Question: How should my client handle benefits for an employee on FMLA if the employee cannot afford to make the premium payments? Answer: During FMLA leave, an employer must maintain the employee’s coverage under any group health plan with the same coverage conditions as if the employee had been continuously employed during the FMLA leave period. If the …
Question: My client has a Section 125 POP plan in place. Can an employee opt out of the Section 125 pre-tax benefit and choose to pay premium contribution on a post-tax basis? If an employee opts to pay post-tax, does the “life event” restriction apply should the employee decide to obtain coverage elsewhere during the policy …
Question: One of our customers has asked me to research guidance on how to handle a terminated employee’s severance and benefits. The employee was terminated on April 10th, and they have agreed to a severance that includes pay and benefits through May 24th. What is the best practice for this? Should they leave this terminated employee …
Question: I am submitting this question on behalf of a client: Can an employer require that an employee enrollment form be completed by a certain date, and if it is not completed by the specified date it is an assumed waiver of coverage? What is the employer liability? Our Response: Yes – you may tell your …
Question: If one of my clients has a company that has a subsidiary, but a single medical plan that covers both the primary and subsidiary company, should the CMS online disclosure of Creditable Coverage for Medicare be filled out for each company separately? Our Response: In accordance with the Creditable Coverage Disclosure to CMS Form Instructions and …
Question: My client is wondering what happens if an employee loses eligibility for coverage (termination of employment) and is currently a part of a civil union with a partner covered under the group health plan (in Illinois). Is the civil union partner eligible to continue coverage under COBRA? Our Response: Because the federal Defense of Marriage Act …
Question: We have an interesting situation with an employee and his family who are on an individual health plan and not covered by the company group health plan. The wife is now pregnant and the individual plan does not cover pregnancy, so they would like to enroll on our health plan mid-year. We checked with the …
Question: How are Social Security benefit amounts calculated if the older worker continues employment? Answer: The worker’s earnings are first restated in terms of today’s wages to reflect wage growth/inflation. Then, the Social Security Administration (SSA) takes the earnings for the highest 35 years, averages them and divides by 12 to come up with an average …
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