Plan Documents

mrsbowden

I am NOT completely familiar with Plan Documents..I understand that it outlines eligibility, schedule of benefits and covered/excluded items of an emplyee benefit plan offered by an employer....

We recently heard that the new IRS Ruling for FSA was ruled to include non-prescripton over-the-counter products. (certain products) We offer a FSA to ee's and were told we should update our plan documents to refelect the new change and inform ee's of this change.

While researching this I found some documents that seem to be something of a plan document but not quit! These things are date for the early 1990's, shouldn't these be update every so many years..months? When should they be updated, only when there is a change to it? Reguardless, I know that there has been changes to the plan documents since 1990 and changes and up dates have not been made.

So my next question is WHO writes the plan documents for Beneifts? The employer, a lawyer and the insurance provider? I am just really not sure about this, should I be writing them and if so HELP!!!!!!!!!!! :-S Where do I start x:-/?

aingram

While I am not answering the questions you posed, I have a comment that you might find helpful. While researching the new regs about allowing over-the -counter medications for FSA's I have found that while you can offer this benefit, it is not necessarily mandatory. Because of the hassle of filing these types of claims, we have decided not to offer this nor amend our plan.


Amanda

mrsbowden

REALLY? not required by law? I thought it was...?
thanks a bunch

Hunter1

Generally, in my experience, the insurance provider/third party administrator writes the plan document, which then has to be reviewed by the employer for completeness/accuracy. Again, my understanding is that any amendments to the plan document must be distributed to participants, so after you've made a few plan amendments, it is best to re-write the plan document so it's a complete, concise document. Ask your providers; for instance, our third party administrator for our health plan charges a one-time fee for a plan re-write, and our FSA administrator's fee for doing so is written into their charges, but they will only provide suggested language. We are ultimately responsible.

LindaS

Aingram - I have been unable to find anything that allows an employer with FSAs to elect NOT to allow this benefit. I even spoke with our TPA regarding it and was informed that since the IRS has decided OTCs are reimbursable, we are required to amen our plan accordingly. If you have found something that states we have the option, I would like to find out where you got it.

SMace

Your plan document has not been updated since the early '90's??? Yikes. It should be done any time benefits change or to be in compliance with any new laws. As I understand there is a lot of compliance info regarding HIPPA that must be in plan docs. Our TPA rewrites ours every year and we review and sign off. I believe there is some fiduciary responsibility to update the plans and there may be some laws (ERISA?) to deal with by not complying. Contact your insurance carrier and demand an explanation. Also, do you have a broker? If you do what the heck have they been doing all these years? Sounds like nothing. Once you get to the bottom of this I would seriously consider changing brokers and/or insurance carriers. If they have not been able to handle the most basic of issues (plan doc), what else are they not doing? Good luck.

jmcaa

You might want to check out the article linked below concerning the IRS Ruling. The ruling states that OTC drugs MAY be reimbursed through FSAs.

Regarding your plan document, our TPA writes it, we look over it, then distribute it.


[url]http://www.morganlewis.com/pdfs/B93E2150-235B-410C-8210FE4B790661D1_Publication.pdf[/url]

mrsbowden

Thank you...You have all been a great help. We do have a broker and I will be checking in with her soon. We have a broker for our Health Benefits not our vision and dental..we go straight to the provider.