COBRA Administration

COBRA services starting at $595 annually.
Contact Stearns HR for more pricing information

Companies who must comply with COBRA rules and regulations can take advantage of Stearns HR affordable administration services. We are always ahead of the game when it comes to the complex, precise process of administering COBRA so our members stay compliant and avoid penalties.

  • COBRA is known as the Consolidated Omnibus Budget Reconciliation Act. It gives workers and their families who lose health benefits the right to choose to continue group health benefits provided by their group health plan for a limited period of time under certain circumstances.
  • The certain circumstances under COBRA include: voluntary or involuntary job loss, reduction in work hours, death, divorce, loss of dependent status and other life events.
  • COBRA requires that employers with group health plans who have 20 or more employees in the prior year offer employees and their families COBRA. This requirement can vary from state to state.
  • Failure to follow COBRA guidelines can result in IRS tax penalties, ERISA penalties, and civil penalties. The maximum excise tax that an employer can pay in one year is the lesser of 10 percent of the employer health plan costs in the previous year or $500,000. ERISA penalties accrue at $110 per day, per violation.
  • Receive excellent customer service from one of our trained and knowledgeable staff members
  • Initial/general notifications of COBRA rights and obligations and COBRA election notices mailed to employees.
  • Tracking and recording COBRA participants and qualifiers
  • COBRA participant management from beginning to end. Including: preparation and mailing of rate change letters, collecting premiums, and ensuring payments are received timely.
  • Monthly premium distribution with itemized reporting
  • Report storage for easy retention if it is ever needed.

Flexible Spending Accounts, Dependent Care Accounts, and Health Reimbursement Arrangements Plan Administration

Pricing for Plan Administration Accounts start at $325 for initial one-time plan fee set up and start at $7 per employee per month.
Contact Stearns HR for more information.

With the cost of health insurance continuing to rise, many employers must ask their employees to contribute to their health care costs. By putting a consumer-directed plan in place, both the employer and employee can benefit.

  • A Flexible Spending Account or Health FSA Plan allows employees to use pre-tax dollars to pay for eligible health care expenses for themselves, their spouse, and their eligible dependents. Enrollment in the plan will require a salary reduction form to be filled out by the employees. The employees determine the amount of money they want set aside out of their paycheck each pay period (not exceeding the IRS maximum limit), this amount will come out of their checks prior to taxes being taken out. Throughout the plan year, employees can submit claims for reimbursement from their FSA account after they have incurred and paid for an eligible expense. Limited FSA Plan Administration is also available with Stearns HR. A limited FSA plan is a more specific plan that is mostly used in coordination with group health H.S.A. plans and limits the type of incurred eligible expenses available for reimbursement.
  • A Dependent Care Account or DCA Plan is very similar to the FSA plan described above, however instead of health care expenses, the DCA plan allows employees to use pre-tax dollars to pay for child/dependent care expenses. Money is set aside from the employees paychecks each pay period pre-tax. Unlike the FSA plan where the employee has access to their entire annual election amount the first day of the plan year, the DCA Plan is a pay as you go account, meaning the amount available for reimbursement throughout the Plan Year is determined by the amount that has been deducted from the employees paychecks to date minus any previous reimbursements in the Plan Year.
  • A Health Reimbursement Arrangement or HRA Plan is an employer funded, tax advantaged employer health plan that reimburses employees for out-of-pocket medical expenses. A large employer HRA plan is used alongside the high deductible group health plan and can reimburse, for example, deductibles, co-payments, and coinsurance amounts. The Plan can be specifically designed to meet the reimbursement and plan administration satisfaction of the employer. A Small Employer HRA or QSEHRA is a qualified HRA Plan that is also an employer funded, tax advantaged employer health plan that reimburses employees for out-of-pocket medical expenses or health insurance premiums, this plan can also be specifically designed to meet the reimbursement and plan administration satisfaction of the employer. Employees submit their eligible incurred health expenses or premiums throughout the Plan year for reimbursement.
  • Enrollment forms and materials provided to group or benefit agency
  • Claim materials, claim filing directions, applicable ID cards, and benefit information provided to participants by mail after enrollment
  • Monitor and tracking participants
  • Prepare and mail applicable payments and explanation of benefits (EOB’s) to providers or employees
  • Provide plan support for participants and employer
  • Assist participants and providers with claim submissions and questions
  • Prepare and deliver monthly claim utilization reports to HIPAA manager on file of the employer
  • Summary Plan Document creation, price is included in plan set up fees
  • Schedule A provided for Form 5500 Filing if applicable

ERISA Plan Documents

Pricing for ERISA Plan Documents start at $420 per plan document.
Contact Stearns HR for more information.

ERISA requires that all employee benefit plans have a plan document. At Stearns HR, we can create separate plan documents for your benefit plans or create a single WRAP plan document that includes all of your welfare benefit plans and group insurance policies and contracts. Stearns HR also has an optional annual maintenance program to ensure you continue to stay compliant year after year.

