FAQ: What should an employer do if they become aware that an employee made a mistake after open enrollment ends?

January 18, 2023

Employers should consider all the facts and circumstances surrounding the mistake before taking any action to correct it.

Under section 125, the employee's election must occur prior to the coverage effective date, and the related deduction should come out of a future paycheck. Section 125 also states that employees should not have the ability to change their elections after the effective date of coverage (i.e., during the plan year) unless the employee experiences a qualifying event. Under ERISA, the employer should operate/administer the plan according to the plan terms, according to relevant laws and in the best interest of plan participants/beneficiaries. So, for all those reasons, the employer should not allow election changes for any period following the effective date of coverage. Rather, allowing election changes after the effective date could be viewed as a violation of section 125 and ERISA. Accordingly, the practice of allowing those changes post effective date should generally be discouraged.

However, employers can allow election changes AFTER open enrollment and BEFORE the coverage effective date. That's a good idea and practice to keep in place to catch errors before the coverage period starts. Also, it's permissible to correct true errors and mistakes that are discovered after the coverage period begins. But it must be a true mistake, not an employee simply changing their mind.

There is a lack of formal guidance when it comes to correcting mistakes, but the general notion from the IRS is that if there's clear evidence of some type of mistake, then the employer can take steps to place everyone back in the position they would've been absent the mistake. Whether the clear and convincing standard is satisfied depends on the nature of the mistake, including when it occurred and when it was discovered. Generally, employer clerical or data entry type mistakes would qualify. Additionally, situations in which the employee could not have benefitted from the election are clear and convincing. For example, if an employee made a dependent care deferral election at enrollment but did not have a dependent, this seems rather clear and convincing evidence of a mistake.

Essentially, it is a facts and circumstances analysis. Factors to consider include:

  • The employee's past elections and benefit usage.
  • Assessment of the employee's truthfulness.
  • Time that has elapsed since the first payroll date after the election was in force.
  • Changed circumstances experienced by the employee that might be evidence of reconsideration rather than a mistake.
  • Other extrinsic evidence of a mistake.

These factors should be applied on a consistent and nondiscriminatory basis and documented.

In the end, it would be the employer’s decision as a plan sponsor to determine whether there is clear and convincing evidence of a mistake. However, the employer should consider the situation carefully before making exceptions because the employer has an obligation to follow the terms of the plan document. Additionally, the employer has an obligation to treat all eligible employees in a like manner. Finally, making an exception may also create an undesirable precedent.

If the employer chooses to recognize the mistake, the insurer or stop loss carrier would need to be agreeable. From a payroll perspective, again, there is no formal guidance, but the general principle is that corrections should put the plan and the participant in the same position as if the mistake had not occurred. The document should be reviewed to see if there is any language that addresses the correction of mistaken elections and recoupment of amounts not withheld. The employer should also confirm that any necessary withholding from an employee’s pay does not violate any state wage withholding laws.

Due to the lack of formal IRS guidance regarding the recognition of mistakes and related corrections, the employer should consult with counsel for guidance. Generally, to avoid section 125 and ERISA compliance issues, the best practice is not allowing employees to change their elections once the coverage period has begun and once salary has been taken from their paychecks — unless there is clear evidence of a mistake.

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FAQ: Which group health plans are subject to MHPAEA?

January 04, 2023

Most group health plans and insurers that provide either mental health or substance use disorder (MH/SUD) benefits in addition to medical/surgical benefits (MED/SURG) are subject to the Mental Health Parity and Addiction Equity Act (MHPAEA). This means plans and insurers cannot impose financial requirements (e.g., deductibles, copays, coinsurance or out-of-pocket maximums), quantitative treatment limitations (e.g., number of covered days, visits or treatments) or non-quantitative treatment limitations (e.g., coverage exclusions, prior authorization requirements, medical necessity guidelines or network restrictions) on MH/SUD benefits that are more restrictive than those applied to MED/SURG benefits. In other words, MH/SUD benefits must be provided in parity with MED/SURG benefits. MHPAEA applies to both fully insured and self-insured plans. There are limited exemptions from MHPAEA, including:

  • Self-insured plans with 50 or fewer employees (including employees of related employers in a controlled group).
  • Stand-alone retiree-only medical plan that does not cover current employees.

Church plans are not exempt from MHPAEA.

