Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC 1
Common Compliance Questions
Nov 02, 2014
This webinar focused on Common Compliance questions from the following areas: ERISA, COBRA, HIPAA, Cafeteria Plans, HSAs, and Health Care Reform.
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
1
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
Common Compliance Questions
By
Larry GrudzienAttorney at Law
2
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
Agenda
• ERISA
• COBRA
• HIPAA
• Cafeteria Plans
• HSAs
• Health Care Reform
3
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
ERISA
4
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?
5
ERISA
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
• When is a benefit considered funded for purposes of ERISA?
6
ERISA
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?
7
ERISA
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
• When is a employee paid only benefit subject to ERISA?
8
ERISA
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
• Is there a statute of limitations on unfiled Form 5500s’?
9
ERISA
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
• Is an employer required to cover same sex spouses under its health and welfare plans under ERISA?
10
ERISA
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
COBRA
11
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?
12
COBRA
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
• If coverage ends for retirees, does the employer have to give them the right to elect COBRA?
13
COBRA
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
• When does entitlement to Medicare terminate COBRA coverage and when?
14
COBRA
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
• Does an employer have to offer COBRA to participants in employee assistance programs and wellness programs?
15
COBRA
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
• How does health care reform affect COBRA?
16
COBRA
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
HIPAA
17
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
• What benefits are considered “excepted” and why it is important?
18
HIPAA
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?
19
HIPAA
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?
20
HIPAA
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
Cafeteria Plans
21
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?
22
Cafeteria Plan
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
• 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?
23
Cafeteria Plan
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
• 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?
24
Cafeteria Plan
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
• My employees want to drop our coverage and elect coverage on the exchange. Is that a qualifying event?
25
Cafeteria Plan
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
• Is an employer required to recognize same sex spouses as spouses under its cafeteria plan?
26
Cafeteria Plan
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
HSAs
27
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?
28
HSAs
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
• 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?
29
HSAs
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
• 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?
30
HSAs
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?
31
HSAs
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
Health Care Reform
32
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?
33
Health Care Reform
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
• In determining whether an employer is large employer for employer mandate purposes, are seasonal and part-time employees considered in the count?
34
Health Care Reform
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
• Does the 30 hour requirement for full-time employees apply to small employers?
35
Health Care Reform
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
• Can employer sponsor a stand alone Health Reimbursement Arrangement in 2014?
36
Health Care Reform
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
• Do seasonal or variable hour employees have to be offered coverage in 2015?
37
Health Care Reform
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
• For the subsidies, how are they determined and what happens if your income does up or down during the year?
38
Health Care Reform
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
• Do you have to be a citizen to be eligible to buy coverage on the exchange and obtain a credit or subsidy?
39
Health Care Reform
Copyright 2014- Not to be reproduced without express permission of Benefit Express Services, LLC
Larry Grudzien
Attorney at [email protected]
www.larrygrudzien.com
40
Contact Information
Related Documents
