Search results for: “Compliance”

  • Compliance Q&A: Can We Pay for Executive Physicals?

    Question Can employers provide physicals for their executives? Summary Yes, but as with most things in benefits, you’ll need to think through the compliance considerations. Unfortunately, it’s not as easy as just reimbursing or paying the cost of the physical. Although it seems like a small thing, simply paying or reimbursing for the cost of…

  • Compliance Q&A: COBRA Implications under Severance Agreements

    Question Typically, when we terminate a management or executive employee, we agree to pay all or part of their COBRA premiums for a period of time. What compliance concerns should we consider? Summary While an employer may subsidize COBRA for terminated employees, including management and executives, there are potential compliance traps for the unwary. These…

  • Why You Should be Auditing Your Monthly Carrier Invoices: Bill Reconciliation from a Compliance Perspective

    Have You Reviewed Your Bills Lately? While conversations about finances are always first on the agenda at annual renewal meetings, there are a variety of reasons why plan sponsors and HR should be paying attention to carrier invoices year-round. As a former account manager, I cannot count the number of times that a client who…

  • Compliance Q&A: Best Practices for Level-Funded Plan Compliance

    Question We are considering moving from a fully-insured to a level-funded group health plan. What should we be thinking about from a compliance perspective? Summary Often considered a hybrid approach, level-funded plans provide the stability of fixed premiums (similar to fully-insured plans) along with the ability to share in a degree of cost savings (a…

  • Compliance Q&A: Accidental MEWA

    Question Our company (Company A) is a closely owned family business and there is a related company (Company B) that has somewhat similar ownership. Company A is owned by four brothers, W, X, Y and Z, and each owns 25% of the common stock. Company B is owned by the same four brothers (10% ownership…

  • Compliance Q&A: Rehire Rules After the Affordable Care Act

    Question My company is an Applicable Large Employer using the look-back measurement method to determine full-time status of our employees. One of our full-time employees left the company to pursue another career. Four months later, he returned to the company as a part-time employee. Do I need to offer him health insurance coverage? Summary In…

  • Compliance Q&A: High-Cost Claimants: ADA, ACA, HIPAA and ERISA

    Question We are examining various health coverage and plan design options in order to save money. One employee, a hemophiliac, has experienced high claims and requires expensive, ongoing treatment. Our reinsurance carrier has imposed a laser at $500,000 for this employee, which is a significant financial burden. May we offer this high-cost claimant cash to…

  • Compliance Q&A: Short Plan Year

    Question We are an applicable large employer (ALE) and we currently operate medical plans and other benefits on a plan year ending March 31st (current plan year ending March 31, 2026). We want to amend our plan year to a calendar year plan so that our employees can better understand the timing and election of…

  • Compliance Q&A: Classing Out Executive Benefits

    Question Our company would like to reward our executive team for their hard work in turning around the company’s recent financial difficulties and making the company profitable again. We would like to pay a greater portion of the premiums for our group health plan for our executives than we pay for our rank-and-file employees. Can…

  • Compliance Q&A: Interns and Offers of Coverage

    Question I have hired a couple of interns. They’re scheduled to work full-time hours but they’re only going to be with us for about four months. Am I at risk of any Affordable Care Act (ACA) “Pay or Play” penalties if I decide not to offer these interns health coverage? Summary If the employer is…