The Consolidated Appropriations Act, 2023 (CAA 2023) sunset a MHPAEA opt-out for self-insured non-federal governmental group health plans. As of September 2022, 229 group health plans covering municipal employees, public school teachers, firefighters, police and public healthcare workers were opting out of MHPAEA. With the enactment of the CAA 2023, new opt-out elections are no longer permitted and existing elections expiring on or after June 30, 2023, cannot be renewed.

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FAQ: We understand that group health plans must provide participants with new price comparison tools beginning in January. Can you please explain these requirements?

December 20, 2022

Effective for plan years beginning on or after January 1, 2023, the Transparency in Coverage Final Rule (TiC) requires most group health plans and carriers to make personalized out-of-pocket cost information available to participants through an internet-based self-service tool or in paper format (upon request). The requirements do not apply to grandfathered plans, account-based plans (e.g., HRAs and FSAs) and excepted benefits (e.g., stand-alone dental and vision benefits).

The purpose of the self-service tool is to provide participants with real-time, accurate estimates of their cost-sharing liability for healthcare items and services from different providers. This information may help participants to understand how costs for covered items and services are determined by their plan and to shop and compare healthcare costs prior to receiving care.

Specifically, the internet self-service tool must provide a participant with the following information:

  • An estimate of the participant’s cost-sharing liability for a requested covered item or service.
  • Accumulated amounts to date that the participant has incurred towards the plan deductible and out-of-pocket limit.
  • The in-network (INN) rate (expressed as a dollar amount) and if applicable, the fee schedule for an INN provider’s services.
  • The out-of-network (OON) allowed amount if the request is for an OON provider’s services.
  • If the request involves a bundled payment arrangement, a list of the items and services for which the cost-sharing information is being disclosed.
  • Any prerequisites (e.g., pre-authorization, concurrent review, step therapy or first-fail protocols) applicable to an item or service.

The information must be provided in plain language and be accompanied by a notice that reflects certain disclosures. Amongst other items, the notice must indicate that the cost-sharing is only an estimate, not a guarantee of coverage, and that participants may still be balanced billed for OON services.

Participants must be able to conduct a search using the tool by entering a descriptive term (e.g., rapid flu test) or billing code, provider name and other factors relevant to determine cost-sharing (e.g., facility name, service location). Where there are multiple results for in-network services, the search must allow participants to reorder information by geographic proximity and estimated cost-sharing amount. If information is requested in paper form, it must be mailed not later than two business days after the request is received.

Importantly, the TiC provided phased-in effective dates for the internet self-service tool requirement. An initial list of 500 “shoppable” items and services must be made available through the tool for plan years beginning on or after January 1, 2023. The current list of 500 items and services is available on the CMS website: CMS 500 Items and Services List for Price Comparison Tool. The list will be updated quarterly. For plan years beginning on or after January 1, 2024, all items and services, including prescription drugs and durable medical equipment (e.g., blood testing strips for diabetics), must be made available.

Employers that sponsor group health plans should consult with their carriers or third-party administrators (TPAs) to ensure the implementation of the self-service tool requirement, including any instructional materials for participants, is on schedule. Like the other TiC requirement (the machine-readable file disclosures), it is anticipated that employers will contract with their carriers and TPAs to assist with fulfilling the requirements. Fully insured plans can contract with their carrier to assume liability for the tool disclosures. Self-insured plans can contract with TPAs or other vendors but remain responsible for satisfying the requirements. It is advisable for employers to engage counsel in the contracting process.

For further information regarding the TiC and self-service tool requirements, please review the following: Transparency in Coverage Final Rule, Fact Sheet and our November 10, 2020 article.

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FAQ: We have failed to file the required Forms 5500 for one of our benefits offerings for several years. What can we do to come into compliance?

December 06, 2022

Because the failure to file Forms 5500 would be a compliance failure, it would be best to consult with legal counsel to determine a path forward. One option that counsel could suggest would be to utilize the DOL’s Delinquent Filer Voluntary Correction Program (DFVCP) to file delinquent filings.
 
The DFVCP gives delinquent plan administrators an opportunity to avoid higher civil penalty assessments if they satisfy the program’s requirements and voluntarily pay a reduced penalty amount. The program is only an option if the DOL or IRS has not already contacted the employer concerning the delinquent filings.

Participating in the DFVCP is a two-part process. First, the employer would electronically file a complete Form 5500 with EFAST2 for each year for which relief is requested. The employer would then electronically submit the filing information and payment to the DFVCP using the DFVCP calculator and webpage.

