As part of our effort is to provide excellence in customer service, AIS is providing many values added services to our clients, specifically on being compliant as per federal requirements. These services are provided to all our clients. Federal law imposes numerous requirements on the group health coverage that employers provide to their employees. Many federal compliance laws apply to all group health plans, regardless of the size of the sponsoring employer. However, there are some requirements for 20+ organization size and some additional for 50+ and 100+ size employers. For this purpose, a large employer is one with 50 or more employees. AIS helps its clients with PCORI and ACA Filing to IRS as well as time to time guide and educate clients to follow the mandatory guidelines by DOL and IRS and set-up compliance to become fully compliant. AIS Insurance provides compliance services listed below to all our clients without any fee (conditions apply).
ERISA – Employee Retirement Income Security Act.
The (ERISA) is a federal law that sets minimum standards for most voluntarily established retirement and health plans in private industry to provide protection for individuals in these plans. It Provide a summary plan description (SPD) that explains the plan’s terms and conditions to all enrolled employees. Are you providing a consolidate and maintain a written plan document (ERISA DOCUMENT) to your employee/new hires within 90 days of plan change? If not, then you are not compliant and can be subject to penalties.
ERISA also need you to file IRS form 5500 if you have 100+ enrolled participants in health plan.
If you are deducting premium from employee’s salary on pre-tax basis, you must have POP document in place to be compliant. Employees make contributions to their group health, dental, and term life insurance before taxes are calculated, POP is enabling them to save FICA and federal income tax (up to 30%) on their insurance deductions with every paycheck. Employers save on FICA taxes (of 7.65%.) If POP document is not generated and employer is making a tax deduction on pre-tax basis, it tends to non-compliant and subject to penalties. This is also called Section 125/Cafeteria plan.
COBRA is a Federal law. This is mandatory for group health plans sponsored by employers with 20 or more employees. It gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, the transition between jobs, death, divorce, and other life events.
In order to qualify for tax-favored status, a benefit plan must not discriminate in favor of highly compensated employees (HCEs) and key employees with respect to eligibility, contributions, or benefits. The Federal government has established regulations that specify requirements for each type of benefit plan governed by IRC Section 125, IRC Section 105, and IRC Section 129. In order to evidence compliance annual tests must be performed and the results documented for each benefit plan. The results are subject to audit by the IRS.
Employer needs to report Health Insurance Offer and Coverage Information’s to IRS and a few selected states at the end of the year. As per the Affordable Care Act (ACA), businesses with Applicable Large Employees (ALE) – 50 or more full-time equivalent employees – must provide the IRS with ACA reporting using IRS form 1094-C and 1095-C that explains what benefits they offered. Those with 49 or fewer employees don’t need to report this data unless they’re self-insured. AIS offers this value-added service to its client to complete these filings to IRS and keeps them absolutely hustle free.
A Health Savings Account (HSA) is a tax-advantaged account to help people save for medical expenses that high-deductible health plans do not cover. An HSA, owned by an employee, can be funded by the employee and the employer. The contributions are invested over time and can be used to pay for qualified medical expenses. Account balances are rolled over from year to year
A health reimbursement arrangement (HRA), is an IRS-approved, employer-funded, tax-advantaged health benefit used to reimburse employees for out-of-pocket medical expenses and personal health insurance premiums.
An HRA is not health insurance. Instead, employers offer employees a monthly allowance of tax-free money. Employees then buy the health care services they want, potentially including health insurance, and the employer reimburses them up to their allowance amount.
An HRA plan is an excellent way to provide health insurance benefits and allow employees to pay for a wide range of medical expenses not covered by insurance. It’s an especially good option for small businesses that can’t afford to offer group health insurance, as the business can choose the amount of the allowance to offer its employees.
A flexible spending account (FSA) is a type of savings account that provides the account holder with specific tax advantages. An FSA, sometimes called a flexible spending arrangement, is set up by an employer for an employee. The account allows employees to contribute a portion of their regular earnings to pay for qualified expenses related to medical and dental costs.
Another type of FSA is a dependent-care flexible spending account which is used to pay for childcare expenses for children age 12 and under and can also be used to pay for the care of qualifying adults, including a spouse, who cannot care for themselves and meet specific IRS guidelines. A dependent-care FSA has different maximum contribution rules than a medical-related flexible spending account.