Employee Benefits Answer Book provides comprehensive guidance for those involved in the design and administration of employee benefit plans.
The Q&A format is ideal for probing key topics such as:
- Health care reform
- COBRA continuation coverage
- Retiree health care coverage
- Health coverage portability requirements
- Group long-term care insurance
- Dependent care assistance
- Adoption assistance
- Vacation and severance pay plans
- Death benefits
- Financing employee benefits
- Financial accounting for employee benefits
- And more!
Employee Benefits Answer Book will help you:
- Set the best Health Care Reform Act strategy for your company and your clients
- Keep in compliance with current and coming requirements
- Find clear answers to hundreds of employee benefits questions
- Avoid costly errors related to employee benefits administration
- Resolve employee benefits issues quickly and effectively
- And much more!
Employee Benefits Answer Book has been updated to bring you plain-language explanations of the latest health care reform developments, including these important topics:
- When a plan is a "grandfathered" plan - and how to keep it that way
- What employers need to do to satisfy "employer responsibility" requirements under the Health Care Reform Act
- How the Health Care Reform Act restricts preexisting-condition exclusions
- Which plans and benefits are subject to new prohibitions on annual and lifetime benefit limits
- When a plan must cover an employee's adult child
- How to comply with no-cost preventive care requirements
- What a plan must do when denying a benefit claim
- What plans must tell employees about their benefits and coverage
- When health reimbursement arrangements can and cannot pay for over-the-counter drugs
- How small employer plans can cash in on a valuable new tax credit
- Why insured plans don't need to worry about tough, new nondiscrimination rules
- How plans must handle premium rebates from their insurers
- What health plan information must be reported on employees' W-2 forms
- And much more!
In addition to Health Care Reform, Employee Benefits Answer Book provides employers and benefits professionals with extensive and up-to-date guidance on other important legal and regulatory developments during the past year, including:
- Important new regulations under the Age Discrimination in Employment Act (ADEA)
- Cost-sharing parity requirements for mental health and addiction benefits
- Expanded FMLA coverage for military family members
- New fringe benefit rules for employer-provided cell phones
- Key changes to the Uniformed Services Employment and Reemployment Rights Act (USERRA)
- New FMLA rules for airline flight crews
- New ground rules for employer-provided adoption assistance
- Important U.S. Supreme Court rulings on employee benefits
- Revised rules for counting intermittent FMLA leave
- Updated guidance on retiree prescription drug benefits
- 1. Introduction
- Thumbnail Guide to Important Regulatory Goals
- Practical Plan Administration
- 2. The Regulatory Scheme: The Employee Retirement Income Security Act of 1974 (ERISA)
- Basic Concepts and Definitions
- Covered Employers
- Covered Employees
- Covered Plans
- Requirements for Plan Document
- Fiduciaries
- Fiduciary Responsibility
- Mandated Benefit Provisions
- Plan Development: Adoption, Amendment, and Termination
- Plan Assets
- Trustees and Investment Managers
- Trust Requirement
- Prohibited Transactions
- Fiduciary Liability
- Nonfiduciary Liability
- Bonding Requirement
- Claims Procedure Requirement
- Reporting and Disclosure Requirements
- Preemption of State Laws
- Penalties and Enforcement
- Remedies for Breach of Fiduciary Duties
- Remedies of Plan Participants and Beneficiaries
- 3. Group Health Plans
- Basic Concepts
- Types of Plans
- Funding Types and Cost Sharing
- Dependent Coverage Requirements
- Coordination of Benefits
- Subrogation
- Code Section 105(h) Nondiscrimination Rules
- Legal Requirements Affecting Health Plans
- Plan Administration
- Health Benefit Claim Processing and Review
- Trust Requirement
- Deductibility of Employer Contributions
- Tax Treatment of Participants
- Medical Savings Accounts
- Employee Assistance Programs
- Workers' Compensation
- 4. Retiree Medical Benefits
- Basic Concepts
- Obligation to Provide Retiree Medical Benefits
- Tax Treatment of Retiree Health Benefits
- Cost Containment Through Plan Redesign
- Plan Cutbacks - Legal Issues
- Plan Administration
- Coordination with Medicare
- Trust Requirement
- Financial Accounting Rules
- Funding Options
- Medicare Risk HMOs and Medicare
- 5. HIPAA and Other Laws Affecting Health Benefits
- Health Insurance Portability and Accountability Act of 1996
- Laws Affecting Maternity, Newborns, and Mothers
- Women's Health and Cancer Rights Act of 1998
- Qualified Medical Child Support Orders
- Medicare Secondary-Payer Rules
- Health Maintenance Organization Act of 1973
- Enforcement
- 6. COBRA Requirements for Continuation of Coverage Under Group Health Plans
- Overview
- Covered Plans
- Definition of "Plan" for COBRA Purposes
- Covered Employers
- Qualified Beneficiaries
- Qualifying Events
- Notice to Participants
- COBRA Election and Enrollment
- Type and Extent of Required Coverage
- Duration of Coverage
- Premiums
- Mergers and Acquisitions
- Preemption of State Continuation Laws
- COBRA Enforcement and Sanctions
- Plan Year
- 7. Cafeteria Plans
- Basic Concepts
- Written Plan Requirement
- Eligible Employees
- Permitted Benefit Choices
- Use-It-or-Lose-It Rule
- Salary Reduction
- Period of Coverage
- Elections
- Premium Conversion Plans
- Flexible Spending Arrangements
- Trust Requirement
- Section 125 Nondiscrimination Rules
