Selected Flexible Benefits and COBRA regulations including changes under PPACA

We are asked about how regulations affect the services we offer and about how PPACA (Healthcare Reform) has impacted our offerings.  Below are some highlights.

-       Health FSA – maximum $2,550 (2015) indexed per year

-       Health FSA – W-2 may need to include Health FSA if employer amount exceeds employee amount

 -      Health FSA/HRA – no OTC medicines without Rx

-       Health FSA with employer credits - the maximum employer credit allowed is greater of 100% employer match of employee deductions or a $500 employer credit

-       Health FSA - employees in Health FSA must be eligible to enroll in employer major medical group plan. If no major medical group plan is offered then employer may not sponsor a Health FSA.

-       HRA - employers must offer separate major medical group plan and HRA enrollment can only be for employees who also enroll in the separate major medical group plan. Applies to employers of all sizes.

-       HRA - As of January 1, 2012 plan years, employers must report to Centers for Medicare & Medicaid Services (CMS) any employee, spouse, or dependent who is covered by both Medicare and the HRA if the HRA amount is $5,000 or more (including rollovers).

-       HRA – PCORI yearly fees due July 31.  $2.08 per employee current rate.

-       Individually Owned Premium Reimbursement - if the policy is owned by the individual and is not a group policy, the HRA or IOP can only reimburse dental, vision, and specified disease premiums. An HRA or IOP can no longer reimburse individual major medical premiums as pre-tax.

-       Plan documents – written plan document required for any pre-tax plans (Health FSA, POP, HRA, etc.)

-       Form 5500 – required for group health plans with one hundred or more employees participating as of first day of plan year.  Required per plan unless plans are under a Wrap plan.

-       Discrimination testing – required for Section 125, HRAs, and self-insured plans.  Awaiting guidance on insured plans.

-       1094-B, 1095-B, 1094-C, 1095-C – employers with 50 or more FTE in 2015 - IRS forms due January 2016 to EEs and March 2016 to IRS. Determines employer shared responsibility and individual mandate penalty and individual tax credit.

-       Cadillac tax – 2018??? – to include FSA or HRA reimbursements and ER contributions to HSA

-       COBRA – Why take COBRA after PPACA?  Chosen by those who have already met deductible, provider not in other plan, or choose dental or vision

-       COBRA - HIPAA certificates no longer applicable