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Frequently Asked Questions
What
is creditable coverage?
What is a certificate
of creditable coverage?
How many employees must
I have employed in order to get a group health plan?
What is a 5500?
What is a Health Savings Account (HSA)?
What is a High Deductible Health Plan (HDHP)?
What is a Health Reimbursement Arrangement (HRA)?
What does the IRS define as qualified medical
expenses?
What are ineligible expenses for HRA and FSAs?
What is a Flexible Spending Account (FSA)?
What is a Dependent Care Account (DCA)?
How
can I retain my health coverage after I leave employment?
What
is creditable coverage?
The concept of creditable coverage is that individuals should be
given credit for previous health coverage when moving from one health
plan to some other health coverage.
What is a certificate
of Creditable Coverage?
You can think of the certificate as written
proof of prior healthcare coverage. Most healthcare insurance
programs impose a waiting period for a pre-existing condition for
all new members. A certificate of credible coverage indicates
the length of time you have been continuously covered under a qualifying
previous healthcare plan and may allow waiver of any waiting period
related to a pre-existing condition. Please visit our
form download page to print a blank certificate
for yourself...
How
many employees must I have employed in order to get a group health
plan?
In the state of Mississippi, 2 employees will make a group.
However, if you have more than 2 full-time employees, you will need
to have 75% participation.
What
is a 5500?
The Form 5500 Series is part of ERISA's reporting and disclosure
framework, which is intended to assure that employee benefit plans
are operated and managed in accordance with prescribed standards.
Recently new regulations state that
effective January 2008 all 5500s must be filed electronically. Click
on the icon below to view the IRS regulation.
What
is a Health Savings Account (HSA)?
The Medicare bill signed by President Bush on December 8, 2003 created
HSAs. They are designed to help individuals save for future
qualified medical and retiree health expenses on a tax-free basis.
Health Savings Accounts can only be utilized with a qualified High
Deductible Health Plan.
What
is a High Deductible Health Plan (HDHP)?
An HDHP meets certain requirements to coincide with the regulations
of an HSA. The HDHP features higher annual deductibles (a
minimum of $1,050 for Self and $2,100 for Family coverage) and annual
out-of-pocket limits (not to exceed $5,000 for Self and $10,000
for Family coverage) than other insurance plans.
What
is a Health Reimbursement Arrangement (HRA)?
An HRA is a tax-benefit approved by the IRS that reimburses employees
for qualified medical expenses that are not covered by your employer’s
health plan. Examples include, copays, deductible and coinsurance.
Only employers are able to contribute to an HRA and any unused fund
may be carried over to the following year (unlike an FSA), depending
on the guidelines of your HRA.
Some HRAs are reimbursed after a paper receipt
is received. However, at MWG Benefits, we utilize a MasterCard
Debit card. With this technology, paper receipts are only
requested when the card is used at certain locations (Drug stores),
and you receive the money immediately. Also, the employer
need not fund his HRA account until notified by the administrator.
What does
the IRS define as qualified medical expenses?
- Deductibles and coinsurance of medical insurance
- Doctor/Dental office visits co-pay
- Prescriptions co-pay
- Orthodontics (not covered by dental insurance)
- Laser eye surgery
- Eye glasses/Contact lenses
- Eye Examinations
- Dentures
- Diagnostic tests/lab fees
- Hospital Services
- X-rays
- Hearing devices and batteries
- Insulin injections
- Drug and alcoholism treatment
- Nursing services
- Birth control pills
- Orthopedic shoes
- Vaccinations
- Crutches/walkers/wheelchairs
- Acupuncture
- Ambulance costs
- Artificial limbs and teeth
- Chiropractic care
- Chiropractors
- Oxygen
- Smoking cessation programs (not gum or patches)
- Surgery
What are ineligible
expenses for HRA and FSAs?
- Weight loss program/health club dues/massage
therapy
- Dental cosmetics-bleaching, etc.
- Over-the-counter medicines even with a doctor’s
prescription
- Nicotine patches/gum
What
is a Flexible Spending Account (FSA)?
An FSA allows eligible employees to use funds provided through employee
salary reductions to pay for certain benefits under the plan with
pre-tax dollars. The employer may also contribute to the FSA.
Employees save on state, federal income, social security and Medicare
taxes when the employee funds the account. The MasterCard
Debit card may be used for FSAs.
What
is a Dependent Care Account (DCA)?
A DCA allows employees to set aside pre-tax dollars through payroll
deductions for eligible dependent care expenses (day care…).
The MasterCard Debit card may be used for DCAs.
DCA eligible expenses include payments made for
services provided in your home or outside your home for dependent
care in order for you and your spouse to work. The coverage
applies to dependents under the age of thirteen, dependent adults
or children 13 years old or older who are mentally or physically
incapable of self-care.
How
can I retain my health coverage after I leave employment?
The following document is from the Mississppi Department of Insurance
and answers questions about COBRA and State Continuation...
 http://www.doi.state.ms.us/publish/cobraandstatecontinuation.pdf
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