- Tax Treatment of Cafeteria Plan Benefits
- Reporting and Disclosure Requirements
- Effect of Other Laws
- 8. Dependent Care Assistance and Adoption Assistance
- Dependent Care Assistance Programs
- Adoption Assistance Programs
- 9. Group Long-Term Care Insurance
- Basic Concepts
- Covered Benefits
- Tax Treatment of Employers
- Tax Treatment of Coverage Provided to Employees
- Tax Treatment of Premium Payments Made by Employees
- Tax Treatment of Benefit Payments Received by Employees
- Tax Reporting Requirements
- Characterization Under Other Laws
- Inclusion in Cafeteria Plans
- Effective Date of HIPAA Long-Term Care Provisions
- 10. Disability Income Plans
- Basic Concepts
- Plan Design and Administration
- Trust Requirement
- Benefit Calculations
- Tax Treatment of Employers
- Tax Treatment of Employees
- Tax Treatment of Self-Employed Persons and Subchapter S Corporation Shareholder-Employees
- 11. Group Term Life Insurance Plans
- Basic Concepts
- General Death Benefit Requirement
- "Group of Employees" Requirement
- Policy Carried Directly or Indirectly by the Employer
- Benefit Formula Precluding Individual Selection
- Nondiscrimination Rules
- Other Plan Design Limitations
- Preemption of State Insurance Laws
- Plan Administration Issues
- Trust Requirement
- Tax Treatment of Employer Contributions
- Income Tax Treatment of Coverage Provided to Employees
- Income Tax Treatment of Death Benefits
- Tax Treatment of Premium Rebates
- Federal Estate and Gift Taxation
- 12. Death Benefits Other Than Employee Group Term Life Insurance
- Dependent Group Term Life Insurance
- Accidental Death Benefits
- Business Travel Accident Insurance
- Group Universal Life Insurance
- Uninsured Death Benefits
- Split-Dollar Life Insurance
- Bonus Life Insurance
- Death Benefits Under Qualified Retirement Plans
- Accelerated Death Benefits
- Living Benefits .
- 13. Fringe Benefits
- Overview
- No-Additional-Cost Services
- Employee Discounts
- Working Condition Fringe Benefits
- Aircraft
- Cars and Other Vehicles
- Club Dues
- De Minimis Fringe Benefits
- Employer-Operated Eating Facilities
- Occasional Meal Money and Local Transportation Fare
- Employer-Provided Transportation in Unusual Circumstances and Because of Unsafe Conditions
- On-Premises Athletic Facilities
- Qualified Transportation Fringe Benefits
- Qualified Moving Expense Reimbursements
- Meals and Lodging Furnished for the Convenience of the Employer
- Employee Gifts and Achievement Awards
- Disaster Relief
- 14. Educational Assistance and Group Legal Services Plans
- Educational Assistance Programs
- Qualified Scholarships and Tuition Reductions
- Job-Related Educational Benefits
- Group Legal Services Plans
- Education Savings Plans
- 15. Vacation and Severance Pay Plans
- Vacation Pay Plans
- Severance Pay Plans
- Golden Parachute Payments
- 16. Family and Medical Leave
- Basic Concepts
- Covered Employers
- Eligible Employees
- Qualifying Family and Medical Leave
- Certifying a Serious Medical Condition
- Substitution of Paid Leave
- Employee Benefits During Leave
- Rights upon Return from FMLA Leave
- Failure to Return from FMLA Leave
- Relationship to COBRA Continuation of Group Health Plan Rules
- Relationship to Cafeteria Plan Rules
- Posting and Disclosure Requirements
- Recordkeeping Requirements
- Relationship to State Laws
- Penalties and Enforcement
- 17. Age Discrimination in Employment Act of 1967
- Basic Concepts
- Covered Employers
- Covered Employees
- Providing Lesser Benefits to Older Workers
- Bona Fide Plan Requirements
- Cost-Equivalency Rule
- Using Retiree Health Benefits to Reduce Other Benefits
- Providing Greater Benefits to Older Workers
- Waiver of ADEA Rights and Claims
- Arbitration of ADEA Claims
- Penalties
- Relationship to State Laws
- 18. Americans with Disabilities Act of 1990
- Basic Concepts
- Covered Employers
- Covered Employees
- Covered Disabilities
- Effect on Welfare Benefits Plan Design
- Disability Inquiries and Confidentiality
- Arbitration of ADA Claims
- Penalties
- Effect of State Laws
- 19. Other Federal Laws
- Labor Laws and Collective Bargaining
- Title VII of the Civil Rights Act of 1964
- Title VI of the Civil Rights Act of 1964
- Equal Pay Act of 1963
- Rehabilitation Act of 1973
- Worker Adjustment and Retraining Notification Act of 1988
- Retiree Benefits of Bankrupt Companies
- Veterans' Health Care Amendments of 1986
- Military Retirees
- Uniformed Services Employment and Reemployment Rights Act of 1994
- Miscellaneous
- 20. Funding and Financing Welfare Benefits
- Overview of Funding Alternatives
- Welfare Benefit Fund Rules
- VEBAs
- Funding Postretirement Medical Benefits Under a Pension Plan
- Financing Welfare Benefits with Life Insurance
- 21. Financial Accounting Rules for Nonpension Retiree and Postemployment Benefits
- Postretirement Welfare Benefits
- Disclosure Requirements
- Reducing or Eliminating FAS 106 Liability
- Postemployment Benefits
Dorinda D. DeScherer, J.D., is a graduate of Barnard College of Columbia University and the University of Maryland School of Law. She was formerly associate managing editor for Prentice Hall Information Services where she had primary responsibility for special projects, including explanatory materials on new tax laws. Ms. DeScherer has more than 25 year of writing and editing experience for a wide range of tax and business publications.
Terence M. Myers, J.D.,is a graduate of Georgetown University and the National Law Center, George Washington University. He is former managing editor of the Tax & Professional Practice unit of Prentice Hall. He has more than 25 years of experience launching, writing, and editing tax and business publications.
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