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.
Contra Costa California Corporate Resolution Establishing a Self-insured Medical Payment Plan for Key Employees is a legal document that outlines the establishment and implementation of a self-insured medical payment plan for key employees in Contra Costa, California-based corporations. This resolution is designed to provide comprehensive healthcare coverage for specified high-ranking employees within the organization. A self-insured medical payment plan is a healthcare program where the employer directly assumes the financial risk of providing medical benefits to employees. Rather than purchasing insurance coverage from a third-party insurer, the employer sets up a fund to pay for all qualifying medical expenses of the key employees. The Contra Costa California Corporate Resolution outlines the specific provisions and requirements for this self-insured medical payment plan. It typically includes: 1. Purpose and Scope: This section sets forth the objective of the resolution, stating that it is designed to ensure adequate healthcare coverage for key employees and to control costs while maintaining quality. 2. Definitions: Various terms used in the resolution are defined to provide clarity and consistency in interpretation. 3. Eligibility Criteria: The resolution outlines the criteria for determining which employees are considered "key employees" and are therefore eligible for participation in the program. Factors like job role, responsibilities, and level of decision-making authority may be considered. 4. Benefits Coverage: The resolution specifies the scope of benefits covered under the self-insured medical payment plan, which may include medical, dental, vision, prescription drugs, mental health, and other necessary healthcare services. 5. Compensation and Funding: This section outlines the financial aspects of the plan, including how the plan will be funded, the employer's contribution, and the employee's contribution (if any). Funding may be through a dedicated fund or by setting aside a specific amount from the corporate budget. 6. Administration and Governance: The resolution establishes the role of an administrator responsible for managing plan operations, claims processing, record-keeping, and compliance with state and federal regulations. It also outlines the responsibilities of the key employees and provides a mechanism for resolving disputes or grievances. It's important to note that there may be different variations of the Contra Costa California Corporate Resolution Establishing a Self-insured Medical Payment Plan for Key Employees, as specific details can vary depending on the organization and its unique requirements. Nonetheless, the key elements mentioned above are likely to be present in most versions. In conclusion, the Contra Costa California Corporate Resolution Establishing a Self-insured Medical Payment Plan for Key Employees is a crucial legal document that outlines the establishment and guidelines for a self-insured healthcare program tailored to provide comprehensive coverage to selected high-ranking employees within Contra Costa, California-based corporations.Contra Costa California Corporate Resolution Establishing a Self-insured Medical Payment Plan for Key Employees is a legal document that outlines the establishment and implementation of a self-insured medical payment plan for key employees in Contra Costa, California-based corporations. This resolution is designed to provide comprehensive healthcare coverage for specified high-ranking employees within the organization. A self-insured medical payment plan is a healthcare program where the employer directly assumes the financial risk of providing medical benefits to employees. Rather than purchasing insurance coverage from a third-party insurer, the employer sets up a fund to pay for all qualifying medical expenses of the key employees. The Contra Costa California Corporate Resolution outlines the specific provisions and requirements for this self-insured medical payment plan. It typically includes: 1. Purpose and Scope: This section sets forth the objective of the resolution, stating that it is designed to ensure adequate healthcare coverage for key employees and to control costs while maintaining quality. 2. Definitions: Various terms used in the resolution are defined to provide clarity and consistency in interpretation. 3. Eligibility Criteria: The resolution outlines the criteria for determining which employees are considered "key employees" and are therefore eligible for participation in the program. Factors like job role, responsibilities, and level of decision-making authority may be considered. 4. Benefits Coverage: The resolution specifies the scope of benefits covered under the self-insured medical payment plan, which may include medical, dental, vision, prescription drugs, mental health, and other necessary healthcare services. 5. Compensation and Funding: This section outlines the financial aspects of the plan, including how the plan will be funded, the employer's contribution, and the employee's contribution (if any). Funding may be through a dedicated fund or by setting aside a specific amount from the corporate budget. 6. Administration and Governance: The resolution establishes the role of an administrator responsible for managing plan operations, claims processing, record-keeping, and compliance with state and federal regulations. It also outlines the responsibilities of the key employees and provides a mechanism for resolving disputes or grievances. It's important to note that there may be different variations of the Contra Costa California Corporate Resolution Establishing a Self-insured Medical Payment Plan for Key Employees, as specific details can vary depending on the organization and its unique requirements. Nonetheless, the key elements mentioned above are likely to be present in most versions. In conclusion, the Contra Costa California Corporate Resolution Establishing a Self-insured Medical Payment Plan for Key Employees is a crucial legal document that outlines the establishment and guidelines for a self-insured healthcare program tailored to provide comprehensive coverage to selected high-ranking employees within Contra Costa, California-based corporations.
