bibliwho

I know the IRS does not allow participants to change their election amounts mid-year (absent a qualifying event). I'm thinking it should be OK to switch brokers, however, as long as the the election amount does not change. The biggest obstacle would presumably be gaining approval from both brokers. Anyone have any experience with this? Many thanks in advance!

Employers can match employees' contributions to their FSA's, up to the limit for that year. Can employers place their own limits based on plan type? In other words, can an employer match up to $2,600 for a family plan, up to $1,500 for a 2-person plan, & up to $500 for a single plan? Along the same lines, can the employer match be different if an employee selects a Cadillac vs. a HDHP plan? Thank you.

Thank you, Jim. We're actually in NH. We've definitely considered using a non-affiliated HRA to get around the 50%-of-deductible restriction. My concern is that the rule appears to be from Anthem & violating it could lead to messiness down the road. My latest brainstorm is to self-insure the second half of the gap (i.e., until the full deductible is met). But we would need a TPA & I'm not sure this is a thing.

Yes, we're aware of the ERISA requirements, Lee. Thank you. I did ask about the 50% cap & it's not unique to our administrator. The explanation given is the essentially the same as given here: https://www.harvardpilgrim.org/portal/page?_pageid=849,971992&_dad=portal&_schema=PORTAL I checked w/ Symetra as they have some gap products that could work. Unfortunately, we have too few covered employees. May ask in a new thread for referrals to other companies that may have products for very small groups in our state. Thanks again!

Thank you, leevena. I ran through a few scenarios w/ major expenses (i.e., full deductible reached) & employees would be significantly impacted. This is primarily because our current provider will allow funding of the HRA only up to 50% of the deductible amount. Now thinking we should look into some kind of gap insurance.

Thank you -- yes, I think your understanding is good. Unfortunately we're a very small employer with only 4 covered staff, so our broker isn't able to provide useful utilization data. There are OOP expenses under the current plan, albeit very low -- $10-$50 copays (including on prescriptions), 20% on durable medical equipment. I am probably overthinking things, but obviously want to tread carefully when making such a major change.

I've been tying myself in knots on the math trying to compare the cost-sharing implications of switching from a Cadillac health plan to a higher deductible plan w/ an integrated HRA. The former is a family plan with a standard deductible of $0, no coinsurance, and a max out-of-pocket of $3k/$6k (per person/ per family). The latter has a standard deductible of $3k/$9k, no coinsurance, and a max out-of-pocket of of $5k/$10k. Copays are naturally a bit higher & the plan is obviously more restrictive all around. If one of the goals is to minimize cost-shifting to employees, how would you go about determining the appropriate HRA contribution amount? My current thinking is that this should be based simply on the increase in the max out-of-pocket i.e., $4k ($10k - $6k). But I'm being thrown off by the much larger increase in exposure from the high deductible ($9k vs. $0). I understand that comparisons will vary depending on total medical expenses, the number of visits, procedures, etc. & should also account for the employee's savings from lower premiums. So it's complex. But I'm hoping someone can help clarify my thinking and perhaps add some insight on how best to approach this. Many thanks in advance.