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

Larry Grudzien

Attorney at Law

How to Tackle Common Health and Welfare Questions Webinar

Larry Grudzien

Attorney at Law

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

Areas of Questions

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? Tax 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? ERISA Issues

Medical Dental Vision Short-term Disability Health FSA Health Savings Account HRA Dependent Care Wellness Benefit EAP Voluntary Benefits Dependent Care Educational Assistance Legal Assistance Adoption Assistance Paid Time Off Benefits Severance Benefits Transportation Plans

• What does it mean when a

benefit under ERISA is funded?

• Can an employer put the name
• f 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? ERISA 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
• f the HRA coverage?
• How does SBC requirements apply to HRAs?
• Can an employer prohibit an employee to separately elect HRA

coverage in COBRA? HRA 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?

Cafeteria Plan Issues

REPORTING AND DISCLOSURE 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?

Reporting and Disclosures 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? Affordable Care Act Issues

QUESTIONS???

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