KIP KRAUS

I don’t know where the representative from your administrator got his/her information, but it’s my understanding that the maximum $50,000 available for a loan is less the highest outstanding loan balance in the previous year. I’ve never heard of the 50% rule you mentioned.

Lorie: I don’t know what the state law mandates specifically, but if you are in fully-insured medical plans the insurers will determine COB. Give them a call. Your Summary Plan Descriptions should also give you the information. In my opinion, it shouldn’t be a problem in fully-insured plans because. As I said, the insurers will make the determination.

If you have an insured medical plan I'd check with the state Insurance Commission as to the legality of canceling coverage retroact. My guess is that it is illegal.

I agree with the EO.

For what it's worth, right or wrong we do not let employees change plans if their doctor doesn't participate in one of our HMOs. Usually that type of information is available before a person enrolls in the HMO.

Jean: That doesn't make sense to me. If you were actively at work on the day you were fired your coverage should end on that date. Check with the insurer. Did the employer offer you COBRA?

I'm afraid you may limited because of the small siez of your group. If there is a benefits broker in your area I recomend contacting them.

Kim: I have no misconceptions about self-insured plans not being controled by state legislation. I just thought I had missed something when I read your first response saying self-insured plans were exempt, but didn't point out the the stop-loss insurance was not exempt from state law. The problems you point out with stop-loss coverage can be a problem regardless of lasering and the risk in a self-insured plan is always a crap shoot.

Rmg if I'm not mistaking stop-loss in New York is also viewed as property and casualty coverage. Therefore, it must be subject to different underwriting criteria than group insurance. I have never seen this lasering type of underwriting, but it makes sense from an underwriter's perspective. Like you, however, it does not appear that this type of singleing out would be discriminatory, because it would be transparent to covered individuals provided they recieve the identical medical coverage as other plan participants.

KGibson: Isn't stop-loss coverage an insured product? Why wouldn't that be regulated by the state insurance commission?

Mojo: That was exactly my point. There's more than one way to skin a cat.

Contact the county offices. They should be able to answer your question.

Let’s see now. If I was a key executive in a company and I decided to take a loan from my 401(k) plan for $25,000, and if at my discretion I decided to invest it with my employer for a return of 10% after 90 days, I think I might do that. However, if I did I would want my employer to write me a check for the principal and interest at the end of the 90-day period, and then I’d pay off my 401(k) loan. Seems like an arms length transaction to me. I’m not sure what would prohibit me from lending my money to my employer or anyone else. Who would object?

Our Plan Trustee is Vanguard and they say that the loan initiation fee must be part of the loan if not paid by the plan. Therefore if the loan is for $5k then $75 is deducted from the loan and $5k is amortized. Don't know any site for their reasoning, but they said if the $75 was simply deducted from the participant's account and the full amount of the $5k loan was given to the participant that the $75 would be an in-service-distribution from the plan, which the participant would otherwise not be elibile for as an active employee. Made sense to me.

Based on what regulations you are talking about there can be varying definitions of "employee". For the most part insurance companies look at eligible employees as their definition of an employee. This could mean employees who work anywhere from 30 hours a week to 40 hours depending on the insurer.

I vote for N0.2. In our case that's the way we do it.

M Mirkin: The first thing to understand is that FMLA allows employers to have DBL/STD benefits run concurrently with FMLA. In our case, any employee who is out on NY DBL is automatically on FMLA beginning the first day of disability. In the case of a maternity related disability, once DBL payments end the employee may continue her FMLA up to the maximum number of weeks remaining. Therefore if her DBL payments end after 6 weeks, which is typical for normal delivery in NY, she can continue FMLA for the remaining 5 weeks. She has 5 weeks remaining because she will not receive DBL payments during the first week. By the way, as far as I know NY does not have a family leave law.

Because the investment firm to which he rolls it over to could charge him an early withdrawal fee. I don't think that has anything to do with the 70 1/2 rule. It just has to do with investment compnay policy.

I have never heard of a plan document that combines two or more pension plans, especially with two or more plan numbers. I've always seen pension plans filed as separate plans. Welfare plans (i.e., health, life, dental,stc.) on the otherhand, can fall under one plan document and one plan number. If I was going to contact a peofessional regarding this issue I'd contact an ERISA attorney, not an accountant. Don't get me wrong, accountants are great at auditing and filing plans, but I don't look to them as authorities on ERISA. Just my preference.

I agree with Kirk. However, It sounds to me like he needs the money if he's worried about the 20% witholding if he rolls it into an IRA and needs the money he may have early withrawal penalties from taking a distribution.

Kirk: You’ve peaked my interest with your post. Why would federal law trump state law with regard to a legal marriage? If I get a sex change does this mean I can be covered as a female under the state and federal EEO laws? Why would the EEOC care about this situation any way? Please educate us.

The employer only has to offer the same coverage that they make available to active employees. Making a change in carriers or coverage is perfectly OK as far as I know. In fact, we just dropped an HMO, but the one that remained as an option was almost identical and 99.9% of Drs. are the same. The only gripe I wouldthey didn't tell you in advance.

Just my guess, but if the laws in the state where they reside continue recognize their original marriage I'd say you need not do anything. What does the insurance company or TPA say?

Good discussions, but I guess ol Uncle Sugar Daddy didn’t think about this scenario. I thought the government thought of everything to protect us from all evil wrongdoing.

rcenturion I would agree with you, but isn't there a requirement to give the canceled spouse a HIPAA notice of credible coverage when his/her coverage is canceled?