Larry M
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Interests
employee benefits;managed care;1/8 scale trains
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Employee Benefits Lawyers rock! Or polka!
Larry M replied to a topic in Humor, Inspiration, Miscellaneous
Are they polka-ing fun at us? -
Health Plans - Fixed Dollar Subsidy
Larry M replied to French's topic in Health Plans (Including ACA, COBRA, HIPAA)
sorry for the delay in responding - the flu got me good! I believe the dollar limit is a percentage of the average premium rate for the largest plans. -
Health Plans - Fixed Dollar Subsidy
Larry M replied to French's topic in Health Plans (Including ACA, COBRA, HIPAA)
The Federal Employees' Plan has had an employer contribution for many years which is the lesser of (1) a percentage of premium and (2) $X - and it works very well. -
Loss of Coverage for Student
Larry M replied to a topic in Health Plans (Including ACA, COBRA, HIPAA)
Although there may not be a special enrollment option in the plan, the plan may allow the student to enroll with satisfactory evidence of insurability. -
terminating a PS plan to start a 401k
Larry M replied to Santo Gold's topic in Retirement Plans in General
If he terminates the old plan, all the employees become 100% vested and have the option to have their accounts distributed to them as soon as termination is final. If he terminates the current plan and asks for a determination letter, and if IRS audits and finds errors, who picks up the tab? Current owner or previous owners? If company was sold and new owner is in place - he may be stuck with past sins anyway. -
terminating a PS plan to start a 401k
Larry M replied to Santo Gold's topic in Retirement Plans in General
If client is concerned about language in old plan, why not persuade him to amend the plan in its entirety (as opposed to just adding the 401(k) provisions? -
Definition of "issued or delivered"
Larry M replied to a topic in Other Kinds of Welfare Benefit Plans
There are different laes, mandates and regulations in each state. Generally, states recognize this and will accept the group policy issued in another state. So, in your example, State A should not require the carrier to amend its contract to cover domestic partners. However, State A or the local governmental entity may require that employers doing business within the jurisdiction recognize domestic partners if they wish to do business with the governmental agency. In such a situation, the employer must provide the coverage for those employees. -
I'm getting sick of this question.
Larry M replied to Penman2006's topic in Defined Benefit Plans, Including Cash Balance
Frank, What kind of radical are you? Beginning of year valuations?? The nerve of giving your client and his/her accountant the range of contribution for the coming year. How could they survive not having to scramble at the last moment to determine (a) how much contribution was needed, and (b) where to get the cash? Heresy, that's what you are practicing. -
Frozen Benefit / Frozen Participants
Larry M replied to Penman2006's topic in Defined Benefit Plans, Including Cash Balance
what happens if the plan becomes top heavy? Do new participants get the top heavy minimums? -
[to those who read the first unedited response, my apologies for pressing the "reply" button before I had written anything. then, again, for those who read this response, I may have to apologize again....] There are two good places to meet health actuaries: 1. The Conference of Consulting Actuaries annual meeting this fall in San Antonio, and 2. One of the many Society of Actuaries' Health Sections meetings during the year. You can find their meeting information at the respective websites http://www.ccactuaries.org/ for the Conference, and http://www.soa.org/ for the Society.
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[This is a laymen’s (non-attorney’s) attempt to differentiate among the various terms in your question.] The Plan Document is the contract which states all the provisions of the plan and delineates the various responsibilities for financing the plan, the eligibility, and all the other aspects of the plan. The plan can be self funded in full, insured in full or a combination of both. An SPD is a Summary [of the] Plan Document. This is supposed to describe, in simple language, the terms of the Plan Document which relate to such items as the benefits provided, the persons eligible, the way in which an individual becomes eligible, the persons responsible for maintaining the plan, and the ways in which appeals can be granted The Group Policy is the contract between the insurance company and the plan sponsor. It may be the same as Plan Document, or it may be part of the Plan Document. A Certificate of Coverage is a document provided by the insurance company to describe to the insured individual the terms of the insurance plan. It may contain all the information required in a summary plan description but, in many cases, it does not. In the latter case, you may be able to turn it into a SPD by attaching a page which includes the missing information (usually involving plan sponsor name, employer identification number, address and telephone number, name, address and telephone of the plan administrator and the person designated as agent for service of legal process, plan’s fiscal year end).
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Eligibility for Retiree Medical Benefits
Larry M replied to a topic in Health Plans (Including ACA, COBRA, HIPAA)
I assume you mean "carrier" or "insurance company" or"hmo" when you say the "provider". As such, the carrier is asking for a simple definition of those who will become eligible to receive retirement benefits. This is the same as it requiring the sponsor to determine eligible active employees and dependents. The employer wants to pick and choose those employees who, at the time they retire, may be eligible for this special privilege. The carrier is concerned that the employer may pick only those retirees who are sick, and abuse the system. So, you need a compromise. Perhaps you should consider limiting those eligible for retiree benefits to the ones who were covered by the previous carrier. At the same time, the sponsor should investigate the probable costs of providing retiree medical and determine whether it can truly afford this luxury. After such a study, the employer may want to look at alternate means of recognizing these individuals' long service. -
Premium Limits for Early Retirees
Larry M replied to a topic in Health Plans (Including ACA, COBRA, HIPAA)
If two plans are available, does an individual who retires at, for example, age 63, have the option of COBRA extension at 102% of active premium vs early retiree plan at 125% of active premium? -
Looking for this annuity table
Larry M replied to jkharvey's topic in Defined Benefit Plans, Including Cash Balance
Try calling someone at Met Life. If has a vast library of tables. -
I believe the threshhold is 20 employees. from Medicare web site: "In most cases, Medicare is primary. Some of the most common situations where Medicare can pay secondary are: -The individual or his/her spouse is currently employed/working and covered under an employer group health plan as a result of current employment. The company has 20 or more employees or participates in a multiple-employer or multi-employer group health plan where at least one employer has 20 or more employees. -Individual in question is entitled to Medicare as a result of a disability, the company has 100 or more employees, or participates in a multi-employer/multiple-employer group health plan where one employer has 100 or more employees. -The individual in question is Medicare entitled due to end-stage renal disease. Medicare is the secondary payer to a group health plan until a 30-month coordination period has ended." In the latter two cases, this is for individuals who are under age 65.
