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Found 6 results

  1. Four entities are in same controlled group/affiliated services group. 3 of the entities participate in one fully insured wrap welfare benefit plan (medical,dental, premium only plan). All insurance contracts for that plan are signed by the plan sponsor (i.e., one of the 3 entities). Since this plan had 140 participants at start of plan year, my understanding is that we will need to file Form 5500 for it. The remaining entity has its own separate fully insured wrap welfare benefit plan (medical, dental, premium only plan ). This entity is the plan sponsor and all insurance contracts are signed by it. There are only 22 participants at start of plan year. Does a 5500 have to be filed for this plan too, or is a 5500 not required for this plan until the plan reaches 100 participant threshold at start of another plan year? Related question: For annual discrimination testing, do you have to aggregate all the participants from both plans together or can you test separately? Thank you for any input .
  2. I'm working with an employer who has employees who do not work over the summer. They will continue to be covered under the employer's group health insurance plan but must pay for their portion of the premiums which would otherwise come out of their paycheck. We are concerned about what happens if the employee does not pay their portion of the premiums. My understanding is that there is a 30 day grace period under the ACA and that if the policy is canceled for non-payment, the employee is not eligible to re-enroll until the next open enrollment period. My questions are: 1) Is it correct that there is a 30 day grace period under the ACA? 2) If so, do you know what statute or regulation requires it? 3) Can state laws require a longer grace period (I believe they can for individual plans but can't find any information on group plans)? 4) Is it correct that they cannot re-enroll until the next open enrollment? Any cite for that? Thank you so much for any help you can give me.
  3. COBRA is outrageously priced. Are there any associations (in Arizona or nationally) for Arizona retired primary and secondary teachers that offer a reasonably priced group Health Care Plan? Most primary and secondary teachers retire at age 52 and have to wait 13+ years for Medicare eligability. Any one with a lead for these people?
  4. I have a self funded health client offering 7 (yes 7) different health plans. One of the self funded health plans is solely funded by employee contributions. How does the law speak to excess contributions? What rights does the employer have to these monies?
  5. Any insight on whether sponsors of self-funded health plans are sharing in rebates paid to the TPA when specialty drugs are run through the medical benefit instead the pharmacy program? We are capturing the rebates paid to the PBM when run through pharmacy benefit.
  6. I've been searching high and low to determine what the penalty would be if a health plan kept an annual limit in place after this year. I haven't yet found anything. Anyone have any thoughts or comments?
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