GM & ASSOCIATES
Address: 400 S BURNSIDE AVE
SUITE 10E
LOS ANGELES, CA 90036
EMAIL INFO@GMA3000.COM
PHONE: : (+1 310 228 7721)
Standard methods bring standard results. We at GMA are the unconventional professionals that set new standards. To embrace changes you must accept and want and see the value of changes. GMA gives you the depth, dimension and experience that you need to create, innovate and strategically evolve into a leading-edge profitable company. Planning and taking the right steps will give management and staff that assurance to act with confidence and inspire trust.
GMA can help your organization create, protect and enhance value. We provide services to give confidence to investors, lenders, management and corporate directors. The confidence is attained from quality information, processes and controls they rely upon to make operating, business and investment decisions.
Continually transforming your business is a key to survival in a world that is quickly changing. Success comes when you transcend day-to-day challenges, create opportunities and sustain true value in this new challenging environment. Your equity holders demand management to actualize company goals and thereby bringing value to your organization. As a leader in the new economy, GMA can assist you in accomplishing these tasks and be the pivoting point to set you in the correct direction. Let us show you how today.
Our consultants provide financial and business consulting services to various industries. The Principals at GMA have over 120 combined years experience in financial and business management.
There is a wide spectrum of services that are or need to be performed either directly by a business entity or through business, financial and management consultants. GMA has enumerated below certain business practices and functions of management and financial consultants. Many of the services listed below are provided by GMA. GMA is project oriented and is able to use its staff or immediately obtain the assistance of our associated professionals. GMA’s fees are typically very competitive. Many of our consultants are partners and we maintain less levels of management hierarchy than the typical consulting firm.
LIST OF SERVICES PROVIDER BY GMA.
| What are | YOUR COMPANY | |||
| CALL US PH. 310-228-7721 FAX 310-861-5093 | Your Unique | PERFORMED | NEEDED | YOUR SCORE | |
| FINANCE | Needs? | BAD 1 – 10 GOOD | |||
| Alternative Debt Financing | |||||
| Bank debt search & negotiation | |||||
| Bank relations management | |||||
| Board of Directors and Finance Committee interaction | |||||
| Cash Management & forecasting | |||||
| Financial analysis for decision making | |||||
| Fixed Assets, acquisition financing & analysis | |||||
| Investor relations, financial | |||||
| New business planning & implementation | |||||
| Private offering/PIPE support | |||||
| Receivables collection management | |||||
| Revenue cycle management | |||||
| Risk Management | |||||
| Strategic Planning – goals and objectives | |||||
| ACCOUNTING & REPORTING | |||||
| Accounts payable control and management (SEE SECT 1) | |||||
| Accounts receivable control and management (SEE SECT 2) | |||||
| Payroll accounting and management | |||||
| Inventory accounting and management | |||||
| Fixed Assets accounting control and management | |||||
| Investment accounting and management | |||||
| Cost Accounting, Job Cost Accounting | |||||
| General Ledger/ Journal entry accounting | |||||
| Financial statement preparation | |||||
| Contribution Profit evaluation | |||||
| Actual vs. budget analysis | |||||
| Financial reporting, customized | |||||
| Financial reporting, software based | |||||
| Account analysis – balance sheet | |||||
| Bank reconciliations | |||||
| Operating reports & financial metrics | |||||
| SEC reporting for Public Companies | |||||
| PLANNING AND BUDGETING | |||||
