Yes, you are required to include a description of the cost sharing provision within your SPD. ERISA requires a description of any cost sharing provisions, which include premiums, deductibles, coinsurance, and copayment amounts, which are considered as employee responsibility. Since the specific premiums change annually, it is common practice for employers to choose not to … Continue reading ARE WE REQUIRED TO INCLUDE A DESCRIPTION OF THE COST SHARING PROVISION WITHIN OUR SPD, UNDER ERISA?
If the benefit plan of the single employer, was adopted by affiliate companies (via adoption agreement or board action) the benefit plan would still be treated as a single employer plan requiring only one filing for Form 5500. After the document is generated, minor alterations would be needed. Primarily the definition of Employer would need … Continue reading WHAT HAPPENS IF THERE IS A PRIMARY EMPLOYER WITH SEVERAL AFFILIATES THAT ALL HAVE DIFFERENT EIN’S, SHARING THE SAME BENEFITS PLAN(S)?
All health and Welfare Plans must be maintained according to a “written instrument” under ERISA. This instrument is the Plan Document. For each plan maintained there must be a separate ERISA Plan number, such as 501, 502, etc. Any and all welfare benefits can be combined into one plan. Alternatively, the plans can be maintained … Continue reading DO MULTIPLE PLAN DOCUMENTS WITH MULTIPLE SPD’S AND SEPARATE ERISA PLAN NUMBERS, HAVE TO BE CREATED IF A CLIENT HAS HEALTH, DENTAL, FSA,HRA, LIFE, ETC.?
Although the following are variable (due to the DOL failing to write many of the required regulations as of yet) the key features of PPACA to take effect in 2014 are: 1. All U.S. citizens will be mandated to purchase a minimum level of health insurance or they will receive a tax penalty (the “individual … Continue reading WHAT CHANGES CAN BE EXPECTED IN 2014 UNDER PPACA?
IRC Code Section 105 covers HRA, while Code Section 125 does not. The main difference is how the IRS can look at the plan and reimbursement features, as well as what can and cannot be excluded from taxable income. This is all connected to the taxability of benefits. Alternatively, FSAs are covered under Code Section … Continue reading HOW ARE CODE SECTION 105 AND 125 DIFFERENT?
If all their Health and Welfare Benefits were encompassed in one plan, they would only be required to file one 5500, but all lines of coverage including those with less than 100 participates would still have to be reported. If the SPDs have not been combined then only the plans with more than 100 participants … Continue reading IF A CLIENT HAS OVER 100 EMPLOYEES ON THEIR DENTAL PLAN AND 75 ON THEIR OTHER PLANS, ARE THEY REQUIRED TO FILE 5500S FOR ALL PLANS? IF NECESSARY, WHAT PROCEDURE SHOULD WE USE TO GET THEM IN COMPLIANCE? HOW DO YOU ADVISE US FOR THE FILING BACK OF THE 5500S?
Two options are available for a company that has adopted a plan that affects tax liability and obligates the company to pay benefits. The first is if they have a Board of Directors who has approved adoption or amendment of the plan through board action, they are not technically required to have an adoption page, … Continue reading IS THE “ADOPTION OF THE PLAN” PAGE REQUIRED? DOES IT HAVE TO BE SIGNED AND DATED BEFORE HR GIVES THE SPD TO A PLAN MEMBER?
Language will be added to non-calendar year plans. Traditionally cafeteria plans must be changed prospectively, but the transition relief would give employers until December 31, 2014 to amend their plans to reflect the transition rules. As long as the amendment is effective retroactively to the first day of the 2013 cafeteria plan, the plan can … Continue reading IN TERMS OF NON-CALENDAR YEAR PLANS, WILL TRANSITION RELIEF LANGUAGE BE ADDED TO THE PLANS? CAN CAFETERIA PLANS BE AMENDED, MID-YEAR, TO ALLOW PARTICIPANTS ON/OFF PLAN TO ENTER EXCHANGE OR ADD COVERAGE TO COMPLY WITH HCR?
Currently our self-insured plans document provides two descriptions for preventive care: benefits provided in adherence with AMA age-based guidelines or benefits provided in accordance with the Patient Protection and Affordable Care Act. When benefits provided in accordance with the Patient Protection and Affordable Care Act is the description used, the SPD states that routine preventive … Continue reading HAVE THE MEDICAL PLAN DOCUMENT TEMPLATES BEEN UPDATED TO REFLECT THE NEW INFORMATION ON WOMEN’S HEALTH PREVENTIVE SERVICES?
If the SBCs are saved as PDF’s you will be unable to upload them into the SPD, as it is typically a MS word doc. Also, it is advised to keep the SBC and SPD separate, ie in two different documents. If joining the two is necessary, the SBC must be prominently displayed in front … Continue reading HOW CAN WE RESOLVE THE ISSUE OF BEING UNABLE TO UPLOAD SBCS INTO THE SPD FOR A GROUP, DUE TO FORMATTING ISSUES?