| HIPAA | ERISA SPDs and wrap documents | Section 125 cafeteria plan | ERISA Form 5500 reporting and SAR | ACA employer reporting |
|---|---|---|---|---|
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What is the health plan?
Although the employer may sponsor the health plan, this is the covered entity, not the employer.
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What is the plan document?
This is the official governing document for the plan.
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What is before the plan's effective date?
To be effective, this is when a cafeteria plan must be adopted.
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What is July 31?
This is the date when the Form 5500 is due for calendar year plans.
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What is minimum essential coverage?
This is the kind of coverage that ALEs must offer to at least 95% of their full-time employees and dependents to avoid Penalty A.
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What is a business associate?
When a covered entity, like a health plan, contracts with a business to help it administer the plan and use protected health information, under HIPAA, the business is considered to be this.
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What is the summary plan description (SPD)?
This document summarizes the plan's terms and explains participants' rights and obligations so the average participant can understand it.
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What is tax-favored status?
Although a cafeteria plan is not an ERISA plan, it allows certain benefits to have this tax benefit.
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What are 2.5 months?
If an employer files a Form 5558 by the Form 5500 due date, then this is how much time the employer receives as an extension.
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What is affordable, minimum value coverage?
This is the kind of coverage that ALEs must offer to their full-time employees to avoid Penalty B.
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What is a business associate agreement?
This is the contract that HIPAA requires between a covered entity (such as a health plan) and the business who provides services to the health plan.
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What is a wrap document?
This document is a plan document, or a combination plan document/SPD, that is designed to include all the information required by ERISA.
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What are taxable?
If a cafeteria plan was never adopted, then all benefits are treated this way.
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What is the ERISA plan year?
This is the plan year that an employer would use if there are different benefits in a mega wrap document.
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What is Form 1095-B?
This form is used by insurers, plan sponsors of multi employer plans, and plan sponsors of self-funded plans that have fewer than 50 employees to report on coverage actually in effect.
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What are required uses or disclosures?
Under HIPAA, this type of use or disclosure includes responding to an individual's request for his or her PHI, an accounting of disclosures, and HHS' request for PHI.
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What is a mega-wrap document?
This document includes all or most of the group benefits and wraps multiple benefits into a single plan.
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What is cafeteria plan disqualification?
If a plan administrator doesn't follow the cafeteria plan document and allows an ineligible person to participate, then this is what can happen to the cafeteria plan.
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What is September 30?
For a calendar year plans, the summary annual report is due to participants on this date.
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What is Form 1095-C?
ALEs use this form to report on coverage that was offered to employees and their dependents.
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What are civil monetary penalties?
Beyond criminal penalties, what other types of penalties can HHS impose when there is a breach of protected health information?
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What is the ERISA plan year?
All benefits in a mega-wrap document have this same number.
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What is cafeteria plan disqualification?
If a plan administrator doesn't follow the cafeteria plan document and wrongly allows a mid-year election change, then this is what can happen to the cafeteria plan.
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What is the policy year?
The Form 5500 filing date is based on the plan year designated in the SPD. For a plan without an SPD, this is the year that is used to calculate the filing date.
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What is the premium tax credit?
The Form 1095-B helps individuals determine if they are entitled to this type of credit.
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What are the monthly measurement method and the lookback measurement method?
These are the two types of measurement methods available to applicable large employers.
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