The basic penalty under the program is $10 per day for delinquent filings. However, the DFVCP allows for a “per plan” cap, which is designed to encourage reporting compliance of employers who have failed to file a Form 5500 for one plan for multiple years. Under the per plan cap, the penalty for small plans is limited to $1,500, and the penalty for large plans is limited to $4,000.

For more information, see the following DOL resources:

DFVCP FAQs »
DFVCP Penalty Calculator, Online Payment Instructions, Examples and Manual Calculations »

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FAQ: How do employers comply with the Massachusetts Minimum Creditable Coverage (MCC) and Health Insurance Responsibility Disclosure (HIRD) requirements?

November 08, 2022

Employers with employees in Massachusetts should be aware of MCC and HIRD requirements and take necessary actions even when their primary business is located outside of the state. These two requirements are outlined below.

Health Insurance Responsibility Disclosure (HIRD)

About HIRD: The HIRD form is a state annual reporting requirement in Massachusetts. The HIRD form collects employer-level information about employer-sponsored health insurance plans to assist MassHealth (the state’s Marketplace) in identifying members who can participate in and who may be eligible for premium assistance from MassHealth.

Covered employers: An employer who has (or had) six or more employees in Massachusetts any month during the past 12 months prior to the HIRD due date must comply with the HIRD form requirement.

Due date: December 15 of the reporting year annually (the form is available on the MassTaxConnect website starting November 15).

Information reported on HIRD: Covered employers must report a separate HIRD form for each FEIN. Further, employers that maintain multiple plan options must file a separate HIRD form for each plan.

The HIRD form(s) should include information on the plan(s) offered to Massachusetts employees for the employer’s upcoming plan year. If plan information for the upcoming plan year is not available, then employers must provide information only for a plan or plans offered to Massachusetts employees for the current plan year. If the employer’s current plan year ends on or before December 31 (e.g., a calendar year plan), an employer must report plan information for the upcoming plan year.

Though the employer is ultimately responsible for ensuring the information is provided in a timely and accurate manner, the form may be completed by its payroll vendor.

Filing method: The HIRD reporting is filed through the MassTaxConnect (MTC) web portal electronically only, and paper forms are not accepted.

MA HIRD Form FAQs »
MassTaxConnect (MTC) »
MA HIRD Form Instructions »

MA Individual Mandate — Minimum Credible Coverage (MCC) and Form MA 1099-HC

About MCC and Form MA 1099-HC: Massachusetts requires its residents (over the age of 18) to carry minimum creditable coverage (MCC) or pay a penalty. It is a similar requirement to the now repealed ACA Individual Mandate; however, a MCC determination involves a more in-depth review. Employers that provide MCC to Massachusetts residents are required to distribute Form MA 1099-HC to those residents and submit reporting electronically to the Department of Revenue (DOR) by January 31, following the end of the medical plan year. However, employers are not required to offer MCC, and there's no penalty if the coverage the employer offers does not meet the MCC standard. For fully insured plans issued in MA, the insurers generally administer these requirements on behalf of the employers.

Covered employers: All employers with at least one Massachusetts resident employee must comply with the Form MA 1099-HC requirement. For fully insured plans sitused in the state, insurers generally prepare and provide Form MA 1099-HC to the state resident employees and report to the DOR on behalf of employers. It is recommended that employers that sponsor fully insured group health plans confirm with their carriers accordingly. For self-insured plans and non-Massachusetts employers, employers are required to distribute Form MA 1099-HC with their Massachusetts resident employees and file with the DOR by January 31. Employers can obtain draft copies of Form 1099-HC on the DOR website.

If an employer is unsure if its plan is considered MCC, the employer can request the Health Connector to make the determination.

Due date: January 31, following the end of the medical plan year.

Information reported on MA Form 1099-HC: A Form 1099-HC indicates the months that the employees and any dependents had MCC in the previous year.

Filing method: Employers must submit Form MA 1099-HC information to DOR electronically in properly formatted XML through MassTaxConnect. For additional information about how to file Form MA 1099-HC information, please refer to the state site, “Submitting Information to DOR.”

The Form MA 1099-HC needs to be sent only to the primary subscriber.

Mass Healthcare – Frequently Asked Questions for Employers »
Health Connector – Employer Advisory »
Health Connector – HDHPs and MCC Requirements »

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FAQ: What COBRA compliance considerations exist when an employee’s domestic partnership ends?

