tsrl01

I'm confused as to exactly which entities must comply with this... Per the regs, it is the Covered Entity that has to comply - what if the CE utilizes TPAs? We have an eligibility TPA sending files to our insurance carrier. Do the eligibility files from the eligibility TPA to the carrier have to be in the 5010 format? The carrier has indicated that it is okay with continuing to receive the file as is and the eligibility TPA will charge an arm and a leg to switch formats...

Should individuals in the payroll/account payable department which have information regarding necessary payroll deductions for medical/health fsa coverage be "behind the firewall"? Or would the functions these individuals are performing not even implicate HIPAA?

I didn't pay much attention to that example since it was a DC example, but I see that now - thanks so much!!

just wondering if there is any IRS guidance on what might constitute a significant cost increase such that it is a permitted election change... The regs are silent, but I wasn't sure whether there was a PLR or a Rev. Rul, etc... 10% okay? Need 30%? Just curious.... Thanks

I am trying to find specifically in the regs/guidance where it provides, in essence, that just because a person is "behind the firewall" and works for the plan, it doesn't mean that person has the right to any and all information about individuals. I need to point to the fact that they are only entitled to information they need to do their job.. The best I can come up with is the minimum necessary requirement. Any other ideas and/or suggestions?

We are looking to merge two 401(k) plans and want to make certain I'm not missing anything... We satisfy the exception for filing a 5310-A and other than resolutions to document the merger, what other things do we need to think about? Are we required to provide notice to participants? The two plans are identical in design (same sponsor, same vesting schedule, etc), and the non-surviving plan has no active employees. I just don't see what else we need to do other than the resolutions and letting the recordkeeper know. Thanks

That's is how I see it - they aren't eligible, so they fail to meet the eligibliity and therefore shouldn't have been covered in the first place, so they are being "kicked out" as of the earlier of January 1, 2009 or the date they no longer satisfied the eligibility requirements.

We have an employer that conducted a dependent audit. Some employees did not respond and therefore dependents got kicked off. Now there are employees coming forward with the appropriate documentation verifying dependent status. If the employer wants to permit the re-enrollment of the dependents, is there anything that would prevent the employer from charging the employee an administrative fee of some sort? Kind of like a penalty for not reading their mail, taking it seriously, responding, etc...

Individuals could complete an HRA in 2009 for a "rewards" (either cash or deposit to an FSA) to be paid (or deposited) in 2010. Is this still allowable under GINA? The information, which includes genetic information, was collected in 2009, it just will be paid out in 2010?

Thanks for your response Sheila - so, if your husband satisfies the wellness condition, the company automatically puts that in his FSA - effective for use as soon as he satisfies the requirement? Thanks again!!

I am trying to figure out whether it is acceptable to contribution wellness incentives into an FSA for an employee... The situation would be that once an employee completes an HRA, the money would be contributed to a health FSA for the employee's use. Is this acceptable? I am also curious as to the logistics - the employee elects $1000 for the year for FSA contributions, on March 2, earns $100, so the employee simply now has $1100 available? The intent is to make it the employee's option - take the money in cash or let them elect to put the money in an FSA. Thank you

I am trying to figure out whether it is acceptable to contribution wellness incentives into an FSA for an employee... The situation would be that once an employee completes an HRA, the money would be contributed to a health FSA for the employee's use. Is this acceptable? I am also curious as to the logistics - the employee elects $1000 for the year for FSA contributions, on March 2, earns $100, so the employee simply now has $1100 available? The intent is that the employee will have a choice - elect the cash or elect to have the money contributed to an FSA. Thank you

It is a DC plan with a separate account

I have requested a copy of the QDRO to review the language again. The plan states that if a participant dies without a beneficiary (and isn't married), the proceeds go to the participant's estate. I'll see what the QDRO procedures provide to see if this is addressed. I'll also see what it says about a beneficiary.... thanks for the suggestions... I'll post what I find.

We have a situation where we have a QDRO, the alternate payee has died and did not name a beneficiary. In paying the benefits due the AP, do we just pay to the AP's estate (which is what we do if a participant does not name a beneficiary and has no spouse, etc.)?

After reading the regs and various commentators, I did not think group legal was a permissible benefit in the cafeteria plan. However, during a Sept 4 discussion with various IRS officials, the woman indicated that one could incorporate a group legal plan in a cafeteria plan (but added that she didn't see why anybody would do it). So, I am a little confused. Any thoughts?

We have two retirees who are both enrolled in a Medicare Advantage plan. Both have also signed up to cover each other and are enrolled in the same plan. Our vendor is not coordinating benefits for these individuals. Is there a Medicare rule which prohibits individuals from being enrolled in two Medicare plans? I am just a little confused. The vendor coordinated benefits earlier in 2006, then stopped mid-year. This leads me to believe that the vendor thought COB was okay (at least originally). Any help/guidance will be appreciated!!