irenesmsaclaims
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No.
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Yes, if it's one plan document with multiple coverages, i.e., dental, vision as well as medical, then one 5500 filing. It depends on the Schedule A information as reported to you close to the end of the plan year.
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Even if one carrier, the HMO and PPO plans are separate and a 5500 return needs to be filed for each, as the numbers wouldn't be combined. Go to an IRS.gov site and download the form 5500 with instructions. It will explain the requirements and cri…
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It's the responsibility of the employee who is divorced to notify the employer or plan administrator, not the spouse (non-employee). That shouldn't stop you from contacting your ex-wife's employer and trying to find out what has happened. The empl…
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Premiums for insurance cannot be a part of the cafeteria plan, unless it's the "premium only" part. It is not permissible to run insurance premiums through the medical spending part of a cafeteria plan. Could you provide more details?
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Sorry, I meant to type Section 125, not Section 25.
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First of all, let's not call this a "qualifying event". That is COBRA terminology. If it's a cafeteria plan, then it's a "qualified family status" change. FSA is the medical spending part of a cafeteria plan. If you are talking about insured med…
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This person has not elected COBRA yet, and is eligible for your coverage. Is she still in the 60-day election period?
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When you look at the SPD, the section called "contributions" should list three options for contributions during a leave of absence. The plan should choose one or two of these, and some of them are mutually exclusive. They can pay as they go, or ca…
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Yes, you should provide all eligible employees the general notice for COBRA, just to be safe.
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Be a little careful with this one. Actively-at-work clauses which delay or deny coverage based on a health condition are a violation of HIPAA.
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[font size="1" color="#FF0000"]LAST EDITED ON 08-23-05 AT 07:15PM (CST)[/font][br][br]Actually, I believe that there has to be an HDHP with an HSA. Companies can subsidise the co-pay for hospitalization, but I'm not sure that if would have to be ta…
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I'm not sure that this would constitute "gross misconduct" and a denial of COBRA. In the very nebulous area of gross misconduct, it is fairly widely agreed that it would be an act for which a person could be arrested and charged, (like theft or kil…
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Marc's right, but there is another angle to consider here, and it depends upon whether or not your plan is self-funded or fully insured. If it is fully insured, and a misstatement is made on the application, an insurance company will typically resc…
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This is not a status change allowed under Section 125, unless your plan had a significant cost increase, and the change is consistent with dropping the coverage. You should not allow it for this reason. I agree with the others that it is extremely…
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Disability plans (short term or long term) almost always exclude work-related injury or illness. Additionally, the exclusion typically says "whether or not Workers Comp. is in force, or whether or not the individual is covered" because the person …
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Regardless of what your handbook says about full-time and part-time and the definitions of each, the policy is a contract between your company and the insurance company, and the insuror will only cover employees working a certain specified number of…
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[font size="1" color="#FF0000"]LAST EDITED ON 05-27-05 AT 08:12PM (CST)[/font][br][br]Thanks, Marc for reviewing this, you're a better man than I am. I read it until I got a headache. To answer JMCAA's question, the premium-only part of a Section …
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[font size="1" color="#FF0000"]LAST EDITED ON 05-26-05 AT 06:50PM (CST)[/font][br][br][font size="1" color="#FF0000"]LAST EDITED ON 05-26-05 AT 06:46 PM (CST)[/font] Ok, either people are employees or they aren't. I have not heard of a "non-active…
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[font size="1" color="#FF0000"]LAST EDITED ON 05-25-05 AT 06:33PM (CST)[/font][br][br]Since the employee has terminated employment, he is no longer participating in your Section 125 plan (COBRA applies to the FSA part of the plan), so the COBRA prem…
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After amending the plan (i.e., during the current plan year), each year thereafter participants will have the 12 months plus the 2.5 months to incur expenses. If you have the grace period, you have to use the previous year's unused amounts before y…
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Once again, it looks like the lawmakers didn't really think this through. If you think about it, if a plan amends for this, then it's about March 15 to incur claims, then, if a plan has a 90-day period after the plan year plus the grace period to c…
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Almost always, eligibility language will state "working or regularly scheduled to work" 25/30/40, (or something else) hours for benefits. I would look at the plan document or policy and make reasonable determination if this fits for this person, i…
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In my opinion, you should be sending an election notice by certified mail, return receipt requested for each covered, terminated employee. You should protect your company because there are penalties for not sending the notice timely. You can't pro…
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If you can get them to sign the enrollment in Marc's situation, which of course they should, then good. But you can't force them to enroll, even if that's the policy under the contract/coverage. If they absolutely won't, then the employer needs to…
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He can waive coverage through his employer's plan, especially if it's contributory. They cannot force them to enroll. His boss may be confused with the inability to drop the coverage without other coverage, or because of a cafeteria plan election,…
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The code is very clear that you cannot commingle these two accounts.
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You would need to see the judgement if your plan requires documentation. The employee, spouse or other dependent can provide the notification of qualifying event. The time frame is within 60 days of the latest of the date of the QE, the date on wh…
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Linda, actually the final rules don't specifically say that the SPD isn't sufficient unless you can verify that it was received by the dependents, but it does say that providing it to the employee doesn't mean the spouse has been also provided, so y…
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Good answers all, but the final rules also include many changes and clarifications which were effective on the first day of the plan year after Nov. 26, 2004. Plans have to be amended to include notification details, specific time frames for notify…