mroberts

I had one of the leading companies in the market come in and give me an overview and it seems pretty safe to me. Yes, there's going to be people that manipulate the system even when it comes to the Little League World Series. However, it seems like these companies have put a lot into making sure the charges being put on these cards are legitimate. There aren't too many people other than benefit professionals out there that would know the ins and out os FSA plans. Since this is the case, I wouldn't be worried about your employees trying to cheat the system. Who's going to take the chance of putting a $1000 into a flex plan to use for groceries? There will always be someone out there, but I would say it's a good investment with these cards. Now, if an employee does find a way around it, as far as penalties for the employer, that I haven't heard anything on yet. I would assume you wouldn't be held responsible, but this is the U.S., not Europe.

I'm not familiar with Ohio state laws, however, I have worked with groups in just about every state and I have never heard of a law that would prohibit you from changing your eligibility period immediately. That being said, to cause the least amount of waves, I would recommend allowing your current employees to continue medical benefits based on the current eligibility requirement of 1000 hours. For any new employees the eligibility requirement should be 1300 hours. You could always require your current part time employees who have elected medical benefits to also satisfy the 1300 hours starting with the next open enrollment period, however, this would probably be a moot point. Most companies do not pay any amount towards the cost of meidcal insurance for part-time employees and the same probably holds true with your company. Therefore, even if you were to change the required hours worked for these employees, for any employees who would be losing coverage they would still be able to elect COBRA and continue it for 18 months since this would be a qualifying event.

Would it be discrimnatory? No, but as Kip points out, the insurance carrier is going to have to know how you are planning to administer the benefits ahead of time. Since it's probable that you're not going to get 100% participation on a 50/50 LTD plan (if I understood your post correctly), the carrier is going to increase the life rate since any employees not electing the LTD coverage are probably extremely healthy. Thus, there is a slight degree of adverse selection going on here. Why not just offer the Life benefit to all your employees? While I do understand that you feel LTD is an important benefit, 100% of your employees are not going to think so. If you are worried about getting the necessary participation in order for the carrier to write the coverage, then I would work with the carrier to communicate this new benefit.

If you are only providing your employees with a summary and not a booklet certificate, you are in violation of ERISA. Coming from a carrier and having created the booklet certificates that your employees receive, I couldn't agree with you more that they are confusing. Nonetheless, much of the small print in the booklets is where problems arise and where companies and carriers find themselves in courts over. If you find the booklets confusing, just provide a summary in addition to the booklets. At least that way your ass is covered. Now, if you are referring to the policy itself, then you only need have a copy of it on hand for employees to look at if they wish.

That would most likely be a case by case or company by company determination. For example, if you're only going to have minimal contact with Hispanic customers then you probably shouldn't be paid as much as someone who's going to have constant contact with Hispanic customers. Supply and demand is going to be a big factor as well.

As papgogi indicated, the employee can not dictate the terms of the FSA. If the employee is worried about unused amounts being in her account after she is termed, tell her to run out and buy some reimburseable stuff ASAP.

If the company wants to go ahead and offer her severance while on STD and for the payments to run concurrent with her disability payments, that's probably not going to be a problem. Just because a person is on disability doesn't mean the employer can't term him or her. Obviously the carrier doesn't want the employee to receive severance payments on top of the disability payments or else she's definitely going to be out as long as possible. Shoot me an email if you would like to discuss further.

This is happening fairly often these days with company shut-down days. Your best bet when it comes to both insured and non-insured benefits is just as libby suggests. Almost all medical carriers and most life and disability carriers will bring the definition down to 20 to 25 hours per week if you know how to push their buttons properly. When it comes to company benefits, take a look at your policy and employee handbook and see of some revisions need to be made, at least temporarily.

Is there any chance in getting a short renewal on the medical? It seems like it would simplify things at least a little bit if it was all in one plan document. Otherwise, follow papogi's advice.

