Tag: eligibility

Question: If a spouse loses coverage under his plan due to nonpayment, is this a qualifying event to permit a mid-year enrollment for our employee to add the spouse? Answer: We are operating under the assumption that your plan specifically provides for mid-year election changes under Section 125 and that your plan documents specifically provide…

Question: If my company has branches in five locations and none of them have over 50 employees, and only two of them are within 75 miles of each other, is the entire company eligible for FMLA or just the two branches? Answer: While you are a covered employer based upon the employee count nationally, the…

Question: We have an employee who reached her 12 months of service mark while she was out on a nonfamily medical leave. Does her time on leave count towards the 12 months of service for federal Family and Medical Leave Act (FMLA) leave, and are we required to give her an additional 12 weeks of…

Question: We have less than 50 employees (including 50 FTE). Can we set eligibility at a level of an employee who works 40 or more hours a week, or does it have to be 30? Answer: An employer with less than 50 employees (including FTE) is not subject to the Employer Shared Responsibility Provision of…

The final waiting period regulations issued June 20, 2014 by the Department of Labor, Internal Revenue Service, and the Department of Health and Human Services confirmed that employers can require new employees to complete a one-month “orientation period” before the eligibility waiting period begins for the employer’s group health plan. These regulations also clarify the…