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Broadly speaking I agree with you, but the company has been advised by separate counsel that the modifier "occupational" would not include activities such as surrogacy since such acts are unrelated to the covered individuals actual occupation.

Specifically looking for cases/authorities that would demonstrate that a health plan participants decision to be a surrogate for profit would not be covered under a health plan that prohibits coverage of occupational illness incurred from work for profit, including self employment.

I anticipate the answer is yes but I am wondering if any one can point me toward a citation that states this. I know the form 5500 instructions require plan sponsor to provide accurate information, but I cant find anything that states it has an affirmative obligation to correct a previously filed 5500 that is inaccurate.

Thank you taking the time to respond, but I do have an additional question: from researching I found this explanation and would love to hear your opinion on it: ""Self-funded plans are not required to cover “essential health benefits.” Nevertheless, the definition of “essential health benefits” has implications for all employee health care benefit plans because, to the extent that such plans offer benefits that are considered “essential,” they are prohibited from imposing lifetime or annual dollar limits on such benefits." So, assuming my self funded plan currently does offer emergency/ambulatory services, then, despite the fact that they are not required to cover essential health benefits, they are nevertheless prohibited from enacting the 20k coverage limit because they currently offer the ambulatory/emergency benefit that is deemed "essential." Would you agree with this analysis? Thank you again for your time.

Self insured plan wants to cap payments made for air ambulances to some arbitrary number, $20,000 for example. Does it matter that this is for emergency care, and is this a essential health benefit under the ACA? Any source you can point do would be appreciated. Thank you!

Sorry I'll try to make it more clear as best I can, but basically the DB plan used to have a DC feature in it whereby certain participants could contribute to separate accounts. Those accounts and that DC feature have been frozen, and now the client wants to pay the frozen accounts out and get rid of the DC feature through a lump sum in service distribution. The issue, as I understand it, is that generally this cant be done in a DB plan. Sec. 414(k) specifies that a DB plan which provides a benefit derived from employer contributions that is based partly on the balance of the separate account of a participant will be treated as a DC plan to the extent benefits are based on the separate account of a participant and as a DB plan with respect to the remaining portion of the benefits under the plan. Again thank you for your help.

Client has a DB plan that has a DC component where certain participants have plan accounts. I am trying to figure out if it is possible for those participants to receive an in service distribution of DC component. Would this be prohibited since the DC is a component of an overall DB plan? Thank you for any clarification you can provide.

Section 3(40)(A) of ERISA provides that the term “multiple employer welfare arrangement’’ (MEWA) does not include an employee welfare benefit plan that is established or maintained under or pursuant to one or more agreements that the Secretary of Labor (the Secretary) finds to be collective bargaining agreements ("CBA"). For purposes of section 3(40) , an employee welfare benefit plan is “established or maintained under or pursuant to one or more agreements which the Secretary finds to be collective bargaining agreements” for any plan year in which the plan meets a certain requirements. One of the requirements is (generally speaking) that at least 85% of the participants in the plan are Individuals employed under one or more CBAs. My question - There is no explanation in the regulation or the preamble that states when during the year this 85% test should be conducted (i.e. first day, last day, etc.) . Does anyone have any guidance they can point me to or an opinion they don't mind sharing on this issue? Thank you.

Client missed minimum funding deadline of September 15, but said date falls on a weekend. Client got the funding in by the following Monday, is this an issue or is the deadline pushed back since Sep. 15th falls on a Saturday this year? I cant seem to find any persuasive information on the matter and prior discussions on benefits link regarding the issue offer differing opinions. Thanks for your help.

Employee has excess deferrals b/t current emp. and former emp. (unrelated), past April 15 deadline, does either employer have to issue corrective W-2?

Background: Client hired employee in January of 2017. Employee maxed out deferral with client (including catch up) in 401(k) plan for 2017. Employee also was paid the remaining portion of his 2016 compensation from former employer in 2017, and former employer withheld based on employee's 2016 deferral elections. Excess deferrals resulted. Correction will obviously not be done by April 15, 2018. Issue: What is the correct course of action in this situation? Set forth below are my basic thoughts: Code § 402(g)(1)-(2) and Reg. Sec. 1.402(g)-1(e)(2) clarify that, unless timely distributed, excess deferrals are (1) included in participant’s taxable income for the year contributed, and (2) taxed a second time when the deferrals are ultimately distributed from the plan. The excessive deferrals involved in the Error were not timely corrected because the April 15 deadline had already passed. Accordingly, the Error’s excessive deferrals must be taxed for the 2017 year (i.e. the year contributed) and again when the excessive deferral is distributed from the plan. If a corrective distribution is not made within the correction period discussed above, then excess deferral cannot be distributed until either (1) the distribution is otherwise permissible under the terms of the plan, or (2) the distribution is necessary to avoid plan disqualification under Code § 401(a)(30) (note: there is not a plan disqualification issue under Code § 401(a)(30) because the Error involves excessive deferrals between two unrelated plans and employers).[[1]] Reg. Sec. 1.402(g)-1(e)(8)(iii) allows for distributions of excess deferrals after the correction period to be distributed from 401(k) plan only when permitted under Code § 401(k)(2)(B). As discussed above, plan disqualification is not an issue; accordingly, I believe the error’s excessive deferral can only be distributed if permitted under the terms of the plan (i.e. termination, age 59 1/2, or other Code § 401(k)(2)(B) permissible times). I could be wrong on this analysis and this is my first go tackling this kind of problem so please let me know if I'm not on track and thank you for your help! [Update]: So a little twist on this analysis; the plan document states that the plan will return any excess deferrals by April 15th of next year, which obviously did not occur. So now it appears as though we do have a plan disqualification issue. Trying to find out the correct course now with this thrown in . [[1]] To elaborate on this point, under Code § 401(a)(30), if the excess deferrals aren't withdrawn by April 15, each affected plan of the employer is subject to disqualification and would need to go through EPCRS. However, in the situation involving the described error, the excess deferral amounts involve two unrelated plans with two separate employers. The IRS has stated on its website that “excess deferrals by a participant will not disqualify a plan if the excess is due to the aggregation of the participant’s deferrals to a plan maintained by an unrelated employer.” Accordingly, the fact that Error involves excessive deferrals among two unrelated plans/employers indemnifies the plans from experiencing a disqualifying event because of the Error.

Does anyone know of how the "would result in an adverse business impact that is greater than de minimis" exception should be interpreted by plan sponsors who want to hold off the mortality table change for this year? I represent a company that has 3 billion in revenue each year and postponement of mortality table change would only yield a savings around 10 million. I anticipate that this is not sufficient to meet the requirement of the Notice but wouldn't mind having some guidance to reference. Thank you.