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Table Of Contents

Table Of Contents - Cafeteria Plan Training & Certification Program


  • What Is A Cafeteria Plan?
  • Tax Savings
  • Employer Benefits
  • Who May Establish A Cafeteria Plan?
  • Understanding Cafeteria Plans
  • 2007 Proposed Cafeteria Plan Regulations
  • 2010 Health Care Legislation
  • Basic Advantages Of Cafeteria Plans
  • Basic Disadvantages Of Cafeteria Plans

Eligible Benefits

  • Eligible Benefits: Introduction
  • Plan Year
  • Eligible Benefits
  • Health Care Premiums
  • Individual Insurance Policies
  • Health Flexible Spending Arrangements (HFSAs)
  • HFSA Requirements
  • Dependent Care Assistance Programs
  • Group Term Life Insurance
  • Group Term Life Insurance: Coverage In Excess Of $50,000
  • Income Replacement
  • Paid Time-Off Buy/Sell Arrangements
  • Buying Of Paid Time-Off Days
  • Selling Of Paid Time-Off Days
  • Section 401(k) Plans
  • Adoption Assistance Benefits/Adoption Assistance Credit

Eligible Expenses

  • Eligible Expenses: Premium Only Plans
  • Eligible Expenses: Health Flexible Spending Arrangement (HFSA)
  • Examples of Eligible HFSA Expenses
  • Electronic Payment Card Programs
  • Newly Eligible Expenses
  • Stand-Alone Health FSAs, Limited-Purpose Health FSAs, And Post-Deductible Health FSAs
  • Eligible Expenses: Dependent Care Assistance Programs
  • Ineligible Expenses: Premium Only Plans
  • Ineligible Expenses: Healthcare Flexible Spending Arrangements
  • Ineligible Expenses: Dependent Care Assistance Programs
  • Ineligible Expenses: Life Insurance

Eligible Participants

  • Definition Of Employees
  • Common Law Employees
  • Former Employees: Retirees
  • Former Employees: Severance Agreements
  • Partners, Independent Contractors, 2% Or More Owners
  • Leased Employees
  • Beneficiaries of Employees
  • Other Relationships
  • Accident And Health Coverage Purchased For Someone Other Than The Employee’s Spouse Or Dependents With After-Tax Employee Contributions
  • Affiliated Service Groups
  • Plan Participation Eligibility Criteria
  • Why Implement Eligibility Rules?


  • Sources Of Cafeteria Plan Law
  • Evolution Of Cafeteria Plans
  • Obtaining IRS Information: Private Letter Rulings
  • Obtaining IRS Information: Information Letters
  • Obtaining DOL Information Letters
  • Obtaining DOL Information: Advisory Opinions
  • IRS Audits
  • DOL Audits

Design Options

  • Cafeteria Plan Designs
  • Simple Cafeteria Plans for Small Employers
  • Premium Conversion Plans
  • Flexible Spending Arrangements (FSAs)
  • Employer Flex Credits
  • Uniform Coverage And “Use-Or-Lose” Rules
  • Health Flexible Spending Arrangement
  • HFSA Design Requirements
  • HFSA Contributions
  • The Use-It-Or-Lose-It Rule
  • HFSA Reimbursements
  • Dependent Care FSAs
  • Dependent Care FSAs Design Requirements
  • Dependent Care FSAs Limits
  • Core-Plus
  • The Fully Flexible Cafeteria Plan
  • Flexible Benefit Credits
  • Opt-Out Feature
  • Health Reimbursement Arrangements (HRA)
  • Differences Between HRAs And HFSAs
  • Claims Submission And Reimbursement
  • Plan Assets: Premium Conversion Plans
  • Plan Assets: Health Flexible Spending Arrangements
  • Plan Assets: Dependent Care Assistance Plans
  • Plan Assets: Core Plans And Fully Flexible Cafeteria Plans
  • Fiduciary Responsibilities
  • Grace Periods

Plan Documentation & Communication

  • Plan Documentation & Communication: Introduction
  • Master Plan Document
  • Distribution Of The Master Plan Document
  • Summary Plan Descriptions
  • Summary Plan Descriptions: Required Content
  • Summary Plan Descriptions: Style And Format
  • Summary Plan Descriptions: Distribution & Disclosure Requirements
  • Summary Plan Descriptions: Reporting Requirements
  • Summary Plan Descriptions: Summary Annual Report
  • Salary Reduction Agreements
  • Summary of Benefit Coverage
  • Employer Responsibilities
  • Plan Communications

Election Options

  • Annual Election Requirement
  • Positive Election
  • Default Election
  • Automatic Election
  • Written Forms
  • Online
  • By Telephone
  • Correcting Election Errors
  • Irrevocable Elections Requirement
  • New Hires
  • Election Options For A POP
  • After-Tax POP: Advantages And Disadvantages
  • Employer Plan Contributions
  • Plan Year

