Section 125 Procedures Manual - Table Of Content

- TABLE OF CONTENTS -

Below are the covered topics for both our Section 125 Training & Certification Program and our Procedures Manual. While each includes numerous tips, examples, and procedural recommendations, the way each is used is different.

For the Training & Certification Program, the content is presented as classroom learning where you complete one lesson, then are quizzed on the what you learn before moving on to the next lesson. The Manual is typically used as a reference material, and allows you to click through to related links (instead of having to use an index, like at the back of a traditional book), so essentially you can click on any topic at any time to see not only that content, but all related content on one page. Click here to order the Training & Certification Program or the Manual individually, or both for a discounted price.

Overview

• What Is A Cafeteria Plan?
• Tax Savings
• Employer Benefits
• Who May Establish A Cafeteria Plan?
• Understanding Cafeteria Plans
• 2007 Proposed Cafeteria Plan Regulations
• 2010 Health Care Legislation
• Basic Advantages Of Cafeteria Plans
• Basic Disadvantages Of Cafeteria Plans

Eligible Benefits

• Eligible Benefits: Introduction
• Plan Year
• Eligible Benefits
• Health Care Premiums
• Individual Insurance Policies
• Health Flexible Spending Arrangements (HFSAs)
• HFSA Requirements
• Dependent Care Assistance Programs
• Group Term Life Insurance
• Group Term Life Insurance: Coverage In Excess Of $50,000
• Income Replacement
• Paid Time-Off Buy/Sell Arrangements
• Buying Of Paid Time-Off Days
• Selling Of Paid Time-Off Days
• Section 401(k) Plans
• Adoption Assistance Benefits/Adoption Assistance Credit

Eligible Expenses

• Eligible Expenses: Premium Only Plans
• Eligible Expenses: Health Flexible Spending Arrangement (HFSA)
• Examples of Eligible HFSA Expenses
• Electronic Payment Card Programs
• Newly Eligible Expenses
• Stand-Alone Health FSAs, Limited-Purpose Health FSAs, And Post-Deductible Health FSAs
• Eligible Expenses: Dependent Care Assistance Programs
• Ineligible Expenses: Premium Only Plans
• Ineligible Expenses: Healthcare Flexible Spending Arrangements
• Ineligible Expenses: Dependent Care Assistance Programs
• Ineligible Expenses: Life Insurance

Eligible Participants

• Definition Of Employees
• Common Law Employees
• Former Employees: Retirees
• Former Employees: Severance Agreements
• Partners, Independent Contractors, 2% Or More Owners
• Leased Employees
• Beneficiaries Of Employees
• Other Relationships
• Accident And Health Coverage Purchased For Someone Other Than The Employee’s Spouse Or Dependents With After-Tax Employee Contributions
• Affiliated Service Groups
• Plan Participation Eligibility Criteria
• Why Implement Eligibility Rules?

Governance

• Sources Of Cafeteria Plan Law
• ERISA
• Evolution Of Cafeteria Plans
• Obtaining IRS Information: Private Letter Rulings
• Obtaining IRS Information: Information Letters
• Obtaining DOL Information Letters
• Obtaining DOL Information: Advisory Opinions
• IRS Audits
• DOL Audits

Design Options

• Cafeteria Plan Designs
• Simple Cafeteria Plans for Small Employers
• Premium Conversion Plans
• Flexible Spending Arrangements (FSAs)
• Employer Flex Credits
• Uniform Coverage And “Use-Or-Lose” Rules
• Health Flexible Spending Arrangement
• HFSA Design Requirements
• HFSA Contributions
• The Use-It-Or-Lose-It Rule
• HFSA Reimbursements
• Dependent Care FSAs
• Dependent Care FSAs Design Requirements
• Dependent Care FSAs Limits
• Core-Plus
• The Fully Flexible Cafeteria Plan
• Flexible Benefit Credits
• Opt-Out Feature
• Health Reimbursement Arrangements (HRA)
• Differences Between HRAs And HFSAs
• Claims Submission And Reimbursement
• Plan Assets: Premium Conversion Plans
• Plan Assets: Health Flexible Spending Arrangements
• Plan Assets: Dependent Care Assistance Plans
• Plan Assets: Core Plans And Fully Flexible Cafeteria Plans
• Fiduciary Responsibilities
• Grace Periods

Plan Documentation & Communication

• Plan Documentation & Communication: Introduction
• Master Plan Document
• Distribution of the Master Plan Document
• Summary Plan Descriptions
• Summary Plan Descriptions: Required Content
• Summary Plan Descriptions: Style And Format
• Summary Plan Descriptions: Distribution & Disclosure Requirements
• Summary Plan Descriptions: Reporting Requirements
• Summary Plan Descriptions: Summary Annual Report
• Salary Reduction Agreements
• Summary Of Benefit Coverage
• Employer Responsibilities
• Plan Communications