Answering the second part of your question first, 5500 schedule Fs are no longer required to be filed per a recent ruling. There's a string somewhere on this message board that discusses it in detail. Now, to get to the first part of your question, I don't believe a government agency would be exempt from a written plan document mainly because not all section 125 plans are the same. Yes, the regulation is the same, but the policy periods are going to be different, the plan maximum for medical and dependent care can vary and so on.

The employee should touch base with her employer with respect to the wording in the severence letter. Obviously if she is deemed disabled by an insurance carrier, she should not be required to be looking for another job. Also, she will be eligible for LTD benefits once she satisfies the elimination period.

When you say plan description are you referring to what was given to employees? There will also be a policy, so I would reference that.

It appears that you already know the answer to your predicament. If the COBRA participant can't get anywhere with the HR office, maybe he or she should go over their head. If that's not an option, I would go to the DOI for whatever state this is or consult an attorney.

What is the employer's stance in not allowing the COBRA particpant into the dental plan? Is there something you're leaving out?

Actually, the IRS just took a look at a similar scenario in which the employer paid for the LTD coverage, but included the cost of the premiums in the participant's gross income and the benefits were found non-taxable. Shoot me an email to discuss further. Take Care!

There's nothing in the regs that says this isn't permissable, so if you do allow it, I would recommend following up with a memo regarding the conversation including date and time so you can start the 45 day countdown for the first month's premium. Furthermore, I would only allow this if the employee had a pretty damn good excuse, i.e. was in a coma, was kidnapped in Columbia.... 60 days is plenty of time to decide what you want to do.

Is the plan we're talking about an HMO or PPO? Most HMOs don't have lifetime maximums, so is it possible to set one up and slide this employee and dependent over?

The flex plan really shouldn't be treated any differently than any of your other plans. If a part-time employee is eligible for medical benefits or any voluntary benefits that allow pre-tax contributions, then he or she should be eligible for your flex plan. As far as determining how many hours constitutes full-time, that's employer discretion. Fairly standard is 30, however, 35, 37.5 and 40 are common, as is the occasional 20 hours.

Agreed. There is no coverage in force prior to taking FMLA, thus, there can be no qualifying event for this employee.

There's a lot of stuff on the web about Defined Contribution Health plans, or consumer-driven as the carriers prefer to call them. Most of the carriers that offer these plans take over the TPA responsibilities, so I don't know how prudent it would be for you to research something for a lazy broker who is eventually going to move the business if it makes sense.

Your best bet is to touch base with each of the carriers to find out what is available. While medical insurance products are fairly standard everywhere in the U.S., the products have to be filed in each state, and therefore, differences will be found due to state regualtions. There has to be a TPA involved paying the claims and most likely this TPA is using an insurance network, so that's a good place to start. I would first determine what kind of plan you are thinking about - HMO, POS or PPO. From there, I would find out the carriers that can offer these plans in the necessary states. Are you a benefits consultant?

As indicated in my original post, this would be defined in the vision SPD. There should be a little blurb somehwere indicating that the service is incurred when services are provided or something along those lines. If you can't find it, I would touch base with your vision carrier.

I guess I don't really understand your question. The employee purchased an individual plan in which the employer paid for it. He is now no longer with the company so he can pay for the individual policy himself. Since he never signed up for the group policy, he wouldn't be entitled to continue it after termination. Even for employees who are under a group plan, the employer doesn't pay for the coverage upon termination.

Whenver employee premium are paid after tax, the LTD benefit is not taxable.

you'll have to check your spd as to when the vision carrier would deem the service complete. obviously this is something that couldn't have been done on one trip since the lenses had to have been picked up and maybe even fitted if this was the first time someone has worn contact lenses. what does the eob from the carrier indicate as the date of service? if all $425 was billed in december then you would definitely count this as a 2001 expenses. if the eob indicates the date of service was in february, then it's 2002. if there's two eobs, billing part of the amount in 2001 and another part in 2002, find out what was actually performed, if anything in 2002, and check your spd for clarification.