Status Changes

  • Permissible Status Changes
  • Coverage Under State Exchanges
  • Change In Employment
  • Change In Employment: Rehires
  • Change In Residence
  • Change In Marital Status
  • Change Of Dependent Status
  • Change In Number Of Dependents
  • Adoption Assistance
  • Cost Changes
  • Coverage Changes: Own Employer
  • Coverage Changes: Other Employer-Sponsored Plan
  • Health Flexible Spending Arrangements
  • Dependent Care Assistance Programs
  • Medicare/Medicaid And Other Government Health Programs
  • HIPAA Special Enrollment
  • FMLA Leave
  • Judgment/Decree/Order
  • “Consistency” Rule
  • Timing Of Changes
  • Receiving, Processing, And Handling Status Changes

Claims Submittal Options & Procedures

  • Where And How Claims Should Be Submitted
  • Time Frame For Submitting Claims
  • Submitting Claims: Written Forms
  • Submitting Claims: Debit Cards
  • Submitting Claims: Debit Cards For Dependent Care
  • Submitting Claims: Health Insurance Company Automatic Reimbursements
  • Submitting Claims: Pre-Approved Annual DCAP Expense Form
  • Claims Dispute Options & Requirements

Reimbursement Options & Procedures

  • DOL Requirements
  • IRS Requirements
  • Reimbursable Expense Analysis: HFSAs
  • Reimbursement Options
  • Reimbursement Must Be For An Eligible Expense
  • Expense Must Be Incurred In An Eligible Time Period
  • Reimbursement Claims Must Be Made In A Timely Fashion
  • “Run-Out” Periods
  • Minimum Reimbursement Requirements
  • Deferral Of Compensation
  • No Commingling Amongst FSA Accounts Or Payment Of Insurance Premiums From An FSA.
  • Receiving Submitted Claims For Reimbursement
  • Processing Claims: HFSA Reimbursement Requests
  • Processing Claims: Invalid HFSA Reimbursement Requests
  • Processing Claims: Valid HFSA Reimbursement Requests
  • Processing Claims: Insurance Company Automatic Reimbursements
  • Special HFSA Issue: Orthodontia
  • Special HFSA Issue: Capital Expenses
  • Special HFSA Issue: Durable Medical Equipment
  • Dependent Care FSA Reimbursement Options
  • Processing Claims: Dependent Care Assistance Plans (DCAPs)
  • Processing Claims: Verification Of DCAP Claims
  • Reimbursements Paid By Mistake
  • Checklist For Processing Claims

Other Administrative Issues

  • The Use-It-Or-Lose-It Rule
  • Forfeitures
  • Uniform Coverage Rule
  • Administrative Issue: Dependent Care Assistance Programs
  • Administrative Issue: Dependent Care Assistance Programs Claims
  • Employer/Plan Responsibility

Integration With Other Laws

  • Interaction With HIPAA
  • Interaction With COBRA
  • COBRA and POP Plans
  • COBRA and HFSAs
  • COBRA and DCAPs
  • Interaction With FMLA
  • Cafeteria Plans During Leave
  • FMLA: Reinstatement To Equivalent Benefits
  • FMLA: Proration Rule
  • FMLA: Required Reinstatement To Equivalent Benefits
  • FMLA: Catch-Up Option

Discrimination Testing Overview

  • Discrimination Testing Overview
  • Reasons For Testing
  • Preparation For Discrimination Testing
  • Discrimination Tests For Self-Insured Medical Plans (Including HFSAs)
  • Testing Universe
  • Excludable Employees
  • Eligibility Test
  • Nondiscriminatory Classification Test
  • Nondiscriminatory Classification Test: Safe Harbor Percentage Test
  • Safe Harbor Test: IRS Comparison Table
  • Nondiscriminatory Classification Test: Fair Cross-Section Test
  • The Benefits Test
  • Discrimination Testing: Key Employees
  • Disability Insurance
  • Premium Only Plans
  • Dependent Care Assistance Programs Overview
  • Dependent Care Assistance Programs Nondiscrimination Requirement
  • Dependent Care Eligibility Requirement
  • Dependent Care Contributions And Benefits Test
  • The 55% Average Benefits Test
  • Concentration Of Benefits Test (The 25% Test)
  • Plan Design
  • Adoption Assistance Programs Discrimination Testing
  • Cafeteria Plan Testing
  • The Three Cafeteria Plan Discrimination Tests
  • HCE Eligibility Test
  • HCE Contributions and Benefits Test
  • Actual Operation
  • 25% Key Employee Concentration Test
  • 25% Key Employee Concentration Test Example

Reporting & Disclosure

  • DOL Requirements
  • IRS Requirements
  • Other Plan Documents


  • Links To Government Sites And Posted Regulations
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