Discrimination favoring management or highly paid employees is not permitted for deductible health and accident insurance plans. For self-insured medical reimbursement plans (i.e., direct payment or reimbursement by the employer of the medical bills of the employee or family), no discrimination, either in eligibility or benefits, is permitted if "highly compensated individuals" are to receive all plan benefits tax-free. The plan must benefit, in general, at least 70% of employees who are not highly compensated employees. However, there are exceptions. A "highly compensated employee" is one who has a significant ownership interest in the company, or who is one of the five highest paid officers or employees. An alternative designation is an income threshold, currently $80,000. If a self-insured plan is discriminatory, an employee who is considered a highly compensated employee must include the amount of discriminatory benefits received in gross income.
Cuyahoga Ohio Corporate Resolution Establishing a Self-insured Medical Payment Plan for Key Employees is a legal document that outlines the implementation and management of a self-funded healthcare program specifically designed for key employees within a corporate organization located in Cuyahoga County, Ohio. This resolution enables the establishment of a comprehensive medical payment plan to provide coverage for medical expenses incurred by key employees and their dependents. The Cuyahoga Ohio Corporate Resolution is a crucial document that sets forth the terms, conditions, and rules governing the self-insured medical payment plan. It addresses various aspects, including eligibility criteria, coverage benefits, employee contributions, claims procedures, and administrative responsibilities. The intention behind such a resolution is to tailor a healthcare program that meets the unique needs of the key employees while maintaining financial stability for the employer. This customized self-insured medical payment plan offers flexibility, control, and potential cost savings to the corporate entity. By assuming the financial risk of providing healthcare coverage directly, the employer can design a plan that aligns with the specific healthcare needs of its key employees. It allows for personalized coverage options, access to preferred medical providers, and cost containment strategies tailored to the organization's financial objectives. Key components of the Cuyahoga Ohio Corporate Resolution Establishing a Self-insured Medical Payment Plan for Key Employees may include: 1. Eligibility Criteria: Specifies the criteria for employees to be deemed as "key employees" and eligible for the self-insured medical payment plan. This typically considers factors such as job position, annual compensation, and length of employment. 2. Coverage Benefits: Outlines the scope of medical services covered under the plan, including hospitalization, physician visits, surgeries, prescription drugs, preventive care, and other necessary treatments. It may also include dental and vision coverage options. 3. Employee Contributions: Defines the portion of healthcare costs to be borne by the key employees, such as monthly premiums, deductibles, and co-pays. The resolution may outline contribution levels based on employee status or salary brackets. 4. Claims Procedures: Defines the procedures for submitting and processing medical claims, including necessary documentation, timeframes, and channels for reimbursement. It may also establish an internal committee responsible for reviewing and approving claims. 5. Administrative Responsibilities: Outlines the responsibilities of the employer or a designated administrator in managing the self-insured medical payment plan. This may include claim administration, enrollment management, compliance with federal and state regulations, record keeping, and reporting requirements. The Cuyahoga Ohio Corporate Resolution Establishing a Self-insured Medical Payment Plan for Key Employees aims to provide a comprehensive and cost-effective healthcare solution for key employees within a corporate organization. By customizing coverage and assuming financial risk, employers can design a plan that meets the specific needs of their workforce while potentially reducing overall healthcare expenditures.Cuyahoga Ohio Corporate Resolution Establishing a Self-insured Medical Payment Plan for Key Employees is a legal document that outlines the implementation and management of a self-funded healthcare program specifically designed for key employees within a corporate organization located in Cuyahoga County, Ohio. This resolution enables the establishment of a comprehensive medical payment plan to provide coverage for medical expenses incurred by key employees and their dependents. The Cuyahoga Ohio Corporate Resolution is a crucial document that sets forth the terms, conditions, and rules governing the self-insured medical payment plan. It addresses various aspects, including eligibility criteria, coverage benefits, employee contributions, claims procedures, and administrative responsibilities. The intention behind such a resolution is to tailor a healthcare program that meets the unique needs of the key employees while maintaining financial stability for the employer. This customized self-insured medical payment plan offers flexibility, control, and potential cost savings to the corporate entity. By assuming the financial risk of providing healthcare coverage directly, the employer can design a plan that aligns with the specific healthcare needs of its key employees. It allows for personalized coverage options, access to preferred medical providers, and cost containment strategies tailored to the organization's financial objectives. Key components of the Cuyahoga Ohio Corporate Resolution Establishing a Self-insured Medical Payment Plan for Key Employees may include: 1. Eligibility Criteria: Specifies the criteria for employees to be deemed as "key employees" and eligible for the self-insured medical payment plan. This typically considers factors such as job position, annual compensation, and length of employment. 2. Coverage Benefits: Outlines the scope of medical services covered under the plan, including hospitalization, physician visits, surgeries, prescription drugs, preventive care, and other necessary treatments. It may also include dental and vision coverage options. 3. Employee Contributions: Defines the portion of healthcare costs to be borne by the key employees, such as monthly premiums, deductibles, and co-pays. The resolution may outline contribution levels based on employee status or salary brackets. 4. Claims Procedures: Defines the procedures for submitting and processing medical claims, including necessary documentation, timeframes, and channels for reimbursement. It may also establish an internal committee responsible for reviewing and approving claims. 5. Administrative Responsibilities: Outlines the responsibilities of the employer or a designated administrator in managing the self-insured medical payment plan. This may include claim administration, enrollment management, compliance with federal and state regulations, record keeping, and reporting requirements. The Cuyahoga Ohio Corporate Resolution Establishing a Self-insured Medical Payment Plan for Key Employees aims to provide a comprehensive and cost-effective healthcare solution for key employees within a corporate organization. By customizing coverage and assuming financial risk, employers can design a plan that meets the specific needs of their workforce while potentially reducing overall healthcare expenditures.
Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés. For your convenience, the complete English version of this form is attached below the Spanish version.
