KIP KRAUS

I must be confused. I thought the catch up contributions were amounts above the $10,500 so unless a person is already maxing out his current contribution, which would get him the maximum employer match any way. How the match comes into play?

You need only offer the QB COBRA for the plan he/she is currently enrolled in until open enrollment or if the QB is moving out of a coverage area.

I never said anything about fund managers, unions were a major cause of ERISA, and only the criminal executives. Did I miss anyone, banks, insurance companies maybe?

The reasons for denying claims that you site are typical legitimate reasons to deny claims in most states. Did the employee follow the claims appeal procedures outlined in the SPD? If not, he/she should do that first.

Joe: That section that says essentially that an employer may provide the provider listing separately from the SPD provided the SPD references that it is available is what I’ve been talking about. I wouldn’t thank that a DOL moron, assuming there are some morons there working there, would even expect an SPD to have 500 pages of providers published in its text. If they do expect it I’d like to ague the point with them.

Very Interesting Pax, but let us also remember that one of the major reasons for ERISA in the first place was to prevent unions from steeling their member’s pension and welfare money, but they still steel from them. I’ve read in the last 2 or 3 years about fund managers who have stolen from their funds. The government can’t protect anyone from thieves. It’s as simple as that.

Amen Bill. I couldn't have said it better. 401(k)s are legal time bombs for employers waiting to explode.

Isn’t it obvious that the Feds want to make it so expensive and difficult for employers to comply with their idealistic rules? They wont be satisfied until they force the country into a national health and welfare state like Europe and Canada. I am still going to do a good faith effort to comply. Some of what they want employers to do is warranted. Some if it is paternalistic and and unreasonable. The only time you really need a comprehensive SPD is to protect your back side in court. 99% of plan participants don't ever consult an SPD. They just get their care and then worry about coverage.

That's what I recall. Give them a copy of the provider list with the SPD. If they can got to any provider in the world you don't need a list.

I would start by contacting the local Blue Cross Blue Shield plans. If you can find a benefits broker contact them too.

It’s my understanding that the SPD need only state that a complete listing of providers is available and where that listing is available. Unless you want to have to update the listing periodically I don’t think publishing it in an SPD makes much sense, but then again I’m not positive that the DOL would agree with me. I am rewriting our SPDs and I am going to tell participants that they can get the listing from BCBS, our HR department or on the web. We have one PPO plan that has 491 pages of providers. I’m sure not going to publish this information in the SPD. If I was going to consult an organization on the DOL requirements I’d consult an ERISA attorney. In lieu of that I’m going to rely on good faith logic.

Our company is privately held so this is not an issue for us. I've also never worked for a company where company stock was part of the 401(k) so I can't really answer any of your other questions.

If the employee is an active employee and otherwise eligible to enroll, why wouldn't he/she be allowed to enroll?

I haven’t seen the Boxer/Corzine proposal, but if Boxer is behind it can’t be employer friendly. I say the government needs to keep their noses out of the pension business, especially 401(k)s. What is a fair amount of company stock that should be allowed in an employee’s 401(k) account, 10%, 20%, or 30%? Can anyone really save me from myself? If Congress wants to make it simple for the idiot employees out there that they think can’t invest properly they could dictate the investment mix an employee can have in his 401(k) plan period. Basing it on their age of course. Then they can really save us from ourselves. Do they have the guts to propose something as socialistic as this, or have they just not thought of it yet? Investing is a crapp shoot people. Corporations have been lying to investors for ever. It just backfired on Enron. Unless we can trust the SEC, IRS, corporate executives and independent auditors, we have no way of protecting our investments. I agree with Mr. Johanson, there's nothing wrong with investing in your own company.

Check you group insurance contract. It usually has limits. You don't want people jumping in and out of a plan, and neither does the insurer.

