PPACA

[Guest Mel Kiper Jr.]

Can someone please point to where "plan year" is defined in PPACA?

[Guest Mel Kiper Jr.]

Can someone please point to where "plan year" is defined in PPACA?

Is everyone assuming it coincides with the Form 5500 filing for the health plan?

[Guest ERISA Pros]

I have yet to find a definition for "plan year." If it refers to the Plan Year for reporting purposes it should have been capitalized. An even more perplexing situation arises when the Plan is a mega-wrap plan, within which various component benefit plans could have plan years different from each other and from the Wrap Plan Year. I tend to think that the plan year for the component benefit plan applies, regardless of the reporting Plan Year. However, the safest approach would be to base changes in coverage on the earlier date or the date most favorable to the Participants.

[Guest Sieve]

Just to clarify, defined terms are not capitalized in the Code or ERISA. They simply are defined. Plan year is defined in ERISA Section 3(39) as " . . . the calendar, policy, or fiscal year on which the records of the plan are kept." If the term is used in PPACA as part of the act that amends ERISA, then the ERISA definition applies.

[Chaz]

Can someone please point to where "plan year" is defined in PPACA?

I'm not sure for what reason you need the definition. If you post more information, I might be able to provide some help.

[Guest JKosciusko]

You cannot find it because it is not defined. However, do note that implementation dates vary by plan years "beginning on or after" certain dates (e.g., September).

If you want the PDF and search it (should you not already have it), I posted it on my site: http://sites.google.com/site/hcrlinks It was driving me crazy trying to find primary source material on PPACA while I prepped for a presentation (thousands of newsletters with every hit!), so I put up one place where I could keep the primary source material. I figured I wasn't alone, so I thought to share.

[Guest ERISA Pros]

Just to clarify, defined terms are not capitalized in the Code or ERISA. They simply are defined. Plan year is defined in ERISA Section 3(39) as " . . . the calendar, policy, or fiscal year on which the records of the plan are kept." If the term is used in PPACA as part of the act that amends ERISA, then the ERISA definition applies.

So, in the case where the wrap SPD has a different Plan Year than the underlying medical plan, are you saying that it is the ERISA Plan Year (for Form 5500 reporting purposes), not the insurance plan year (when rates change), that determines when the employer must comply with the law?