Top 6 Questions Regarding Common Compliance
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This presentation reviews common questions in ERISA, COBRA, HIPAA, Cafeteria plans, Medicare, and Health Care Reform.
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Top 6 Questions Regarding Common Compliance
- 2. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC By Larry Grudzien Attorney at Law
- 3. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC •ERISA •COBRA •HIPAA •Cafeteria Plans •HSAs •Health Care Reform Agenda
- 4. ERISA
- 5. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC Does an employer with under 100 participants in their medical plan need a plan document? ERISA
- 6. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC ERISA When is a benefit considered funded for purposes of ERISA?
- 7. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC When is an employee assistance plan and/or a wellness program subject to ERISA? ERISA
- 8. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC ERISA When is a employee paid only benefit subject to ERISA?
- 9. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC Is there a statute of limitations on unfiled Form 5500s’? ERISA
- 10. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC ERISA Is an employer required to cover same sex spouses under its health and welfare plans under ERISA?
- 11. COBRA
- 12. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC Can qualified beneficiaries change and add benefits at open enrollment? Do qualified beneficiaries have special enrollment rights? COBRA
- 13. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC COBRA If coverage ends for retirees, does the employer have to give them the right to elect COBRA?
- 14. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC COBRA When does entitlement to Medicare terminate COBRA coverage and when?
- 15. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC COBRA Does an employer have to offer COBRA to participants in employee assistance programs and wellness programs?
- 16. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC COBRA How does health care reform affect COBRA?
- 17. HIPPA
- 18. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC What benefits are considered “excepted” and why it is important? HIPPA
- 19. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC If an employer wants to charge a smoker a higher premium, must it meet the requirements for a wellness program under the HIPAA regulations? HIPPA
- 20. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC Can employer deny coverage under a health plan to an employee if he or she does not participate in a employer sponsored wellness program? HIPPA
- 21. Cafeteria Plans
- 22. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC Can premiums from individual policies be reimbursed pre-tax under a cafeteria plan? Cafeteria Plans
- 23. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC Cafeteria Plans If an employer switches to a High Deductible Health Plan in the middle of the year, can employees have the right to change their election for coverage under the health FSA? Can a change in cost or coverage be a reason to change an election under a health FSA?
- 24. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC Cafeteria Plans Can an employer give an employee the right to change the character of any carryover? Will the carryover make an employee ineligible to make a HSA contributions for the next year? How does an employer determine the COBRA premium on a carryover?
- 25. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC Cafeteria Plans My employees want to drop our coverage and elect coverage on the exchange. Is that a qualifying event?
- 26. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC Cafeteria Plans Is an employer required to recognize same sex spouses as spouses under its cafeteria plan?
- 27. HSAs
- 28. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC 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
- 29. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC 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?
- 30. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC 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?
- 31. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC 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
- 33. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC When is the employer mandate effective? January 1, 2015 or on the employer’s renewal date? Health Care Reform
- 34. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC Health Care Reform In determining whether an employer is large employer for employer mandate purposes, are seasonal and part-time employees considered in the count?
- 35. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC Health Care Reform Does the 30 hour requirement for full-time employees apply to small employers?
- 36. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC Health Care Reform Can employer sponsor a stand alone Health Reimbursement Arrangement in 2014?
- 37. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC Health Care Reform Do seasonal or variable hour employees have to be offered coverage in 2015?
- 38. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC Health Care Reform For the subsidies, how are they determined and what happens if your income does up or down during the year?
- 39. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC Health Care Reform Do you have to be a citizen to be eligible to buy coverage on the exchange and obtain a credit or subsidy?
- 40. Questions?
- 41. Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC Contact Information Larry Grudzien •Phone: 708-717-9638 •Email: larry@larrygrudzien.com •Site: www.larrygrudzien.com