| Acquiring/negotiating project financing | |||||
| Budgets, development & compliance monitoring | |||||
| Business Plans | |||||
| Feasibility Studies | |||||
| Financial modeling for long-range planning | |||||
| Profit Planning | |||||
| Short-term financial projections | |||||
| AUDITS AND TAX | |||||
| Due Diligence reviews | |||||
| Internal Audit | |||||
| Managing the Independent Audit | |||||
| Risk Assessment | |||||
| Tax & compliance reporting | |||||
| Tax planning | |||||
| MANAGEMENT & HUMAN RESOURCES | |||||
| Compensation policy guidelines | |||||
| Cost control policy & oversight | |||||
| Employee benefits review/upgrade | |||||
| Executive compensation | |||||
| Executive training in finance | |||||
| Financial advisory to top management | |||||
| Infrastructure development | |||||
| Insurance coverage management | |||||
| Management team training in finance | |||||
| PEO search, qualification & implementation | |||||
| Personnel management | |||||
| Staff planning | |||||
| MERGERS & ACQUISITIONS, PUBLIC OFFERINGS | |||||
| Deal negotiation support | |||||
| Deal structure brain storming | |||||
| Investment Memorandum support | |||||
| IPO Planning | |||||
| M&A evaluation & analysis | |||||
| OPERATIONS MANAGEMENT SUPPORT | |||||
| Credit granting policy | |||||
| Operating policies & procedures | |||||
| Operational planning | |||||
| Pricing and rate setting policy guidelines | |||||
| Records retention policy & oversight | |||||
| CORPORATE & BOARD GOVERNANCE | |||||
| Maintenance of corporate permanent records | |||||
| Minutes – bylaws – articles management | |||||
| Code of ethics – conflict of interest policies | |||||
| New board of director guide – investment policy | |||||
| TAX PLANNING AND PREPARATION | |||||
| Preparation of tax supporting documents | |||||
| Tax planning | |||||
| Tax returns | |||||
| After tax maximization of profit | |||||
| * At each level below the CFO, some support, guidance and oversight by management is required to ensure acceptable performance. | |||||
| SECTION 1 | |||||
| ACCOUNTS PAYABLE | |||||
| Review or develop a Policies and Procedures manual with desk top procedures | |||||
| Verify accurateness of invoice, match with packing slips, obtain approvals | |||||
| Enter vendor invoices to payable system | |||||
| Classify invoices to the proper G/L account | |||||
| Request and maintain vendor W-9 information | |||||
| Prepare and file required 1099 forms | |||||
| Maintain vendor master files | |||||
| Respond to vendor inquiries about payment status | |||||
| Retrieve copies of payments as necessary | |||||
| Process requests for stop payments when necessary | |||||
| Issue checks (or pay with internet banking) to vendors based on due dates or client instruction | |||||
| Reconcile vendor statements to accounts payable ledger | |||||
| Reporting to organization on detailed aged payables and cash requirements | |||||
| Archive reports | |||||
| Review AP aging for cash flow projections | |||||
| SECTION 2 | |||||
| ACCOUNTS RECEIVABLE | |||||
| Review and develop Policies and Procedures | |||||
| Credit granting and limits | |||||
| Billings prepared as needed and mailed out (all billings provided to Client for approval prior to mailing) | |||||
| Maintain revenue codes and GL accounts | |||||
| Record and account for revenue | |||||
| Enter receivable transactions into the accounting system | |||||
| Prepare and deliver periodic statements | |||||
| Issue client-approved credit memos and refund checks | |||||
| Maintain subsidiary receivables ledger | |||||
| Process client-approved adjustments | |||||
| Apply cash received to customer accounts and resolve “short pays” | |||||
| Phone collections as needed by client | |||||
| Prepare deposit slips and make bank deposits – post totals to sales journal (or other system) | |||||
