Larry Grudzien Attorney at Law
How to Tackle Common Health and
Welfare Questions Webinar
Larry Grudzien Attorney at Law
• 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
• 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 VisionShort-term
DisabilityHealth FSA
Health Savings
Account
HRA Dependent
Care
Wellness
BenefitEAP
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
of 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 voluntary benefit?
• Why is this exemption so important?
• What actions by an employer will make the employer lose the exemption?
ERISA 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
of 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
• 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
• 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
• 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
Larry Grudzien
Attorney at Law
www.larrygrudzien.com
Call Larry