Q & A with HR Service, - HR, Compliance & Benefits Admin

• HR Compliance (ACA)
• Benefits Administration
• Benefit Compliance
• Human Resource Management
• Staffing
• Recruiting
• Benefits Administration
• Creating/updating employee handbooks and policy manuals.
• Performance Management
• Leader and Employee Training
• Employee Appraisals
• Coaching

HR Compliance entails:

• Federal and state laws
• Company SOPs and policies
• Code of conduct
  Data privacy and security
• Fraud detection and prevention (anti-money laundering, anti-bribery, etc.)
• Business ethics (gift policy, conflicts of interest
• Discrimination
• Sexual harassment
  OSHA regulations and workplace safety
• Workplace violence
• Risk management
  Workplace substance abuse
• Workplace violence
  Diversity and inclusiveness in the workplace

A Section 125 premium-only-plan (POP), is a cafeteria plan which allows employees to pay their health insurance premiums with tax-free dollars. Traditionally, POP plans have been used in combination with employer-sponsored group health insurance plans. However, employees can also use POP plans to pay individual health insurance premiums with tax-free dollars. Using a Section 125 POP to pay for insurance premiums benefits both employers and their employees.

The U.S. Department of Labor, Internal Revenue Service, and the Pension Benefit Guaranty Corporation jointly developed the Form 5500 Series, so employee benefit plans could utilize the Form 5500 Series forms to satisfy annual reporting requirements under Title I and Title IV of ERISA and under the Internal Revenue Code.

Once a Form 5500 is completed and filed, you must prepare a Summary Annual Report (SAR) for each of your welfare benefit plans subject to ERISA reporting. After submitting, the SAR summarizes Form 5500 information. Then notifies participants that Form 5500 and a copy is available to participants who request. SARs must be distributed to covered participants within nine months after the end of the plan year. A sample SAR format is accessible from https://www.dol.gov/.

If an employer has at least 50 full-time employees, including full-time equivalent employees, on average during the prior year, the employer is an Applicable Large Employer (ALE) for the current calendar year and are required to provide medical insurance and submit ACA Reports annually to employees and the IRS to avoid penalties.

Determine ALE status for 2019 based on 2018 data. Identify full-time employees based on the ACA's definition of full time (averaging 30 hours of work or more per week during a month), considering special classifications such as staffing employees, independent contractors, temporary or short-term employees, and even interns. Assess whether the monthly measurement method or look-back measurement method to determine full-time status is best, based on the nature of the company's workforce.

Update plan documents and summary plan descriptions, if necessary, for the measurement method selected. Select the appropriate safe harbor the company will use for the affordability calculation:  W-2, rate of pay, or federal poverty line. Make sure Social Security number request obligations are being fulfilled. Check reporting obligations for non-ALEs that self-insured group health plans. Review the instructions for required forms, noting changes from prior years.

What Constitutes a Material Modification Warranting SMM?
Whenever one of your health and welfare employee benefit plans are changed or when there is a required change to the information provided in the Summary Plan Description (SPD), participants must be informed, either through a revised SPD or more commonly through a Summary of Material Modification (SMM). The following are examples of material changes warranting SMM notices:
 Provisions that establish new benefits or services;
 Changes that eliminate benefits or services;
 Changes that increase premiums, deductibles, coinsurance, copayments;
 Provisions that establishes new conditions or requirements;
 Modifications that narrow or expand the circumstances under which benefits are paid;
 Changes to any of the terms of the plan, not reflected in the most recently provided Summary of Benefits and Coverage (SBC) and;
 Terminating the plan or parts of the plan.
When Must SMM be distributed?
Material modifications that reduce health plans benefits or services must be distributed to participants as soon as possible, but no less than 60 days before the plan’s adoption of the reduction unless already covered in an SPD distributed within this time frame. If the modification does not reduce a benefit, the SMM must be distributed within 210 days after the end of the year in which the modification became effective.
How to Deliver SMM?
SMM must be furnished in a way that is reasonably calculated to ensure actual receipt using one of the below methods. Keep documentation to be able to prove to the DOL notices were given.
1. First, second, or third class mail
2. Hand-delivered (more challenging to prove delivery unless obtained a signature)
3. Electronically

A Summary Plan Description (SPD) is a document that employers must give free to employees who participate in Employee Retirement Income Security Act-covered retirement plans or health benefit plans. The SPD is a detailed guide to the benefits the program provides and how the plan works.