Conditional Offer of Coverage for Spouses

Question: My client would like to only allow only spouses who do not have other coverage to enroll on their benefit plan. Is this permissible? Compliance Team Response:   Conditional spousal offers of coverage are permitted.  There is no requirement under the ACA pay or play rules to offer coverage to a spouse (the offer […]

ACA Pay or Play Applicability to Independent Contractors

Question:  How are independent contractors handled for reporting under ACA?  They are not offered benefits.  Compliance Team Response:    The ACA pay or play rules apply only to an employer’s common-law employees.  There is no obligation (or even ability to) offer coverage to properly classified independent contractors who are paid by Form 1099 (because these […]

ERISA Electronic Disclosure Rules

Question:  When does ERISA require that employees provide an electronic disclosure authorization?  How about an acknowledgement of receipt? Compliance Team Response: ERISA Electronic Disclosure Rules (SPDs, SMMs, etc.) The standard ERISA disclosure rules provide that ERISA-required documents must be provided to participants in a manner that’s “reasonably calculated to ensure actual receipt” by the intended […]

Substantiation of Mid-Year Section Permitted Election Changes

Question:  Are employers required to confirm a mid-year Section 125 permitted election change event with documentation from the employee that substantiates the event? Compliance Team Response: It’s fine if the company wants to make it a standard practice to confirm that the mid-year event at issue has actually occurred.  However, such documentation is not required. […]

Bona Fide Orientation Periods

The waiting period rules under the ACA can be complex. Question:  How can an employer offer coverage as of the first day of the fourth full calendar month of employment without violating the ACA 90-day waiting period rules? Compliance Team Response: The ACA pay or play rules provide that an ALE will not be subject […]