Make sure FMLA (Family Medical Leave Act) definitions are as intended in the plan document.

The way a member has access to the FSA or DCA account (or not), the method for contribution submission and what happens when someone comes back from leave are all important areas to consider.

If not considered correctly, a number of folks can be at risk.

For an employer, the answer is simple. Based on what the group Plan(s) states for hourly requirement to be a full time employee (FTE) , the employer must look back to the prior CALENDAR YEAR and see if they had the equivalent of 20 full time employees for 6 months. Part time employees are considered a fraction of a FTE. The payroll records are the best place to start looking at numbers.

Open Enrollment allows a COBRA Participant to make changes to their enrollment, just like an active employee.

Sometimes there is confusion about a COBRA Participant’s right to change their election at open enrollment. Many times this means adding a dependent or a Plan (i.e. adding dental if they didn’t have it before). During the plan year, a COBRA Participant can only reduce enrollment status.

Watch out for dependent age out rules. Not all carriers are the same.

Only medical carriers were required to change to the 26 year old age out ruling and some carriers (like dental) stayed at the traditional levels (usually 19/23). This can create confusion and certain issues, especially with COBRA related events.

One of biggest areas to highlight is the changes that Healthcare Reform has made to 26 year old age out rules. This specific ruling could likely make the Plan non-compliant, risking the entire pre-tax benefit everyone receives. The most overlooked, but nearly every time needs to be updated, the Premium Only Plan.

Here is how it works…

If an FSA member has contributed more to the Plan, than they have been reimbursed at the time of an event, they ARE eligible to continue the FSA through COBRA.

If the opposite is true, then the member IS NOT eligible to continue through COBRA.

Many times, it is best to have the same administrator manage the Cafeteria Plan and COBRA.

The Benefit of the Benefits Card is simply to add convenience when paying for healthcare, dependent care or transit expenses. By using "the card," members can avoid taking money out of their pockets and going through the reimbursement process (i.e. a direct deposit or a check being delivered in the mail).

Only approved transactions can be processed, so documentation is required to be sure an eligible transaction occurred during the correct period of time. An easy step, for the added convenience.