| Process daily sales and deposit reports | |||||
| Verify daily deposits and report variances | |||||
| Reconcile and verify credit card deposits | |||||
| Assist in rate /product/service setting | |||||
| Aging analysis and reporting | |||||
| NON FINANCE SERVICES | |||||
| MARKETING AND SALES | |||||
| Marketing plan | |||||
| Defined sales objectives | |||||
| Professional support to achieve the plan | |||||
| Reporting and management of the outcomes | |||||
| HUMAN RESOURCES | |||||
| CORE SERVICES | |||||
| TIME & ATTENDANCE | |||||
| STAFFING | |||||
| TALENT RELATIONS AND MANAGEMENT | |||||
| LABOR/MANAGEMENT RELATIONS | |||||
| EMPLOYEE RELATIONS | |||||
| OUTPLACEMENT PROGRAM | |||||
| ETHICS ADMINISTRATION | |||||
| DRUG TESTING | |||||
| LEAVE ADMINISTRATION | |||||
| TRAINING | |||||
| OCCUPATIONALS HEALTH, SAFETY & SECURITY | |||||
| PERSONALL/PAYROLL PROCESSING & RECORDS MAINTENANCE | |||||
| REPORTS | |||||
| FREEDOM OF INFORMATION/PRIVACY ACT | |||||
| PERSONNEL SECURITY | |||||
| BENEFITS ADMINISTRATION | |||||
| PROJECT BASED SERVICES | |||||
| HUMAN RESOURCES AUDIT | |||||
| CLASSIFICATION AND POSITION MANAGEMENT | |||||
| COMPENSATION ADMINISTRATION | |||||
| HUMAN RESOURCES DEVELOPMENT | |||||
| PERFORMANCE MANAGEMENT | |||||
| COACHING | |||||
| PARTICIPATION IN RELATED INDUSTRY SPONSORED INITIATIVES | |||||
| POLICY & PROGRAM ISSUE | |||||
| GMA105PLAN INCOME TAX AND SOCIAL SECURITY TAX SAVINGS FOR THE SEL EMPLOYED BUSINESS OWNERS
1. What is GMA105PLAN?
GMA105PLAN is the name for a “medical expense reimbursement plan” designed for small businesses. “Medical expense reimbursement plan” is the term the IRS uses to describe a plan like GMA105PLAN in the tax code, which is authorized under Internal Revenue Code Section 105. One way the self-employed can reduce the high cost of health insurance and out-of-pocket medical expenses is to establish a Section 105 HRA plan
2. How does a GMA105PLAN plan work?Section 105 HRA plans are designed specifically for small business owners that can legitimately hire their spouse. Because the spouse/employee can be reimbursed for family expenses the employer indirectly benefits as well. After the plan is adopted by the business entity, participating employees give the business a list of medical care expenses for them and their dependants. The employer writes a check to “reimburse” the employee for the medical care expenses. The reimbursements are a tax deduction for the company, but are not taxable income to the employee. This type of plan is made possible by Section 105 of the Internal Revenue Code, Revenue Ruling 71-588 and IRS Letter Ruling 9409006.
Section 105 of the Internal Revenue Code has been around since 1954. Section 105 HRA plans are widely accepted with over 50,000 small business owners taking advantage of the tax deduction. Average tax savings are approximately $2,600 per year. The actual savings depend on the amount of the health care and insurance premiums payments.
3. Who Can ParticipateSection 105 HRA plans are best suited for employees of sole proprietors, corporations, limited liability companies, and partnerships. Business owners generally can’t participate in a Section 105 HRA plan. This is why the spouse/employee approach has become so popular. 4. What businesses qualify for a GMA105PLAN plan?The simple answer is “all”. All businesses will realize a tax benefit by implementing a GMA105PLAN plan. The BEST application of a GMA105PLAN plan is for the self-employed that has a spouse who is active in the business on a part or full time basis. The small business owner hires their spouse and adopts a GMA105PLAN plan. The spouse then requests reimbursement for the family’s medical expenses under the plan. All of the family’s medical costs including insurance premiums are now a tax deduction for the business.
If your spouse has assisted in the business operation and was never paid as an employee it is not a problem. Basically If your spouse provides services to your business, those services should generate compensation for your spouse. Simply begin paying your spouse a salary or hourly wage with the required payroll withholdings. Now you have an employee and your business qualifies for a GMA105PLAN plan. Remember also that it may be wise to have your wife on payroll to build social security benefits!
5. What deductions would I have with a GMA105PLAN plan?
The IRS says that any medical care expense that qualifies for a deduction on schedule A of a personal income tax return can be reimbursed under a HRA plan. Under a GMA105PLAN plan you will no longer have a self-employed health insurance deduction that is included on page one of your tax return. Rather, 100% of your health insurance will be reimbursed to your employee spouse from your business. The reimbursements will qualify as a “business expense” and be fully deductible. The tax benefit strategy is significant since you save not only “regular” tax on the premiums but also self-employment tax of up to 15.3%. Presently you may deduct only health care expenses in excess of 7.5% of AGI (adjusted gross income) on schedule A (1040). Example: If AGI is $50,000 and you have $5,000 in out-of-pocket medical expenses, you can only deduct $1,250 ($50,000 X .075 = $3,750, and $5,000 – $3,750 = $1,250). With a spouse/employee Section 105 HRA, the employer can deduct the entire $5,000 as a business expense. Qualifying medical expenses include: health insurance premiums, eye care, prescription drugs, dental and orthodontics, out of pocket costs for doctors, clinics, hospitals, emergency rooms, and some travel and lodging. Recently also over the counter medicine is allowed as a health care expense such as aspirin, coughs solutions and much more.