Election Options

• Annual Election Requirement
• Positive Election
• Default Election
• Automatic Election
• Written Forms
• Online
• By Telephone
• Correcting Election Errors
• Irrevocable Elections Requirement
• New Hires
• Election Options For A POP
• After-Tax POP: Advantages And Disadvantages
• Employer Plan Contributions
• Plan Year

Status Changes

• Permissible Status Changes
• Coverage Under State Exchanges
• Change In Employment
• Change In Employment: Rehires
• Change In Residence
• Change In Marital Status
• Change Of Dependent Status
• Change In Number Of Dependents
• Adoption Assistance
• Cost Changes
• Coverage Changes: Own Employer
• Coverage Changes: Other Employer-Sponsored Plan
• Health Flexible Spending Arrangements
• Dependent Care Assistance Programs
• Medicare/Medicaid And Other Government Health Programs
• HIPAA Special Enrollment
• FMLA Leave
• Judgment/Decree/Order
• “Consistency” Rule
• Timing Of Changes
• Receiving, Processing, And Handling Status Changes

Claims Submittal Options & Procedures

• Where And How Claims Should Be Submitted
• Time Frame For Submitting Claims
• Submitting Claims: Written Forms
• Submitting Claims: Debit Cards
• Submitting Claims: Debit Cards For Dependent Care
• Submitting Claims: Health Insurance Company Automatic Reimbursements
• Submitting Claims: Pre-Approved Annual DCAP Expense Form
• Claims Dispute Options & Requirements

Reimbursement Options & Procedures

• DOL Requirements
• IRS Requirements
• Reimbursable Expense Analysis: HFSAs
• Reimbursement Options
• Reimbursement Must Be For An Eligible Expense
• Expense Must Be Incurred In An Eligible Time Period
• Reimbursement Claims Must Be Made In A Timely Fashion
• “Run-Out” Periods
• Minimum Reimbursement Requirements
• Deferral Of Compensation
• No Commingling Amongst FSA Accounts Or Payment Of Insurance Premiums From An FSA.
• Receiving Submitted Claims For Reimbursement
• Processing Claims: HFSA Reimbursement Requests
• Processing Claims: Invalid HFSA Reimbursement Requests
• Processing Claims: Valid HFSA Reimbursement Requests
• Processing Claims: Insurance Company Automatic Reimbursements
• Special HFSA Issue: Orthodontia
• Special HFSA Issue: Capital Expenses
• Special HFSA Issue: Durable Medical Equipment
• Dependent Care FSA Reimbursement Options
• Processing Claims: Dependent Care Assistance Plans (DCAPs)
• Processing Claims: Verification Of DCAP Claims
• Reimbursements Paid By Mistake
• Checklist For Processing Claims

Other Administrative Issues

• The Use-It-Or-Lose-It Rule
• Forfeitures
• Uniform Coverage Rule
• Administrative Issue: Dependent Care Assistance Programs
• Administrative Issue: Dependent Care Assistance Programs Claims
• Employer/Plan Responsibility

Integration With Other Laws

• Interaction With HIPAA
• Interaction With COBRA
• COBRA and POP Plans
• COBRA and HFSAs
• COBRA and DCAPs
• Interaction With FMLA
• Cafeteria Plans During Leave
• FMLA: Reinstatement To Equivalent Benefits
• FMLA: Proration Rule
• FMLA: Required Reinstatement To Equivalent Benefits
• FMLA: Catch-Up Option

Discrimination Testing Overview

• Discrimination Testing Overview
• Reasons For Testing
• Preparation For Discrimination Testing
• Discrimination Tests For Self-Insured Medical Plans (Including HFSAs)
• Testing Universe
• Excludable Employees
• Eligibility Test
• Nondiscriminatory Classification Test
• Nondiscriminatory Classification Test: Safe Harbor Percentage Test
• Safe Harbor Test: IRS Comparison Table
• Nondiscriminatory Classification Test: Fair Cross-Section Test
• The Benefits Test
• Discrimination Testing: Key Employees
• Disability Insurance
• Premium Only Plans
• Dependent Care Assistance Programs Overview
• Dependent Care Assistance Programs Nondiscrimination Requirement
• Dependent Care Eligibility Requirement
• Dependent Care Contributions And Benefits Test
• The 55% Average Benefits Test
• Concentration Of Benefits Test (The 25% Test)
• Plan Design
• Adoption Assistance Programs Discrimination Testing
• Cafeteria Plan Testing
• The Three Cafeteria Plan Discrimination Tests
• HCE Eligibility Test
• HCE Contributions and Benefits Test
• Actual Operation
• 25% Key Employee Concentration Test
• 25% Key Employee Concentration Test Example

Reporting & Disclosure

• DOL Requirements
• IRS Requirements
• Other Plan Documents

Regulations

• Links To Government Sites And Posted Regulations

Your Cafeteria Plan training can be purchased as a Training & Certification Program ($799) or Manual ($799) only, or combined ($999). We also offer discounts for purchasing training for multiple employees or administrators.