I would use the COBRA rates less the 2% admin fee. What kind of explanation needs to be given other than that’s the actuarial cost of the plan spread out among all plan participants? In other words it’s the actual cost of providing the plan. Any more detail than that is too much information. You certainly can’t give everyone an underwriting lesson. Your other alternative is to take the total cost of the plan and divide it by every employee in the plan and use that figure, but then that's not the true cost for a single person versus a person with a family. Keep it simple.

Unless you are talking about an employer so small that they can’t get medical coverage through a group insurance arrangement I don’t know why an employer would want to purchase individual medical policies. Typically an employer can get group coverage cheaper and better than an individual can.

I’m not sure about what the immigration laws allow for, but do you become covered by Canadian health care when your TN visa expires? If so, it occurs to me that even if you elected COBRA your employer could cancel it when you become covered under the Canadian system. On the other hand, the only thing I can see in the COBRA regs. Is that it applies to employees who were covered prior to termination of employment. So I would guess you are eligible to take COBRA coverage.

What alien status is “Visitor”? If your visa expires when you lose your job and you stay here, are you an illegal alien? If so, you’re not covered by COBRA in my opinion.

Kirk is correct. By the way if you look at his profile you’ll see that he is an attorney. I recall reading about at lest one case where a person signed off on COBRA coverage, but changed his mind during the election period and was still able to elect COBRA. I’ve seen a number of general releases, and never have I seen any that try to release an employer from statutory benefits such as COBRA, Workers’ Compensation, Unemployment Benefits, etc.

If you have to comply for all other participants, what would it make a difference if you do or don't apply it to domestic partner coverage? In my opinion if you have an ERISA plan you must comply with ERISA as it relates to all participants simiarly situated. Are you planning on making statements in your plan documenst that some plan provision don't apply to domestic partners? Doesn't make sense to me, but then again neither does domestic partner coverage.

I’m not an attorney, but in most states if an employee can prove that his/her injury or malady is employment related he/she files a Workers’ Compensation claim against the employer’s WC insurer or the employer’s self-insured WC plan. If the employer refuses to allow the employee to file at work the employee can usually file directly with the state Workers’ Compensation Board and they will notify the employer. Unless there is something that I’m not aware of, which could be the case, I believe that WC is the sole remedy for work related injuries unless you live in a state that has elective coverage and the employer does not participate, but this does not preclude a person from having legal representation.

I’m not an attorney, but in most states if an employee can prove that his/her injury or malady is employment related he/she files a Workers’ Compensation claim against the employer’s WC insurer or the employer’s self-insured WC plan. If the employer refuses to allow the employee to file at work the employee can usually file directly with the state Workers’ Compensation Board and they will notify the employer. Most states require employers to have WC coverage. Unless there is something that I’m not aware of, which could be the case, I believe that WC is the sole remedy for work related injuries unless you live in a state that has elective coverage and the employer does not elect coverage, but this does not preclude a person from having legal representation. I would first inform the employer that I wish to file a WC claim. If the employer is not covered or refuses to allow the employee to file a claims I would then contact the WC Board and/or a WC attorney.

Mary C: I find it odd that an attorney would advise you to pay people under a self-insured STD plan for intermittent leaves under FMLA. As you know FMLA does not require the employer to pay employees while on FMLA. A STD plan can be designed in any manner that precludes individual selection and if it does not allow for pay for intermittent leave it should be fine. Most STD plans do not pay for intermittent leave pay and typically define disability as total inability to perform your job. Even if your plan is totally self-insured, which really is a salaried continuation plan, you should be able to deny intermittent leave pay. I’d be curious as to why your attorneys advised you to do what you are doing. In my opinion there is nothing discriminatory in denying intermittent leave pay under any sick pay plan. Even in the STD mandated states, I don't believe intermittent leave pay is required, at least in New York it isn't.

By the way Mojo. Just so you don’t confuse people out there the current census data from the U.S. Census Bureau at www.census.gov says the uninsured figure for 2000 was 38.7 million, or 14% of the population. By the way, the current percentage of people in the poverty level is 31.1 million, or 10.9% of the population. Telling people that the uninsured is 50% is total misinformation. Look it up.