Eric Allen Kauk, Esq., LL.M., Author at Catholic Benefit Plans

FAQ: My plan terms include out-of-pocket spending limits that are based on a formula (a fixed percentage of an employee’s prior year compensation). If the formula stays the same, but a change in earni

FAQ: My plan terms include out-of-pocket spending limits that are based on a formula (afixed percentage of an employee’s prior year compensation). If the formula staysthe same, but a change in earnings results in a change to the out-of-pocket limitssuch that the change exceeds the thresholds allowed under paragraph (g)(1) of theinterim final regulations relating […]

FAQ: My group health plan normally charges a copayment for physician visits that do not constitute preventive services. The plan charges this copayment to individuals age 19 and over, including emplo

FAQ: My group health plan normally charges a copayment for physician visits that do notconstitute preventive services. The plan charges this copayment to individuals age19 and over, including employees, spouses, and dependent children, but waives itfor those under age 19. Is this permissible? Yes. The Department of Labor’s regulations implementing PHS Act section 2714 provide […]

The Advantages of Church Plans.

The Advantages of Church Plans. Compliance Tip: Ask yourself (or your Catholic benefits attorney) “how can I prove that we have a church plan?” In our experience every church-related organization believes that they have church plan. But, frankly very few organizations have taken the steps necessary to be certain that their plans will be treated […]

February 1, 2022
Eric Allen Kauk, Esq., LL.M.
Best Practices, Compliance, Dioceses, ERISA, Religious Orders

Are you sure that your brokers and consultants disclose all their compensation? Plan administrators face penalties for hidden broker pay.

When are employers required to provide COBRA notices?

When are employers required to provide COBRA notices? Compliance tip: Spouses and dependent children covered under an employer’s health plan have an independent right to elect COBRA coverage. Employers or health plan administrators must provide an initial general notice if employees are entitled to COBRA benefits. Many employers provide an initial notice about COBRA coverage […]

If a terminated employee elects COBRA can they later enroll in a Health Insurance Marketplace plan?

If a terminated employee elects COBRA can they later enroll in a Health Insurance Marketplace plan? Compliance Tip: Ensuring that departing employees understand their COBRA rights AND responsibilities is crucial. If an employee elects COBRA continuation coverage, they will have another opportunity to request special enrollment in a Marketplace plan or new group health plan […]

Which employers are required to offer COBRA coverage?

Employers with 20 or more employees are usually required to offer COBRA coverage and to notify their employees of the availability of such coverage. COBRA applies to private-sector employees and to most state and local government workers.

What is the cost of coverage under COBRA?

What is the cost of coverage under COBRA? Compliance Tip: Severance Agreements can affect the employee’s COBRA rights. While an active employee, the employer may have paid all or part of the employee’s grouphealth premiums. Under COBRA, a former employee will usually pay the entire premium– that is, the premium that they paid as an […]

What is a “Convention or association of churches”?

What is a “Convention or association of churches”? Compliance Tip: There are special Aggregation Rules that apply to dioceses and religious orders. The definition of “convention or association of churches”, in a legal sense, is murky to say the least. The IRS has interpreted the term to mean a “cooperative undertaking by churches of the […]

Church plan challenges.

Church plan challenges. Compliance Tip: A well-written plan document can be crafted to meet nearly all challenges. Church plans can provide significant advantages to benefit plans. However, they are not without certain challenge. Without the protection of ERISA’s federal power of pre-emption, church plans can be subject to state law benefit mandates, laws relating to […]