Pearce
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I guess I missed that the wife was not now covered under her employer's plan. The wife, if covered under her spouse's coverage would be eligible when she lost coverage under her husband's coverage (termination of employment or reduction of hours)…
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If your employee's husband is covered by group coverage currently and he loses that coverage due to loss of eligibility for the coverage (termination of employment, reduction in hours of work) he should be offered COBRA continuation by his employer,…
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I'm probably weighing in too late with too little, but we all know that every COBRA participant has a minimum of 30 days from the due date to render a payment. The date on the envelope is what counts and not the date that the post office gets aroun…
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One time fee of $150.
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From the Final COBRA Regulations issued in 1999. "Paying for COBRA Continuation Coverage The 1987 proposed regulations identify the qualified beneficiary as the person that can be required to pay the applicable premium. Many plans and employers hav…
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I can't speak for insured STD coverage because I have always been with companies providing salary continuation through the employee payroll and the benefit is taxable. As for LTD you can purchase the coverage and include in the contract that the in…
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When looking at what is allowable as it relates to your 125 Plan, don't forget to look at your actual plan document and SPD. Your plan may be more restrictive than the IRS regulations, and if your plan did not adopt the final regulations regarding …
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Simply putting someone on "leave of absence" does not guarantee that benefits are available. Yes as a self insured health plan you can pretty much do as you please but shouldn't you really be following the plan document regarding coverage during a …
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You don't say for how long this employee was out due to the disability. Did you follow the FMLA regulations, if applicable to this specific case, regarding benefits?
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Termination of employment, alone, provides the ability for a qualified beneficiary dependent child to carry COBRA coverage for up to 18 months.
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Your medical insurance (fully-insured or self-insured), life insurance and accidental death and disability insurance [not an all encompassing list]all generally have provisions related to leaves of absence and clearly state how long an employee may …
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I guess the real answer can only come once someone clearly understands what the original poster means. It is not clear whether the spouse of the retiring employee will lose eligibility for coverage by definition in the plan when the employee retires…
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If the spouse is losing coverage because she does not meet the plan's definition for eligibility as a dependent of the retiring employee, then she is losing coverage because of the employee's retirement or termination of employment. The spouse woul…
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The employee out on FMLA who does not pay their portion of the normal premium (assuming they were given information regarding how and when to make those payments) may have coverage terminated with a 15 day notice of termination of that coverage (pro…
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Before you set up a plan you should read the regulations and any IRS comments regarding. I researched this a few years ago (not currently administering a 132 plan) and there may have been some changes; however, I believe that carry over is allowed …
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If your question is whether people that are dropped during open enrollment are COBRA Qualified Beneficiaries,in general the answer is NO. You do not offer COBRA to someone who is dropping coverage as a choice. However, if a enployee is dropping a …
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I run a report various times during the year to get the YTD contribution paid by the employee. Download that then divide by per payroll deduction amount. The result should be the number of payrolls YTD. If it is not I look at that specific deduct…
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There is no federal law that requires open enrollment in a health plan. If you are fully insured, there may be a state law to consider. Our self-insured plan does not have open enrollments; however, we do follow all of the HIPAA regulations regard…
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The changes allowable due to changes in coverage are addressed in the final regulations. Your 125 plan document may need to be amended to allow all of the permitted election changes so you will need to additionally check your own documents.
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The cost of coverage changes allowed under Section 125 may or may not apply. The underlying plan in this case is the health plan and if it abides by the HIPAA Special Enrollment regulations in the strictest since, the health plan would not allow en…
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Your employee is likely just going to have to wait for your open enrollment. Your healthplan can adhere to the strictest interpretation of the HIPAA Special Enrollment regulations which would not consider this a loss of coverage due to loss of elig…
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The final federal COBRA regulations specifically address mergers and acquisitions. Without going back to read them again I am fairly certain that the acquiring company is going to have the COBRA obligation, even if the employees not hired are termin…
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If by "unreimbursed medical spending account" you are referring to a Section 125 Flexible Spending Account (FSA) for Medical Expenses you are incorrect. It is possible that your specific 125 plan has a restriction of $5,000 on your medical spending…
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The fact that the Retiree is Medicare eligible does necessarily make a change (unless you plan specifies otherwise) in the benefit of the Retiree's dependents. COBRA would only be offered to the dependent if the dependent was losing coverage becaus…
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If your eligibility for the health insurance actually reads the way you say it does (you have quoted wording from an employee handbook and not necessarily is that the same as the wording in your plan documents or contracts) then you would have to wa…
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Correct if limiting age is intended to mean a previously eligible dependent child who has lost coverage because the child no longer meets the age requirements of a dependent child.
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If the COBRA QB choses to enroll in coverage with the new spouse then that is an event which would allow you to terminate COBRA coverage. However, there is no obligation for the QB to enroll in other available coverage. The other plan WOULD be obl…
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Changes in cost of coverage and/or changes in coverage are not reasons that would allow a change in FSA election mid-year. See the Permitted Changes in the Final Regulations.
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As I interpret the current wording of your policy you are saying that you will cover the period of time the person is disabled due to the pregnancy. Physicians consider the person disabled for a period of from 6-8 weeks after the delivery, dependin…