September 3, 2003. The Departments of Treasury and Revenue released today a ruling that will allow certain Over the Counter medications to be used as deductible items through an employer sponsored Health Reimbursement Arrangement. These items include those that are used to treat or cure a specific existing illness or symptom. (Such items may include OTC medications used for allergies, pain relief, antacids, or cold medicines.) Items used for general health and well being, such as vitamins and toiletries can not be reimbursed through such a health plan. For further details, see Revenue Ruling 2003-102. 6. Can I really hire my spouse?
In 1999 the IRS Industry Specialization Program offered a coordinated issue paper regarding Section 105 and the spouse/employee issue that said: “The extent and nature of a spouse’s involvement in the business operations is critical. Although, part-time work does not negate employee status, the performance of nominal or insignificant services that have no economic substance or independent significance may be challenged. Merely calling a spouse an “employee” is not sufficient to qualify a non-working spouse as an employee”.
If your spouse provides meaningful services to your business, and your business (employer) would need to hire someone else to provide the same services, then your spouse would qualify to establish a Section 105 HRA. We can assist you in the documentation of your spouse’s responsibilities and develop a job description to complement the responsibilities. 7. How much can be reimbursed to employees?We will work with you to determine the maximum amount that can be reimbursed under The Smart Section 105 Plan. Typically, the maximum amount allowed, as a medical reimbursement, is 80% of an eligible employee’s income. 8. How To Establish a Section 105 HRA and Employ Your SpouseSetting up a Section 105 HRA would include: Resolution, Plan Document, Summary Plan Description, Forms, and other forms
You would have a choice of applying for a Federal Employer Identification Number (FEIN). You can’t be an employer without a FEIN. You can apply for the FEIN using IRS SS-4 Form. The other option is to have your spouse hired by a PEO or “employer of record” service, where the spouse becomes their employee which is billed back to you at a little fraction above cost.
9. Are the reimbursements classified as income to my employees?No. The IRS is very specific about excluding medical reimbursements from the gross income of the employee.
HRAs Can Be Designed To Pay Last, After The Health FSA. Normally the health FSA must be the payer of last resort. Thus if an employee participates in both the HRA and a health FSA and they both cover the same expenses, the employee would first look to the HRA for payment increasing the likelihood the employee might have to forfeit unused health FSA funds. The good news is the IRS has authorized employers to design HRAs to require the health FSA to pay first, which will reduce health FSA forfeitures under the use-it-or-lose-it rule. 10. Gma105plan offers significant tax advantages
11. Who qualifies for a GMA105PLAN?Sole Proprietors: Nearly 80% of the small business owners who use a GMA105PLAN are sole proprietors (schedule C preparers). To be eligible for the Section 105 tax deduction, sole proprietors:
Because Section 105 HRAs are non-discriminatory, business owners who have additional employees may be required to offer a GMA105PLAN to non-spousal employees. Eligibility for additional employees is determined based on ERISA and DOL guidelines. A GMA3000 Specialist always available to make the right determination.
Partnerships: Partners in a general partnership are eligible to enroll in a GMA105PLAN. To be eligible for the Section 105 HRA tax deduction, the partner:
In cases where one partner may qualify to enroll and other partners are not qualified in a GMA105PLAN, (possibly because a partner is not married, or the spouse does not provide services to the business). It makes sense to enroll the partner/s who is/are eligible for the Section 105 HRA.
Corporations: While many regular corporations already pay health insurance premiums for owners and employees, and openly deduct 100% of the cost as a business expense, many can benefit by adopting a Health Reimbursement Arrangement through GMA3000. To qualify, the owners and employees:
Since Health Reimbursement Arrangements are nondiscriminatory, corporations adopting a GMA105PLAN HRA may be required to extend the benefits to additional employees.
