Discrimination testing in group health plans

[Guest Kim Guynan]

Is IRC 105 discrimination testing required for all self-funded group health plans?

[Guest kclark]

The "eligibility test" & the "benefits test" of Section 105(h) of the tax code do apply to all self-insured plans and to "administrative services only" contracts. However, the requirements do not apply to HMOs or other prepaid health plans that are regulated under state or federal law.

As well, there are "special exemptions" for all L"routine medical diagnostic procedures," including lphysical examinations. Also exempted are accidental death & disability benefits and business travel accident insurance.

Hope that helps!