ERISA

[Guest pedmund]

Does anyone have a clear definition of what makes a plan fall under the guidelines of ERISA? The new HIPAA privacy guidelines state that an employer may be a covered entity if they fall under the ERISA guidelines. Does the fact that an employer deducts their employees' premiums on a pre-tax basis make their plans an ERISA plan?

[oriecat]

Since I just got back from an ERISA compliance seminar, I'll take a stab here.

An ERISA plan would be one that:

• Is a plan, fund, or program
  
• Maintained by the Employer (or an employee organization)
  
• To Provide to Participants or Beneficiaries
  
• Certain Listed Benefits
  
• Through insurance or otherwise
  

What kind of benefit are these premiums for?

[Guest pedmund]

Premiums are being deducted for medical, dental, vision, life ins. etc.

[oriecat]

I believe all of those benefits are covered by ERISA, unless it is a government or church plan.

Do you provide SPDs? Do you file a 5500 form?

[GBurns]

In general the deduction of premium alone is regarded as a payroll practice and is exempt from ERISA. BUT anything more would most likely cause the plan to fall under ERISA.

Selection of vendor or policies to be offered would make it ERISA.

Endorsement as being "approved" would also in most cases cause it to be ERISA.

If any administration, decision making, claims or dispute arbitration or involvement in decisions, enrollment or information distribution etc would make it ERISA.

[Guest pedmund]

In response to the SPD/5500 question. Groups that have more than 100 participants file 5500. The groups are provided SPD or Certificates depending on the type of plan they choose for their employees.

[oriecat]

Oh I see. I thought you were talking about your own plan(s).

Regarding the 5500 - if they are filing one, then it must be an ERISA plan, otherwise there would be no requirement to file one. (I think.)