French

No this is no joke. The TPA is a very large insurance carrier and believes that the reports they provide are sufficient for an ERISA audit.

For the past few years, our audit firm (one of the big 4) has performed an annual ERISA claim audit for our self-insured plan on-site at the TPA. For 2008 we have changed to a new TPA. As part of our contract discussion, we wanted to include specific language addressing this. According to the TPA, this is not standard with their other accounts. Is the audit firm (which we have also changed for 2008) following a specific guideline or just being overly vigilant?

We are considering expanding our definition of eligibility to cover home schooled children but want to require some type of verifiable documents. We've been told by an employee that the State of Texas does not require any documents. Does anyone have knowledge of this and perhaps provide us some guidance on how to deal with this matter?

We will begin offering same-sex domestic partner benefits in January. We are working with our payroll department to set up the federal and state taxation. We only offer a 2 tier structure - individual and family. My understanding in general is that if an employee elects to cover a same-sex domestic partner who is not considered a tax-qualified dependent , the cost of coverage for that individual must be deducted on an after-tax basis. Is there any difference in the way we would set up the tax status if the employee already covered a biological child and therefore had family coverage and now choses to cover a same-sex domestic partner? I have not been able to find a lot of information about this.

The wish came true - the Yankees are gone for another year Go Red Sox!

As a result of doing an RFI, I have now learned quite a bit about these programs and the institutions that offer them. I however have been asked an additional question by senior mgmt. concerning reporting the value of this benefit on a 1099 form. Does anyone have any experience with this or should I just refer this question to a tax lawyer? Thanks.

An employee's spouse will begin teleworking shortly and we were asked whether contributions to the Dependent Care FSA can be reduced as a result of this change. Our SPD identifies a qualifying event as an employment status change that affects eligibility which I do not believe this situation fits. However I think it is a valid question especially in today's working environment as often times working at home is the only way one can retain a job and this might not have been predictable. I assume that we are not the only employer that has been asked this question. Thoughts and comments based on the regs??

Here is the BLS link with 2006 data http://www.bls.gov/news.release/pdf/ecec.pdf

Thanks - I did find some information on both the BLS and DOL websites.

Our new CEO is interested in offering executive physicals as a perk. He is apparently interested in a program similar to that at the Mayo Clinic. I have obtained some benchmark data on prevalence and am now seeking more specifics - tests and screenings included, costs - anything that may be of value. Thanks.

I am looking for benchmark data for total benefits as a percentage of payroll. Can someone suggest where to look or a survey that we can participate in for this information. Historically we have used data from Hay but we are looking for a new or additional source. Thanks.

We are a medium size employer with a small location in Omaha, NE. We are interested in offering a group health plan at this location if possible. Can someone suggest an insurance carrier besides BCBS? We've already been in touch with our Aetna rep with no luck. Thanks.

We will be offering nutritional counseling with an on-site dietician as part of our "wellness" programs. From what I have read, unless these services have been prescribed by an MD for treatment of a specific medical condition, they would not be reimbursable. Is my interpretation correct or is there some wiggle room?

Been a while since one of these questions has been brought to my attention so I am requesting your assistance. I think the answer is cut and dry but I've been wrong before. Employee is married and elected family coverage in our medical plan but only lists one child Spouse has individual coverage at her current employer. She gives birth 2 weeks ago and is currently out on short term disability with her employer. Employee has requested one of 2 actions: (1) add spouse and newborn to our medical plan or (2) drop coverage entirely with us and join spouse's plan Can he do either under HIPAA? With respect to #1, it is the addition of the spouse that has me unsure despite everything that I've read and for #2 it is dropping coverage outside of our Open enrollment period. Your help/comments are greatly appreciated.

Can a QPSA notice be distributed electronically? I read some time ago that the IRS and Treasury were considering this but don't remember seeing anything else about it. Thanks.

Has anyone implemented a smoking surcharge for health plan coverage? We have been asked to consider this and I have explained some of the requirements due to HIPAA. I have several concerns/questions the first of which are (1) obtaining the information and maintaining privacy for employees and/or dependents, (2) if we were to require employees to enroll in a smoking cessation program to avoid the surcharge, are we responsible for the cost of the program? I would prefer to work on wellness in the organization with a positive spin with incentives for healthy behaviors - plus I would assume the smokers would question why we aren't targeting those with other unhealthy behaviors. Any thoughts would be wonderful.

Don, Thank you very much for such a quick response and the link.

Hi, Does anyone know if there is a resource to find out all the current state mandated health care benefits? Thanks.

We had out auditors sign a BAA in 2004 before they began auditing our health plan for 2003. We had no resistance from them though there were several versions of the BAA before final signatures obtained.

Here are some examples of what I've heard and read: 1. If an employee quits mid-year and does not elect COBRA, would he/she be entitled to the grace period? 2. If an employee quits mid-year and elects COBRA but ceases payments before the end of the calendar year, when would the grace period begin for the former employee? 3. If a former employee electing COBRA benefits from the grace period, should additional premium be charged? It would seem that these questions would need to be addressed before changing the plan document to allow for the grace period.

Is anyone having any doubts about implementing this grace period in light of some of the questions raised with respect to COBRA? We have put the brakes on implementing at this time after having read some of the concerns raised in the administration of COBRA (we handle it internally so are even more concerned about compliance).

Sometimes but not always. If an employee was employed for 6 months and then left for 2 or 3 and then returned, we will do an adjusted service date. Again that date becomes applicable for several of our benefit plans.

After reviewing additional information and additional discussions, we came to the conclusion that we must follow the same payment rules that are in effect for our other unpaid leaves of absences. As it turns out, the payment options offered for sabbaticals is different than for any other personal leaves of absence, so we must continue to offer both the catch-up and pay-as-you-go options. Thanks for all your comments on this subject. Another question though - definition of service. If an employee is a rehire with an adjusted date of hire but has only been on the payroll for 6 months out of the prior 12 months, has the requirement of being employed for one year been fulfilled? There is disagreement about this amongst our team. It would seem that being on the payroll means to be employed but since we use the adjusted service date for purposes of retirement plan vesting and paid time off accrual calculations, shouldn't it be applied consistently across all "plans"? Again, appreciate any comments/questions regarding this.

I could definitely use some additional help with this question. I asked our FSA administrator and was told that Section 213 is what they use to determine what is reimbursable. However they also referenced Section 125 saying that it said that health insurance premiums are not reimbursable therefore long term care premiums are not reimbursable. When I looked at Section 213 (d) (10), it specifically said eligible long-term care premiums for any qualified long-term care insurance contract (as defined in section 7702B(b)). And I cannot find the specific reference in Section 125 that denies these premiums from being reimbursable. What am I missing in the logic?

All of our members sign a release agreement and attend a safety orientation meeting with our fitness center personnel. This is required at least every 2 yrs or whenever there is a change in the fitness center guidelines.