. My skeptic radar would switch on if advisors asserted the main value of their services was sponsor avoidance of fiduciary duties, rather than support for the duties sponsors rightly retain.

Getting back to Len's original question, the best quantitative info I've found was right under all our noses here at BenefitsLink, in the form of a link to an IOMA survey which indicates about 20% of employers currently offer advice services, with 30% considering it. Here's an additional source, found via Google: From 12/98 CFO Net: "Today, 14 percent of plans offer access to advisory services, according to technology research firm Forrester Research Inc., in Cambridge, Massachusetts. An additional 62 percent of human-resource executives say they would consider providing unambiguous, direct-investment advice." The depth of 401k knowledge Forrester's bright-eyed techsters have you can probably read through, but you go with what you can find. I believe 401kWire or others of its ilk are trying to sell stats of this kind at their sites. DPaciorek, are you suggesting employers may inadvertently be supplying 'advice'("invest your money here rather than there") that they label as education ("investing involves risk and making choices")? [This message has been edited by Greg Judd (edited 01-05-2000).] [This message has been edited by Greg Judd (edited 01-05-2000).]