Lori B
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Wow, that can get you sued if the ee didn't authorize the deduction from pay. You can always ask...but you can't force the issue. There is no way to ever force an ee to pay back a flex acct for health spending. ERISA views it like a risk shifting …
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Actually, you can ask for reimbursement but you can't force it. Kind of like I can ask you to pay me $100 today but you have no obligation to do so. We have some ees who actually do pay it back b/c they realize they haven't paid it in and they fee…
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The EEOC does look at this as sex discrimination. Of course, the EEOC's interpretations of law aren't law. Nevertheless, it is far more prudent to make this a temporary disability leave or, alternatively, a parental leave policy that treats the se…
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Yes, it can be any 12-month period and you need to remain consistent. It is possible though to have a short plan year if you want to adjust it to some other time period. This issue is much easier now that 5500s aren't required for standalone 125 p…
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Our vacation accrual is the same as Sally above. Our sick time though is only 5 days per year. (but we offer STD and payout unused time at the end of each year). We do not combine vac and sick because that triggers unique issues under Illinois la…
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P.S. One more point: 125 enrollment can never be late. It would appear that the latecomers who slide in within the 30-day grace period would be paying their premiums post tax since they blew a most unforgiving deadline for 125.
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I agree about making ees stick to deadlines; however, be careful. Many health plan documents (at least for fully insured plans) provide a 30-day grace period for various enrollments. Our group carrier allows this grace period to run from 30 days a…
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Just an update - I'm now hearing conflicting info on this one. One of our TPAs says no 5500 for a 125 plan. The other says we should still file it since we have more than 100 ees, just no Schedule F. Be careful.
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You no longer need to file a 5500 for a stand alone 125 plan. If your 125 plan is combined with your group health plan, you would still need to file.
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The taxation issues depend on how the premium is being paid. We currently have a fully insured STD plan that is completely voluntary. (ie, if ee wants it, they pay 100% of the premium.) The ee pays the premium after tax, which means the benefits …
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How does your flex plan document define "dependent"? Did the employee list this person as a dependent on their enrollment form? These are your starting points.
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We offer an HMO and PPO. We pay 80% of ee coverage for HMO and about 75% for HMO family coverage. We pay 72% of ee coverage for PPO and about 65% for PPO family coverage. We pushed our broker to provide statistics of what other employers are doin…
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Hi I don't think your contract with the carrier would allow it. Group plans usually designate the employer portion for the group. Assuming you could do it, is it a precedent you want to set for others? Lori
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Hi This is a serious issue. If you are audited, both company and ee must pay back taxes on all those deductions. We outsourced our 125 plan to a company called Allied Benefit Systems in Chicago. They provided the plan documents, an SPD, the dire…
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There seems to be a lot of confusion with this issue. I do note that regs recently changed to expand the types of qualifying reasons to allow a mid-year change. Under the old regs, this reason would never qualify. Under the new regs, I believe ch…
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Hi Sue You appear to be in Illinois, my stomping ground. Illinois regs and cases are pretty tight here. If they accrued vac time, it is theirs. The answer to your problem is to clarify that ees aren't accruing until after the initial 90-day mark…
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If someone is electing dep care or medical reimbursement amounts, they must make an affirmative election each year. It would be completely inappropriate to enable them to keep using a prior year's election. I would really question any provider tha…
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We're currently pursuing this in CA with an ergonomic type injury. Too early to tell if we will have success or not.
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You do take your ee as you find them. However, if a prior employer's environment helped contribute to the condition, your carrier should attempt to subrogate against that prior employer to help share expense.
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Our rating went from .99 to .69 this year. The 30-point drop brought a substantial reduction in premium. (about 20-25% as I recall) Anything over 1 is indeed considered "high" but it doesn't take much to get there. I have found that the claims…
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I'd stay as far away from advances as possible. If you must offer them, are you withholding all the taxes up front? IRS wants ee taxes as soon as they receive the benefit of the money. Most people get this wrong and withhold on the back end. T…
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Absolutely agree with above comments. What is "clear" fraud to you and I is never clear when you have to prove it to a jury of the ee's peers, not your peers.
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This issue has come up in other posts. You may want to do a search. COBRA can be used (and should be used) for reduced hours. It isn't just for termination. My concern is how you have treated other folks in the past. This is one area that cries…
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I think lack of communication is a big complaint with many carriers and open claims. I would look for a carrier that provides you with internet access to open claim notes. You can get in and review the claim as it progresses, including nurse notes…
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First, we encourage ees to schedule appointmts after hours, if at all possible. If that is not possible, and they want pay, they use sick time for follow up visits. We pay the initial visit on the date of injury.
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I believe the OSHA log only applies to lost time incidents. If ee only had brusing, I doubt they took time off? I'd report it to both work comp carrier and your gen'l liability carrier. Keep in mind that work comp might not cover this, but your…
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Theresa is absolutely correct. If the remote locations are not covered, take a look at state law too. There are a few states that have similar laws in place like FMLA that may still apply.
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See the post about "who pays" in the main employment forum today. The discussion compliments this topic nicely.
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We use Aetna and this has never been an issue (yet). I would suggest calling your rep and perhaps your broker to have a chat about service expectations.
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Amen sister! Plea to all participants...let's keep the integrity of the forum to a place where we share meaningful knowledge. It is a reality that business today is increasingly global and thus HR needs to think globally as well if we are to be ef…