administering health & welfare plans: common compliance questions
TRANSCRIPT
Areas of Questions
• ERISA
• COBRA
• HRAs
• Cafeteria Plans
• HSAs
• ACA
ERISA
ERISA
Do not-for-profit employers have to comply with ERISA?
Which employers do not have to comply with ERISA?
ERISA
Can an employer have different renewal dates for benefits contained
a wrap document?
Why is a plan year do important?
ERISA
When is an employee assistance plan and/or a wellness program
subject to ERISA?
ERISA
Can an employer put the name of a plan on a checking account?
What happens if the employer does that?
ERISA
What is the penalty for not filing a Form 5500s?
ERISA
• What is a MEWA?
• What does it apply to employers?
• When is one created?
COBRA
COBRA
Can qualified beneficiaries add benefits at open enrollment?
COBRA
If coverage ends for retirees, does the employer have to give them
the right to elect COBRA?
COBRA
If an employee drops coverage, does an employer have to offer his
or her spouse COBRA?
COBRA
Can a COBRA participant drop coverage at anytime?
COBRA
Can individual pretax COBRA premiums?
If so, when is it permitted?
HRAs
HRAs
Is an employer allowed to limit the type of benefits it reimburses
under its HRA?
HRAs
Can an employee participate in a HRA if he or she is covered under
another employer’s group health plan?
HRAs
How does the informational reporting apply to HRAs?
Is there separate reporting?
HRAs
Can an employer limit the amount it reimburses to participants on a
monthly basis?
HRAs
What is the penalty if an employer reimburses individual premiums
under an HRA?
CAFETERIA PLANS
Cafeteria Plans
What is the impact on the Health FSA if the employer allows an
employee to participate in the Health FSA and he or she is not
eligible to participate in the employer’s group medical plan?
Cafeteria Plans
Can a cafeteria plan contain different eligibility requirements for
different employee groups?
Cafeteria Plans
What is the impact if an employer allows employees to pre-tax
voluntary benefit premiums?
Cafeteria Plans
Can an employee be allowed to drop coverage during the year if he
or she deems it unaffordable?
Cafeteria Plans
Is an employer required to provide an SPD to participants in a
Health FSA?
HSAs
HSAs
An employee is covered by a HDHP. He also covers his spouse.
His spouse has other coverage that is not a HDHP. Can he
contribute at the family coverage level?
HSAs
• An employee covers himself, his wife and their sons age 21, 22
and 24 in a HDHP. He does not claim his sons as tax
dependents.
• Are his son’s eligible to contribute to their own HSA. If so, how
much?
• Can the employee reimburse his son’s medical expenses from his
HSA?
HSAs
An employee participates in a HDHP with his wife and children. His
wife also participates in a health FSA at work. She can be
reimbursed for his medical expenses under the Health FSA, but
does not submit any for him for the year.
Does that affect his eligibility to contribute to an HSA for the year?
HSAs
Can a husband and wife have a joint HSA?
If an individual has single coverage and contributes at the single
coverage rate can he or she reimburse expenses for his wife and
children?
HSAs
Can an employee elect out of a Health FSA before the end of the
plan year, if he or she becomes covered under a HDHP?
ACA
ACA
Who has to be provided a Form 1095-C for 2015?
ACA
Can a small employer require an employee to work 40 hour per
week to be eligible for medical coverage?
ACA
If an employee transfers from full-time to part-time, when can the
employer drop coverage?
ACA
Can an employer offer employees an opt out option?
Who cannot be offered an opt out?
ACA
Does an employer have to provide an annual enrollment each year,
even for those employees who waived coverage?
ACA
To which employees, does the 90 day waiting period apply?
ACA
When does a 60 day advance notice has to be provided to
participants?
ACA
How do wellness incentive affect the affordability requirements?
QUESTIONS?
