tsrl01

We have an employee who has moved from a full-time position to a part-time position mid year. Under the ACA, do we have to keep this employee on our benefits for the remainder of the stability period? Or, can we terminate benefits because the employee is no longer in an eligible class?

Thank you for your reply - I am referring to the reporting obligations under CMS which require that settlement agreements with Medicare-eligible individuals be reported to the government.

If as part of a severance agreement, employees are given funds to purchase COBRA, is that reportable to CMS? I understand that if a settlement, severance, etc. payment to a Medicare - eligible individual if the payment relates to past or future medical expenses, but if the settlement just includes funds to use for COBRA (we don't know whether they actually purchased COBRA or not), do we have to report?

If a voluntary vendor offers a premium discount for other benefits (1% discount for our life coverages). My concern is that this would constitute "consideration" and therefore would not satisfy that prong of the safe harbor exemption. Any thoughts?

If a voluntary vendor offers a premium discount for other benefits (1% discount for our life coverages). My concern is that this would constitute "consideration" and therefore would not satisfy that prong of the safe harbor exemption. Any thoughts?

We submitted our plan to the IRS under VCP about 6 months ago and just found an issue completely unrelated to the VCP submission. I do not see any requirements that we can't still self correct the recently identified problem, but wanted to see if anybody had a different opinion. In my mind, since there isn't a specific exclusion, as long as the issue would otherwise qualify for self correction, I can. Any insight would be appreciate - because maybe I completely missed an all cap requirement that says differently....

Looking for thoughts on whether the Virta diabetic add on program would be subject to COBRA. I'm inclined to say no, that it is an independent, non-coordinated benefit (disease-specific, excepted benefit, but wanted to see what everyone else's thoughts are. Thank you!

One of our carriers inadvertently sent us a file for another client of theirs. We sent an internal email to all those who received the email by mistake notifying them that it was sent to them in error and requested a response back that the email had been deleted. We also notified the carrier and informed them of the same. The carrier is now requesting that we sign a certification that we in fact deleted the email and did not view it. Are we under any sort of an obligation to sign this certification? We notified them of their error and confirmed via email that we deleted the file and did not keep it, but they have said that isn't sufficient, they need a certification signed by us. This just seems a bit overboard.

We have a situation where a participant in a plan has died. His brother has provided a POA naming him. He doesn't have any letters of testamentary because he's saying he doesn't need one - he's the POA. Our process is to require a letter of testamentary to show who was appointed the executor. Are we ok distributing to the estate without a letter of testamentary - just distribute to the estate - paid to the estate, etc. I think we still need one - we need something to show that this person has the authority to sign on behalf of the estate. Any help would be appreciated. Thank you,

Thank you!

We have an individual who wants to rollover their SIMPLE IRA from a previous employer into our 401(k) plan. I do not see anything which would prohibit this, but want to check. A SIMPLE IRA is treated like any other IRA for distribution purposes - so as long as the SIMPLE IRA has satisfied the 2-year requirement, it appears to be ok, but I'm afraid I'm missing something. Does anybody have any other information?

This probably sounds elementary, but what is the significance of subscriber to member ratio when negotiating contracts with vendors. Is a higher ratio (3.5) better than a lower (2.0) or is it the other way around. I would think lower is better if my understanding is correct.

We've received a divorce decree from a participant in Nebraska. Pursuant to the signed decree: 'For the purposes of continuation of health insurance coverage, the Decree shall become final and operative six months after the Decree is entered." Question: Has anybody dealt with this before? I have seen mention of this situation on Benefitslink threads, but curious how it was resolved practically... because the plan is self-funded would ERISA preemption apply? Or because of the manner in which it is worded - that for health insurance, the divorce isn't effective until six months, the COBRA qualifying event doesn't happen until 6 moths? Nebraska Statue Below: 42-372.01. Decree; when final. (1) Except for purposes of appeal as prescribed in section 42-372, for purposes of remarriage as prescribed in subsection (2) of this section, and for purposes of continuation of health insurance coverage as prescribed in subsection (3) of this section, a decree dissolving a marriage becomes final and operative thirty days after the decree is entered or on the date of death of one of the parties to the dissolution, whichever occurs first. If the decree becomes final and operative upon the date of death of one of the parties to the dissolution, the decree shall be treated as if it became final and operative the date it was entered. (2) For purposes of remarriage other than remarriage between the parties, a decree dissolving a marriage becomes final and operative six months after the decree is entered or on the date of death of one of the parties to the dissolution, whichever occurs first. If the decree becomes final and operative upon the date of death of one of the parties to the dissolution, the decree shall be treated as if it became final and operative the date it was entered. (3) For purposes of continuation of health insurance coverage, a decree dissolving a marriage becomes final and operative six months after the decree is entered. (4) A decree dissolving a marriage rendered prior to September 9, 1995, which is not final and operative becomes operative pursuant to the provisions of section 42-372 as such section existed immediately preceding September 9, 1995. Source:Laws 1995, LB 544, § 2; Laws 1997, LB 434, § 1; Laws 2000, LB 921, § 34.

Once a Plan Administrator has obtained consent to distribute documents electronically - where does the burden of proof lie? Say the plan administrator emails to the address on file, but does not request a return receipt, but the email does not kick back as invalid, if the participant then claims to have not received the document, who has the burden? I've been looking for cases, guidance, etc., but the only thing I've found is the Thomas case wherein the employer posted on a website, but did not inform the individuals that it was posted. Any further information/guidance/cases, etc. is greatly appreciated!

Can someone point me to the statutory authority (or an IRS publication, etc.) which precludes passive enrollment for FSAs? Can the spousal surcharge roll over? What about any tobacco surcharge?