Yes, it is generally permissible for a health plan to offer different waiting periods for different groups of employees, if the distinctions are not discriminatory and comply with applicable laws.

COBRA-qualified beneficiaries should be given the same open enrollment rights as similarly situated employees. Open enrollment materials should be provided by qualified beneficiaries in a manner that provides a reasonable opportunity to make changes to their elections. These changes can include changing their coverage plan, adding a spouse or dependent (who do not gain their own COBRA rights, just coverage), and adding/switching to benefits not previously elected.

A qualified High Deductible Health Plan (HDHP) must cover an individual as of the first day of a month to be eligible for an HSA contribution. To be a qualified HDHP for HAS contribution purposes, the following conditions must be met:

• The HDHP must satisfy the minimum deductible for single and family coverages.
  • 2024: $1,600/$3,200
• The HDHP must satisfy the maximum out-of-pocket limit.
  • 2024: $8,050/$16,100
• The individual cannot have impermissible other coverage. All that matters is whether there’s some other health plan or account (besides another HSA) that can cover the individual’s expenses before the minimum deductible is met.
  • Watch out for the spouse’s health FSA or similar account.
  • Watch out for the employee’s prior general purpose health FSA if it has a grace period or a carryover.
  • Watch out for Medicare coverage for the individual who wants to contribute to an HAS.
  • Watch out for add-on benefits.
  • Watch out for state benefit mandates for fully insured plans.
• The individual cannot be claimed as someone else’s tax-dependent.

Not always. These documents won’t always include important provisions such as eligibility language, identification of the plan administrator and fiduciary, and other ERISA basics like the ERISA plan number. While some carriers and TPAs include ERISA language in their certificates or benefit explanations that state that the provided documents constitute the formal plan document or the SPD or both for the underlying benefit, as well as some of the ERISA bells and whistles required for ERISA compliance, it’s more usual for the provided document not to be held out as a compliant ERISA plan document. We use different forms of wrap documents when this is the case.

The SPD can be distributed electronically (e.g., by email, posting to an intranet with an email identifying its location) for plan participants who either work at a computer or consent to electronic distribution. In both instances, whenever a document is distributed, it must be accompanied by a notice outlining the importance of the document and that a paper copy is available upon request (sample language available).

The Department of Labor’s safe harbor rules require using a computer to be integral to the plan participant’s job, wherever they’re working, for the documents to be distributed electronically without getting consent. If the individual doesn’t sit at a computer, they must likely consent to electronic distribution. For participants for whom electronic delivery is not an option, physical, i.e., paper delivery, is required. Paper delivery can be accomplished via mail or hand delivery. With either option, the employer should be able to demonstrate that the documents were provided to the participant.

The number one issue we deal with when discussing the Medicare Secondary Payer rules with clients is that they can’t discourage employees from enrolling in the group health plan, including remaining enrolled in the group health plan. They can’t incentivize or induce an individual to take Medicare over the group health plan. Beyond a potential re-adjudication of claims, the penalty for noncompliance is $11,162 per violation, with adjustments made each year for inflation. What constitutes dissuasion and inducement isn’t precisely defined, but anything beyond general education regarding Medicare offered to all employees should be closely scrutinized.