S Corporations: Greater than 2% S corporation shareholder-employees (hereafter referred to as shareholders) are also eligible to enroll in a GMA105PLAN. The shareholder:
NOTE: When a corporation reimburses a shareholder for medical expenses, payments must be reported on the shareholders’ W-2 and are subject to federal and applicable state tax. The shareholder may deduct the insurance premiums “before the line” on their personal tax return up to the deductible limits set by the IRS. The health reimbursements are not subject to social security/Medicare tax, resulting in 15.3% tax savings up to $94,200 (2006) and 5.3% Medicare tax without limits. TECHNICAL DOCUMENTS ON § 105
The principal author of this notice is Lorianne D. Masano of the Office of Division Counsel/Associate Chief Counsel – IRS
Part III – Administrative, Procedural, and Miscellaneous Health Reimbursement Arrangements Notice 2002-45 PURPOSE This notice provides basic information about a type of employer-provided health reimbursement arrangement (HRA) described below. Published elsewhere in this bulletin is a revenue ruling providing guidance involving an HRA. This notice is divided into eight parts. Part I of the notice describes HRAs and their general tax treatment. Part II of the notice outlines the benefits that may be offered under an HRA. Part III details who may be covered under an HRA. Part IV deals with the interaction between HRAs and cafeteria plans. Part V covers ordering rules for reimbursement from HRAs and § 125 health flexible spending arrangements. Part VI relates to the applicability of § 105(h) non-discrimination rules to HRAs. Part VII explains how to provide COBRA continuation coverage under HRAs. Part VIII addresses certain other matters.
I. Tax Treatment of HRAs Generally An HRA is an arrangement that: (1) is paid for solely by the employer and not provided pursuant to salary reduction election or otherwise under a § 125 cafeteria plan; (2) reimburses the employee for medical care expenses (as defined by § 213(d) of the Internal Revenue Code) incurred by the employee and the employee’s spouse and dependents (as defined in § 152); and (3) provides reimbursements up to a maximum dollar amount for a coverage period and any unused portion of the maximum dollar amount at the end of a coverage period is carried forward to increase the maximum reimbursement amount in subsequent coverage periods. To the extent that an HRA is an employer-provided accident or health plan, coverage and reimbursements of medical care expenses of an employee and the employee’s spouse and dependents are generally excludable from the employee’s gross income under §§ 106 and 105. Assuming that the maximum amount of reimbursement which is reasonably available to a participant under an HRA is not substantially in excess of the value of coverage under the HRA, an HRA is a flexible spending arrangement (FSA) as defined in § 106(c)(2). II. Benefits under an HRA To qualify for the exclusions under §§ 106 and 105, an HRA may only provide benefits that reimburse expenses for medical care as defined in § 213(d). Each medical care expense submitted for reimbursement must be substantiated. An HRA may not reimburse a medical care expense that is attributable to a deduction allowed under § 213 for any prior taxable year. Additionally, an HRA may neither reimburse a medical care expense that is incurred before the date the HRA is in existence nor reimburse a medical care expense that is incurred before the date an employee first becomes enrolled under the HRA. Reimbursements for insurance covering medical care expenses as defined in § 213(d)(1)(D) are allowable reimbursements under an HRA, including amounts paid for premiums for accident or health coverage for current employees, retirees, and COBRA qualified beneficiaries. However, see Part IV for a discussion relating to cases in which an employer provides an HRA in conjunction with another accident or health plan. If an HRA is an FSA, reimbursable medical care expenses may not include expenses for qualified long-term care services as defined in § 7702B(c). See §§ 106(c) and 213(d)(1)(C). An HRA does not qualify for the exclusion under § 105(b) if any person has the right to receive cash or any other taxable or non-taxable benefit under the arrangement other than the reimbursement of medical care expenses. If any person has such a right under an arrangement currently or for any future year, all distributions to all persons made from the arrangement in the current tax year are included in gross income, even amounts paid to reimburse medical care expenses. For example, if an arrangement pays a death benefit without regard to medical care expenses, no amounts paid under the arrangement to any person are reimbursements for medical care expenses excluded under § 105(b). See § 1.105-2 of the Income Tax Regulations. Arrangements formally outside the HRA that provide for the adjustment of an employee’s compensation or an employee’s receipt of any other benefit will be considered in determining whether the arrangement is an HRA and whether the benefits are eligible for the exclusions under §§ 106 and 105(b). If, for example, in the year an employee retires, the employee receives a bonus and the amount of the bonus is related to that employee’s maximum reimbursement amount remaining in an HRA at the time of retirement, no amounts paid under the arrangement are reimbursements for medical care expenses for purposes of § 105(b). Similarly, if an employer provides severance pay only to employees who have reimbursement amounts remaining in a purported HRA at the time of termination of employment, no amounts paid under the arrangement are reimbursements for medical care expenses for purposes of § 105(b).
