What is a cafeteria plan?
A cafeteria plan is a separate written plan maintained by an employer for employees that meets the specific requirements of and regulations of section 125 of the Internal Revenue Code. It provides participants an opportunity to receive certain benefits on a pretax basis. Participants in a cafeteria plan must be permitted to choose among at least one taxable benefit (such as cash) and one qualified benefit.
A qualified benefit is a benefit that does not defer compensation and is excludable from an employee’s gross income under a specific provision of the Code, without being subject to the principles of constructive receipt. Qualified benefits include the following:
- Accident and health benefits (but not Archer medical savings accounts or long-term care insurance)
- Adoption assistance
- Dependent care assistance
- Group-term life insurance coverage
- Health savings accounts, including distributions to pay long-term care services
The written plan must specifically describe all benefits and establish rules for eligibility and elections.
A section 125 plan is the only means by which an employer can offer employees a choice between taxable and nontaxable benefits without the choice causing the benefits to become taxable. A plan offering only a choice between taxable benefits is not a section 125 plan.
Effective October 31, 2014, the Centers for Medicare & Medicaid Services (CMS) Office of e-Health Standards and Services (OESS), the division of the Department of Health & Human Services (HHS) that is responsible for enforcement of compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) standard transactions, code sets, unique identifiers and operating rules, announces a delay, until further notice, in enforcement of 45 CFR 162, Subpart E, the regulations pertaining to health plan enumeration and use of the Health Plan Identifier (HPID) in HIPAA transactions adopted in the HPID final rule (CMS-0040-F).
This enforcement delay applies to all HIPAA covered entities, including healthcare providers, health plans, and healthcare clearinghouses.
On September 23, 2014, the National Committee on Vital and Health Statistics (NCVHS), an advisory body to HHS, recommended that HHS rectify in rulemaking that all covered entities (health plans, healthcare providers and clearinghouses, and their business associates) not use the HPID in the HIPAA transactions (see http://ncvhs.us/wp-content/uploads/2014/10/140923lt5.pdf). This enforcement discretion will allow HHS to review the NCVHS’s recommendation and consider any appropriate next steps.
An employer can have a program that rewards employees for attaining positive health goals, but it must remain voluntary and not penalize workers who decline to participate, the EEOC said yesterday in announcing its first Americans With Disabilities Act lawsuit over such programs.
According to the EEOC, Orion Energy Systems, based in Manitowoc, Wisconsin, violated the ADA by requiring an employee to submit to medical examinations and questions that were not job-related or consistent with business necessity as part of its wellness program. And when the employee refused to participate in the program, the company allegedly transferred responsibility for paying the entire health premium to her.
A majority of employers now offer some sort of wellness program — 94 percent of employers with over 200 workers, and 63 percent of smaller ones, according to Karen Pollitz of the Kaiser Family Foundation. So employers with these programs need to be especially mindful…
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By Dallas Salisbury, EBRI
This week marks the 40th Labor Day since President Ford signed the Employee Retirement Income Security Act of 1974 into law. ERISA has been amended many times since then—as have Internal Revenue Code provisions that relate to ERISA-covered employee benefit plans. Private-sector regulatory change has come as well, via the Financial Accounting Standards Board. The U.S. and global economies, trade and employment have changed continuously over this 40 years, as has the general societal view of individual responsibility
I will leave to others conclusions on why things have gone as they have, but will provide four data pictures of the 40 years of ERISA—and by coincidence, my entire career in the benefits world—which has revolved around ERISA and employee benefits.
Chart 1 shows income sources in 1975 as reported by the Current Population Survey. Many describe the 70’s and earlier as the…
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