October 25, 2022

When eligibility for coverage is lost due to a change in relationship status, employees and employers may assume COBRA is always offered to the individual losing coverage. However, when a domestic partnership ends that is not necessarily the case.

Federal COBRA requires most employers to offer qualified beneficiaries who lose coverage as a result of a COBRA qualifying event (e.g., termination of employment, reduction of hours, divorce) the opportunity to continue health coverage for a specified time period. Unlike spouses and dependent children, domestic partners are not considered qualified beneficiaries under COBRA and therefore do not have independent election rights. In the event a domestic partnership ends, the nonemployee domestic partner does not have continuation rights under COBRA.

However, children of the domestic partnership who were considered dependents under the plan terms may have COBRA continuation rights. (Termination of a domestic partnership that causes a domestic partner's child to lose coverage under the plan is likely a qualifying event for the child, if the child will have ceased to be a dependent under the terms of the plan).

Some states have their own continuation of coverage laws (often known as “mini-COBRA”) which may apply to domestic partnerships. Employers should review state continuation laws to determine whether mandatory coverage continuation rules apply.

Additionally, employers that offer domestic partner coverage can design their health plans to provide domestic partners with COBRA-like continuation coverage. Employers interested in adding continuation coverage need to work with their insurance carrier or TPA and stop-loss provider prior to implementing continuation of coverage. Any addition to continuation coverage rights beyond what COBRA requires should be drafted in clear terms with the assistance of legal counsel.

NFP has a whitepaper that can assist you in addressing benefits issues involving domestic partners. Please ask your consultant for a copy of “Domestic Partner Benefits: A Guide for Employers.”

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FAQ: Is a supplemental life plan offered to employees subject to ERISA’s requirements even if employees pay the full premiums post-tax?

October 11, 2022

The answer will depend on what “offered to” employees means. Unless the employer’s actions vis-à-vis the supplemental plan stay within the “voluntary plan safe harbor” or another exemption applies, the benefit will be subject to ERISA. Generally, ERISA applies to any employer-maintained plan, fund, or program providing medical, dental, vision, prescription drug, health FSA, HRA, accident, disability, or death benefits. Despite ERISA’s far-reaching application, certain types of plans and programs are exempt from ERISA. Governmental plans (including state, city, county and public school plans) and church plans are exempt. Programs maintained solely to comply with state law requirements for workers’ compensation, unemployment compensation or disability insurance and payroll practices that pay benefits solely out of the employer’s general assets are also exempt.

In addition, ERISA’s regulations provide a safe harbor from the law’s application for certain insurance arrangements where the employer maintains minimal involvement (referred to as the voluntary plan safe harbor). Under these arrangements, coverage must be voluntary, and employees must pay the full premium. Further, the employer’s role must be limited to allowing an insurer to offer and publicize a program to employees, collecting premiums through payroll deductions, and remitting these premiums to the insurer. The employer must not put any conditions on an employee’s election of benefits nor profit from the program.

Importantly, the employer must not “endorse” the program. Practically speaking, this is the most difficult safe harbor requirement to satisfy. Unfortunately, endorsement is not clearly defined in the regulations. However, from a series of court cases and DOL advisory opinions, we know that the following actions may be seen as an endorsement:

  • Recommending the program
  • Selecting the insurer
  • Negotiating terms
  • Allowing premiums to be paid pre-tax through the cafeteria plan
  • Linking coverage to employee status
  • Using the employer’s name (i.e., the “ABC Company Supplemental Life Plan”)
  • Assisting employees with enrollment and claims
  • Saying ERISA applies

These endorsement factors – alone or in combination – could push the program outside the voluntary plan safe harbor. Employee perceptions regarding employer endorsement are particularly important. Since it is not easy to predict what a reviewing court or the DOL will view as an endorsement, an employer wishing to maintain a voluntary safe harbor must be very careful in their communications regarding the program. For example, enrollment materials should make clear that the coverage is not an employer-sponsored ERISA plan (in contrast to other available benefits), and employee questions about the program should be redirected to the insurer.