III. Coverage under an HRA Medical care expense reimbursements under an HRA are excludable under § 105(b) to the extent the reimbursements are provided to the following individuals: current and former employees (including retired employees), their spouses and dependents (as defined in § 152 as modified by the last sentence of § 105(b)), and the spouses and dependents of deceased employees. The term “employee” does not include a self-employed individual as defined in § 401(c). See § 105(g). An HRA may continue to reimburse former employees or retired employees for medical care expenses after termination of employment or retirement (even if the employee does not elect COBRA continuation coverage). For example, an HRA may have a provision that reimburses a former employee for medical care expenses only up to an amount equal to the unused reimbursement amount remaining at retirement or other termination of employment. The plan may also provide that the maximum reimbursement amount available after retirement or other termination of employment is reduced for any administrative costs of continuing such coverage. Additionally, an HRA may or may not provide for an increase in the amount available for reimbursement of medical care expenses after the employee retires or otherwise terminates employment (even if the employee does not elect COBRA continuation coverage).
IV. HRAs and Cafeteria Plans Employer contributions to an HRA may not be attributable to salary reduction or otherwise provided under a § 125 cafeteria plan. An accident or health plan funded pursuant to salary reduction is not an HRA and is subject to the rules under § 125. However, an HRA is not considered to be paid for pursuant to salary reduction merely because it is provided in conjunction with a cafeteria plan. Additionally, if an employer offers employees a choice between employer-provided non-taxable benefits (e.g., coverage under an HRA and coverage under a health maintenance organization (HMO)), with no cash or other taxable benefits available to employees, the choice is not an election to which § 125 applies. If an employer provides an HRA only in conjunction with another accident or health plan and that other plan is provided pursuant to a salary reduction election under a cafeteria plan, then all the facts and circumstances are considered in determining whether the salary reduction is attributable to the HRA. Assuming that the terms of the salary reduction election indicate that the salary reduction is used only to pay for the specified accident or health plan offered in conjunction with the HRA and not to pay for the HRA itself, the mere fact that an employee may participate in the HRA only if the employee participates in a specified accident or health plan funded pursuant to a salary reduction election does not necessarily result in the salary reduction being attributed to the HRA. In such situations, if the salary reduction election for a coverage period to fund the specified accident or health plan offered in conjunction with the HRA exceeds the actual cost of the specified accident or health plan coverage for such coverage period, the salary reduction is attributable to the HRA. For purposes of this rule, “salary reduction” includes a choice to forgo receipt of any benefits that would be taxable but for the fact they are offered under a § 125 cafeteria plan. For any coverage period, for purposes solely of determining whether a salary reduction election exceeds the cost of coverage, the actual cost of the specified accident or health plan coverage for the coverage period may be determined pursuant to the rules for determining the COBRA applicable premium under § 4980B(f)(4). For example, assume that an employer offers an HRA and an employee who participates in the HRA must also participate in the corresponding employee-only or family coverage offered in a high-deductible accident and health plan. If the COBRA applicable premium for the high-deductible accident and health coverage would be $1,800 for the employee-only coverage and $4,500 for family coverage if such coverage were offered separately from the HRA, then the annual maximum allowable salary reduction election in this case is $1,800 for employee-only coverage and $4,500 for family coverage in order for the salary reduction to be treated as not attributable to the HRA. An arrangement is not treated as an HRA if the arrangement interacts with a cafeteria plan in such a way as to permit employees to use salary reduction indirectly to fund the HRA. Therefore, where an employee who participates in a reimbursement arrangement has a choice among two or more specified accident or health plans to be used in conjunction with the reimbursement arrangement (or a choice among various maximum reimbursement amounts credited for a coverage period) and there is a correlation between the maximum reimbursement amount available under the HRA for the coverage period (disregarding amounts carried forward from previous coverage periods) and the amount of salary reduction election for the specified accident and health plan, then the salary reduction is attributed to the reimbursement arrangement even if the amount of salary reduction election is equal to or less than the actual cost of the other accident or health coverage. For example, assume an employer offers a reimbursement arrangement plus other specified accident or health plan coverage with the actual cost for family coverage for the specified accident or health plan being $4,500 and the employee having