Common Health and Welfare Questions Webinar Larry Grudzien Larry - PowerPoint PPT Presentation

How to Tackle Common Health and Welfare Questions Webinar Larry Grudzien Larry Grudzien Attorney at Law Attorney at Law

Areas of Questions 1. TAX 2. ERISA 3. HRAs 4. Cafeteria Plans 5. Reporting & Disclosure 6. ACA

TAX ISSUES

Tax Issues • For waiving medical coverage, an employer provides its employee a cash payment of $300. Is the payment taxable? • Would an employee be taxed on the $300 if he or she elected health coverage? • Would the employer payment be taxable if contributed to a health FSA or to a HSA?

Tax Issues • Would giving an employee $100 for satisfying a wellness goal be taxable? • Would distributing fitness watches under a wellness program be a taxable event? • Would employer contributions to an HSA or health FSA under a wellness program be taxable?

Tax Issues • Can an employer pay for a new employee’s COBRA premiums tax free? • Can an employer include tax free medical coverage as part of a severance package? • Are governments, churches and not-for-profits not subject to various nondiscrimination tests in the Internal Revenue Code?

ERISA ISSUES

ERISA Issues • Do not-for-profit employers have to comply with ERISA? • Which employers do not have to comply with ERISA? • Can employers not subject to ERISA pick and choose what sections to comply?

ERISA Issues • What is a plan sponsor? Why is that term important? • Who is the plan administrator? What are its duties? • What is a plan number? • Who is a Plan fiduciary? Why is the term important?

ERISA Issues What benefits are subject to ERISA? Short-term Health Savings Medical Dental Vision Health FSA Disability Account Dependent Wellness Voluntary Dependent HRA EAP Care Benefit Benefits Care Educational Legal Adoption Paid Time Off Severance Transportation Assistance Assistance Assistance Benefits Benefits Plans

ERISA Issues • What does it mean when a benefit under ERISA is funded? • Can an employer put the name of a plan on a checking account? • What happens if the employer does that? • Does any reporting or disclosure change?

ERISA Issues • When does an employer have to file a form 5500? • What has to be filed? • What is the penalty for not filing a Form 5500? • Are there any programs available to reduce the penalty?

ERISA Issues • What is a MEWA? • When does it apply to employers? • When is one created?

ERISA Issues • What is a voluntary benefit? • Why is this exemption so important? • What actions by an employer will make the employer lose the exemption?

HRA ISSUES

HRA Issues • Is an employer allowed to limit the type of benefits it reimburses under its HRA? • Can an employee participate in an HRA if he or she is covered under another employer’s group health plan? • How does the PCORI and Employer Mandate reporting apply to HRAs? • Is there separate reporting?

HRA Issues • Can an employer limit the amount it reimburses to participants on a monthly basis? • What is the penalty if an employer reimburses individual premiums under an HRA? • Can an employer reimburse Medicare premiums?

HRA Issues • How is the premium for HRA coverage determined under COBRA? • Does an employer have to allow an employee to opt-out of the HRA coverage? • How does SBC requirements apply to HRAs? • Can an employer prohibit an employee to separately elect HRA coverage in COBRA?

CAFETERIA PLAN ISSUES

Cafeteria Plan Issues • 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? • Can a cafeteria plan contain different eligibility requirements for different employee groups? • What is the impact if an employer allows employees to pre-tax voluntary benefit premiums?

Cafeteria Plan Issues • Can an employee be allowed to drop coverage during the year if he or she deems it unaffordable? • Is an employer required to provide an SPD to participants in a Health FSA? • Is a Health FSA subject to HIPAA Privacy requirements?

REPORTING AND DISCLOSURE ISSUES

Reporting and Disclosures Issues • Under ERISA, who is responsible for completing the reporting and disclosure requirements? • Do participants have to be given a paper copy of any notice or disclosures? • What evidence should the employer keep as proof that the notices were provided?

Reporting and Disclosures Issues • What notices and disclosures have to be provided at initial enrollment? • What notices or disclosures have to be provided annually? • What notices can be included in an SPD?

AFFORDABLE CARE ACT ISSUES

Affordable Care Act Issues • Can a small employer requiring an employee to work 40 hours per week be eligible for medical coverage? • If an employee transfers from full-time to part-time, when can the employer drop coverage? • Does an employer have to provide an Annual Enrollment each year, even for those employees who waived coverage?

Affordable Care Act Issues • To which employees does the 90-day waiting period apply? • When does a 60-day advance notice have to be provided to participants? • To what employees does a Form 1095-C have to be provided?

QUESTIONS???

Call Larry Larry Grudzien Attorney at Law 708.717.9638 larry@larrygrudzien.com www.larrygrudzien.com