Accordingly, the fact that an employee pays their premiums post-tax is not a conclusive factor in whether ERISA applies. The plan must be scrutinized for employer endorsement. Offering supplemental life coverage in association with the employer’s other benefits (including basic life with the same insurer) is strong evidence of endorsement, thereby falling outside the voluntary plan safe harbor. This means the supplemental life benefit is subject to ERISA’s plan document, summary plan description, Form 5500 reporting, disclosure, claim procedures, and fiduciary requirements. But a detailed factual analysis of the offered coverage in question is necessary to say with certainty whether ERISA’s voluntary plan safe harbor requirements are met. Since the consequences of ERISA noncompliance are significant and the endorsement determination is highly-fact specific, employers should seek a determination from their legal counsel before relying on the safe harbor to conclude ERISA does not apply.

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FAQ: What are the Medicare prescription drug (Part D) disclosure requirements? How does an employer comply?

September 27, 2022

To comply with Medicare Part D, an employer that sponsors a group health plan offering prescription drug coverage must satisfy two basic disclosure requirements.

First, the plan must notify all Medicare Part D eligible individuals whether or not the prescription drug coverage is creditable, meaning it is expected to pay on average as much as the standard Medicare Part D coverage. The creditable status of the coverage can be determined through actuarial analysis or via the CMS Creditable Coverage Simplified Determination. If a plan has several benefit options (e.g., PPO and HMO), the creditable coverage status must be determined separately for each option. However, generally, an employer can provide a single notice for an HRA integrated with a major medical plan.

CMS has provided Model Disclosure Notices (in English and Spanish) that an employer may use to meet this requirement. The notice must be provided annually prior to October 15, which is the beginning of the annual enrollment period for Medicare Part D. The notice must also be provided when a Medicare Part D eligible individual joins the plan, when the creditable coverage status changes, or upon request.

Medicare Part D eligible individuals may include active employees, disabled employees, COBRA participants and retirees, as well as their covered spouses and dependents. Because an employer cannot always identify these individuals (particularly if eligibility is not based on age), a practical approach is to provide notices to all enrolled in or eligible to enroll in the prescription drug coverage. Generally, a single disclosure notice may be provided to the employee and any dependents residing at the same address; the employee should be instructed to share the notice with any Medicare Part D eligible dependents. The Medicare Part D notice may be provided separately or combined with other benefit materials, such as enrollment packets, provided the notice is “conspicuous and prominently presented” in accordance with specific CMS instructions.

An employer may distribute the Medicare Part D notice by hand, by mail or by electronic delivery (in accordance with the DOL electronic disclosure safe harbor). Under this safe harbor, employees with integral access to the employer’s computer system at work can be defaulted to electronic delivery, with the option to opt out. For this population, if the employer posts the notice on the intranet, the employer must notify employees (e.g., via email) of the notice availability and significance, and the right to request a paper copy. Those without integral access to the employer’s computer system as part of their job would need to affirmatively consent to electronic delivery in accordance with the DOL guidance.

The purpose of the disclosure is to enable Medicare Part D eligible individuals to make informed decisions regarding their coverage and compare the available options. The notice is important because individuals who do not maintain creditable coverage for a period of 63 days or longer following their initial enrollment period for Medicare Part D are subject to late enrollment penalties. The penalties are based on the duration of the lapse in creditable coverage and continue for the duration of the Part D coverage. Although there are no specific employer penalties associated with this notice requirement, failing to provide the notice may be considered a breach of an employer’s fiduciary obligations to the plan.

The second requirement is that an employer must disclose the plan’s creditable coverage status to CMS within 60 days of the start of each plan year. A disclosure to CMS must also be made within 30 days of any change in the creditable coverage status or the termination of the plan. The process involves completion of a disclosure form on the CMS Creditable Coverage Disclosure webpage, which must be signed electronically by an individual authorized by the plan. For access to the form and related CMS guidance and instructions, please see: Disclosure to CMS Form  and Disclosure to CMS Guidance and Instructions | CMS

For more information, please ask your broker or consultant for a copy of our “Medicare Part D Disclosures: A Guide for Employers” white paper.

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FAQ: We are a large employer subject to the employer mandate. One of our employees just switched from full-time to part-time. When should we terminate coverage?

September 13, 2022

There are specific rules related to eligibility and changes of status related to the employer mandate. A change in status means that the employee has had a bona fide change in employment status from part-time (PT) or variable hour to full-time (FT) or vice versa. It does not include an employee who has not experienced a bona fide change in employment and whose hours are simply trending lower or higher.