a choice to salary reduce $2,500 or $3,500 to fund this coverage. An employee who elects family coverage and $2,500 salary reduction receives a $1,000 maximum reimbursement amount under the reimbursement arrangement for the coverage period and an employee who elects family coverage and $3,500 salary reduction receives a $2,000 maximum reimbursement amount under the reimbursement arrangement for the coverage period. In this case, although the maximum allowable salary reduction is not exceeded, a portion of the salary reduction is attributed to the reimbursement arrangement because the increase in salary reduction election is related to a larger maximum reimbursement amount in the reimbursement arrangement for the coverage period. This arrangement is not an HRA and is subject to § 125. Similarly, assume an employer provides a reimbursement arrangement in conjunction with another accident or health plan. Employees participating in the reimbursement arrangement are reimbursed up to $1,000 each year for substantiated § 213(d) medical care expenses and unused amounts remaining at the end of the year are carried forward for reimbursements in later years. The employee-share of the annual premium for the other accident or health plan is $1,500. Employees have a choice either to use amounts in the reimbursement arrangement to pay for the premium for the other accident or health plan or to pay that premium pursuant to a salary reduction election. Under this plan, the reimbursement arrangement does not reimburse any portion of the premium paid by salary reduction. Because an employee may use the reimbursement arrangement to pay a portion of the premium in lieu of electing to salary reduce, the reimbursement arrangement is indirectly funded pursuant to salary reduction. This arrangement does not meet the definition of an HRA because it is funded by salary reduction and it is subject to the rules under § 125. Further, if the amount credited to a reimbursement arrangement is directly or indirectly based on the amount forfeited under a § 125 FSA, the arrangement will be treated as funded by salary reduction. For purposes of making this determination, facts and circumstances taken into consideration include the manner in which salary reduction is implemented for other accident or health plans offered by the employer. Because an HRA is paid for solely by the employer and not pursuant to salary reduction, the following restrictions on health FSAs under § 125 are not applicable to HRAs: (1) the prohibition against a benefit that defers compensation by permitting employees to carry over unused elective contributions or plan benefits from one plan year to another plan year; (2) the requirement that the maximum amount of reimbursement must be available at all times during the coverage period; (3) the mandatory twelve-month period of coverage; and (4) except as otherwise provided in this notice, the limitation that medical expenses reimbursed must be incurred during the period of coverage. As a result, the maximum reimbursement amount for a coverage period (not including amounts carried forward from previous coverage periods) need not be available at all times during the coverage period. Also, an HRA may specify a coverage period for a reimbursement amount that is less than a year. Although claims incurred during one coverage period may be reimbursed in a later coverage period, an unreimbursed claim may be reimbursed in a later coverage period only if the individual was covered under the HRA when the claim was incurred. Additionally, the maximum reimbursement amount credited under the HRA in the future (not including amounts carried forward from previous coverage periods) may be increased or decreased. However, see § 1.105-11(c)(3)(ii) regarding operational discrimination in favor of highly compensated individuals (as defined in § 105(h)). Thus, if an increase in maximum reimbursement amounts in an HRA favors one or more highly compensated individuals, the HRA may violate these non-discrimination rules.
V. Ordering Rules for HRAs and § 125 Health FSAs A medical care expense may not be reimbursed from a § 125 health FSA if the expense has been reimbursed or is reimbursable under any other accident or health plan. If coverage is provided under both an HRA and a § 125 health FSA for the same medical care expenses, amounts available under an HRA must be exhausted before reimbursements may be made from the FSA. However, a § 125 health FSA will not violate this rule if coverage is provided under both an HRA and a § 125 health FSA and the FSA reimburses a medical care expense which is not reimbursable by the HRA. In no case may an employee be reimbursed for the same medical care expense by both an HRA and a § 125 health FSA. Consistent with these rules, before a § 125 health FSA plan year begins, the plan document for the HRA may specify that coverage under the HRA is available only after expenses exceeding the dollar amount of the § 125 FSA have been paid. For example, if an employer sponsors a § 125 health FSA and an HRA, both of which provide coverage for the same medical care expenses, and the HRA plan document includes a provision that the HRA is not available for reimbursements of medical care expenses that are covered by the § 125 health FSA until after expenses exceeding the dollar amount of the § 125 FSA have been paid, then those medical care expenses may be reimbursed first from the § 125 health FSA and then from the HRA when the amount available under the § 125 FSA is exhausted.
