Stop Loss?

[SLuskin]

For Health and Welfare 5500s, does anyone know if you have to get a Schedule A or Schedule C information from the stop loss carrier?

I have a broker who is telling me the stop loss carrier said this is not reported, but that doesn't sound right to me.

Thank you.

[Guest agoodman@erisapros.com]

Payments under stop loss policies are typically made under an arrangement entered into between the employer and the insurance company. Stop loss benefits are generally paid directly to the employer rather than to participants or beneficiaries.

Reimbursements under stop loss policies will be treated as plan assets in two basic situations: (1) where the policy is issued directly to the plan; and (2) where plan assets (including participant contributions) are used to pay all or part of the stop loss premiums. SOURCE: EBIA Form 5500 Workbook for Health and Welfare Plans, 2007 Plan Years, Background Topic 3, E. 2. a. See also DOL Advisory Opinion 92-02A (January 17, 1992).

Aspen Publishers 5500 Preparer's Manual, 2009 Plan Years, Sec. 8.01[C] states that "(s)chedule A is not required if the plan sponsor is the policyholder and pays the premiums. Schedule A is required if the plan is the owner of the policy and pays the premiums."

In a typical situation, where a stop loss policy is entered into between the employer and the insurance company, no Schedule A is required to be filed.

For more information on ERISA and Form 5500s, you can visit our website at www.erisapros.com.

[SLuskin]

Thank you. That was very helpful.