As a reminder, an applicable large employer subject to the employer mandate has two methods for determining FT employees: monthly measurement and look-back measurement. An employer must use the same method for all employees in the same category. For this purpose, there are only four identified categories: collectively bargained and non-collectively bargained employees, employees covered by different collective bargaining agreements, salaried and hourly employees, and employees whose primary places of employment are in different states.

If an employer is using the monthly measurement method, then eligibility is determined on a monthly basis. If an employee had a bona fide change from FT to PT, the employee would lose eligibility at the end of the month when the change in status occurred. COBRA would be offered for a reduction of hours. If an employee has a change from PT to FT, the employee would be offered coverage the first of the month following the change.

If the employer is using the look-back measurement method, there are different rules for new employees versus ongoing employees. An ongoing employee is defined as one who has been employed for an entire standard measurement period.

Let’s first consider an ongoing employee determined to be FT upon hire and initially offered coverage following the plan’s waiting period. If that FT employee has a change in status to PT, the employer may terminate eligibility on the first day of the fourth month following the change (assuming the employee has indeed worked PT hours during the interim three months). If an employer terminates eligibility prior to this date, there is risk of an employer mandate penalty. Again, COBRA would be offered for a reduction in hours.

If an ongoing employee was determined to be PT during the most recent measurement period and experiences a change to FT, their ineligibility may remain through the corresponding stability period. An employer may be more generous and offer coverage earlier. For example, the employer may offer coverage following the waiting period or the first of the fourth month following the change.

Next, let’s discuss new employees under the look-back measurement method. If a new employee is determined to be FT upon hire, offered coverage following the waiting period and then experiences a change in status to PT, the employer may terminate eligibility at the end of the month when the change occurred. If the new employee was determined to be PT (or variable hour) upon hire, placed in an initial measurement period and then has a change in status to FT, the employee must be offered coverage by the first day of the fourth month following the change (or the first day of the initial stability period, whichever is earlier).

As one can see, these rules are very complex. NFP has a whitepaper and chart that can assist you in reviewing and applying these rules. Please ask your consultant for a copy of “ACA Look-Back Measurement Method: Offers of Coverage and Changes in Status.”

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FAQ: If an employee doesn’t return to work following FMLA or state law leave, when should benefits terminate?

August 30, 2022

Following the expiration of any federal FMLA or state protected leave, an employee may stay on health benefits for as long as the eligibility terms of the plan allow. The Summary Plan Description, any employee handbooks or other communication describing benefit eligibility during leaves of absence should be consistent with the plan terms and approved by the carrier (stop-loss carrier if self-insured). In addition to ERISA’s fiduciary requirement to follow the terms of the plan, if a group unilaterally allows an employee to stay on the plan for longer than the carrier allows, then they risk having to self-insure claims incurred during the extended period.

A solid leave policy can support consistent and predictable benefits administration during extended employee absences. However, deciding an employee’s benefit eligibility while on leave as a one-off or promising more than what’s allowed in the plan document further risks setting a precedent or inadvertent discrimination, even if intended as generosity. For example, the ADA could be implicated if an employer has an informal practice of allowing only nondisabled employees on sabbaticals to remain on the plan longer than disabled employees on medical leave.

Applicable large employers (ALEs) also need to consider the employer mandate. If an ALE uses the look-back measurement method to determine health plan eligibility, an employee who earned full-time status in the most recent measurement period would remain eligible throughout the stability period regardless of the number of hours worked. The chosen measurement method should be incorporated into the health plan’s eligibility terms consistent with the SPD, employee handbook and other benefits communications. Note that when employment ends during a stability period, the individual is no longer an active employee under the terms of the health plan or for employer mandate penalty purposes.

A COBRA qualifying event occurs when benefits (but not necessarily employment) are terminated consistent with the plan’s eligibility requirements and any employer leave policy. That is, a reduction in hours (extended leave of absence) has caused a loss of coverage.

The right to continue those coverages during leave for other, non-health benefits (e.g., disability, life) is similarly governed by the eligibility terms of each respective plan document. Employers should review their disability and life plans and carrier contracts to determine whether they hold any administrative responsibilities for providing conversion notices or paperwork when coverage terminates.

Administering benefits during leaves can be complicated. There are different state and federal laws at play depending on a given employee’s reason for leave and work location. Employers should work with their legal counsel and HR experts to set up solid leave policies and ensure compliance with all applicable laws. Employment termination for those who do not return from FMLA or state protected leave is a separate issue for which employers should consult with employment law counsel.

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