VI. Nondiscrimination Rules Applicable to HRAs Section 105(h) sets forth nondiscrimination rules for self-insured medical expense reimbursement plans. To the extent an HRA is a self-insured medical expense reimbursement plan, the nondiscrimination rules under § 105(h) apply to the HRA. See § 1.105-11.
VII. COBRA Continuation Coverage An HRA is a group health plan generally subject to the COBRA continuation coverage requirements. If an individual elects COBRA continuation coverage, an HRA complies with these COBRA requirements by providing for the continuation of the maximum reimbursement amount for an individual at the time of the COBRA qualifying event and by increasing that maximum amount at the same time and by the same increment that it is increased for similarly situated non-COBRA beneficiaries (and by decreasing it for claims reimbursed). Premiums are determined under the existing rules in § 4980B. An HRA complies with the COBRA requirements for calculating the applicable premium under § 4980B if the applicable premium is the same for qualified beneficiaries with different total reimbursement amounts available from the HRA (and otherwise also satisfies the requirements of § 4980B). For example, if the annual additional reimbursement amount credited under an HRA is $1,000 and the maximum reimbursement amount remaining for two similarly situated qualified beneficiaries at the time of their qualifying events is $500 and $5,000, the applicable premium is the same for each individual. The plan rules of an HRA may provide for continued reimbursements after a COBRA qualifying event regardless of whether a qualified beneficiary elects continuation coverage. For example, an HRA might allow reimbursements up to the unused maximum reimbursement amount following termination of employment. In such a situation, an HRA subject to COBRA must still comply with the COBRA continuation coverage requirements. If a qualified beneficiary elects COBRA continuation coverage in addition to the continued reimbursement amount already available, an HRA complies with the COBRA requirements by increasing the maximum reimbursement amount at the same time and by the same increment that it is increased for similarly situated non-COBRA beneficiaries (and by decreasing it for claims reimbursed).
VIII. Other Matters Accident or health plans that meet the definition of an HRA are subject to a variety of statutory rules and provisions, many of which are not addressed in this notice. Among the statutory provisions not addressed in this notice are: The deduction limitations under §§ 419 and 419A (for employer contributions to welfare benefit funds) and under § 404 (for amounts paid or accrued under plans providing for deferred benefits that are not provided through a welfare benefit fund). The application of the nondiscrimination requirements under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), including the extent to which underwritten individual health insurance policies purchased and reimbursed by an HRA are treated as health insurance coverage offered under a group health plan. Other requirements under HIPAA, including the requirement that a group health plan provide certificates of creditable coverage. The requirements for welfare benefit plans under the Employee Retirement Income Security Act of 1974 (ERISA). The proposed regulations relating to health FSAs under § 125 state that certain requirements apply whether or not the health FSA is part of a cafeteria plan. Future guidance will modify the proposed regulation under § 125 to clarify that while those rules continue to apply to health FSAs provided pursuant to salary reduction election under a § 125 cafeteria plan, they do not apply to HRAs. COMMENTS REQUESTED Comments are requested about the rules set forth in this notice. Send comments to : CC:DOM:CORP:R (Notice 2002-45), Room 5226, Internal Revenue Service, POB 7604, Ben Franklin Station, Washington, DC 20044. Comments may be hand-delivered between the hours of 8 a.m. and 5 p.m. to: CC:DOM:CORT:R (Notice 2002-45), Courier’s Desk, Internal Revenue Service, 1111 Constitution Avenue, NW, Washington, D.C. Alternatively, taxpayers may submit comments electronically at: Notice.Comments@irscounsel.treas.gov (a Service Comments e-mail address).
DRAFTING INFORMATION The principal author of this notice is Lorianne D. Masano of the Office of Division Counsel/Associate Chief Counsel (Tax Exempt and Government Entities), IRS. For further information regarding this notice contact Lorianne D. Masano at (202) 622-6080 (not a toll-free call).
OTHER TECHNICAL DOCUMENTS
http://www.irs.gov/businesses/small/article/0,,id=157049,00.html
http://www.ltcconnection.com/annex/adv_1289.pdf#search=’IRC%20162%28l%29.’ |