  • A Summary Plan Document or SPD is one of the most important documents participants are entitled to receive after becoming a participant of the employer’s ERISA covered retirement or health benefit plan. An SPD explains to participants what the plan provides, how to file a claim, and how the plan operates. The required information in an SPD include eligibility information, how to submit a claim for benefits, and when their coverage ends.
  • A Summary Plan Document is an individual document that is created for each in force benefit plan for plan participants to meet ERISA requirements and guidelines. A WRAP Plan Document is a consolidated employee welfare benefit that combines all of the in force benefit plans into one document to meet ERISA requirements and guidelines. The decision to either have separate Summary Plan Documents or one WRAP Plan Document is the employer’s. Typically, the decision is made depending on the way the employer files their Form 5500. If the employer files one Form 5500 for all benefit plans, a WRAP Plan Document is chosen. If the employer files separate Form 5500’s, the employer can choose to continue to have separate Plan Documents for each in force benefit plan or they can decide to combine all of them into one WRAP Plan Document. Legal counsel is recommended for employers who decide to change the way they file their Form 5500 from year to year as IRS and DOL rules may require the employer to file additional forms or paperwork for the change in status.
  • Employers of all sizes who offer group benefit plans are legally obligated to provide participants, free of charge, the SPD or WRAP Plan Document. If a plan is changed, participants must be informed, either through a revised summary plan document, or in a separate document known as a summary of material modifications, also at no charge. Employers must also provide employees each year a copy of the plans summary annual report (Form 5500).
  • Failure to provide an SPD or WRAP Plan SPD within 30 days of receiving a request from a participant can result in a penalty of up to $110/day per participant or beneficiary for each violation. Failure to furnish to the DOL any requested information relating to the employee benefit plan can result in a penalty of up to $152 per day. Not having an SPD could trigger a plan audit by the U.S. Department of Labor (DOL).
  • Preparing a summary plan document or WRAP plan document for the benefit plans in force for the current Plan Year for review and use. Carrier certificates and benefit summaries are provided by the employer and included in the documents to meet ERISA standards.
  • Letter templates and distribution directions and guidelines provided for Employer customization for use to distribute document materials to plan participants.
  • Documents are provided in a CD-ROM format or can be emailed to employer, paper binder format is available upon request.
  • Section 125 Premium Only Plan document included with purchase of the summary plan document service.
  • Specialty Summary Plan Documents, if applicable, include: Health Reimbursement Arrangement Summary Plan Document, Flexible Spending Account Summary Plan Document, Dependent Care Account Summary Plan Document and Premium Only Plan Document with Health Savings Account Module available. The specialty summary plan documents may have an extra cost.

Non-Discrimination Testing

Pricing for Non-Discrimination Testing starting at $750 per test.
Contact Stearns HR for more information.

Employers who have Health Flexible Spending Accounts (FSA), Dependent Care Accounts (DCA), Health Reimbursement Arrangements (HRA), Group Term Life Insurance, and Self-insured Medical Plans are obligated, each year, to ensure these plans do not discriminate in favor of Highly Compensated Individuals (HCI). At Stearns HR we partner with a leading health benefits management affiliate to provide affordable and effective testing solutions.

  • Cafeteria plans, self-insured health plans, flexible spending account plans, and dependent care plans are subject to nondiscrimination requirements under the Internal Revenue Code. Testing is intended to prevent these plans from discriminating in favor of highly paid and key employees. Noncompliance may result in tax consequences for the HCI individuals, including, paying taxes on their cafeteria plan salary reductions.
  • Designated and knowledgeable Business Analysts at CXC Solutions that will provide step-by-step guidance throughout the service
  • Testing tool is backed by a leading employee benefits attorney firm
  • Business Analyst at CXC Solutions will filter and cleanse all data gathered by the employer in order to perform testing
  • Tool is the only solution reviewed by the Employee Benefits Institute of America (EBIA)
  • Tool accurately and automatically identifies employees in the “prohibited groups,” in accordance with current regulations
  • Tool has a built in recommendation module included to reduce the likelihood of having a plan fail and jeopardize favorable tax treatments.
  • HIPAA compliant solution
  • Ability to store up to 7 years of data for audit readiness.
  • Cafeteria plans that do not pass all of its nondiscrimination tests will have taxable income applied
  • If a self-insured health plan does not pass its tests, certain reimbursements paid to highly compensated employees will be taxable.
  • If a dependent care plan fails any of its tests, the benefits provided to highly compensated employees will not qualify for exclusion from income.
  • Employer may be subject to interest and penalties on top of additional taxes for testing failure outcomes or noncompliance.

ACA Benefit Notices

Pricing for ACA Benefit Notice Service starts at $275.
Contact Stearns HR for more information.

Annually, employers are required to provide their Employees with various notices federally regulated by the Department of Labor (DOL), the Employee Retirement Income Security Act (ERISA), Centers for Medicare/Medicaid (CMS), and the Affordable Care Act (ACA). Stearns HR generates these notices for you and have mailing options available to keep you compliant.

  • Annual Benefit Notices are a collection of health care notices required under the DOL, PPACA, ERISA, COBRA, and HIPAA to be distributed to employees and their dependents during certain times of the year. Most employers satisfy these requirements at the time of their benefits open enrollment period at the beginning of the plan year. The required notices include: the group health plan Summary of Benefits and Coverage (SBC), CHIPRA Notice, HIPAA Special Enrollment Rights Notice, Availability of Health Insurance Notice, Marketplace Notice, Medicare Part D Creditable Coverage Notice and more.
  • Penalties for not distributing the annual benefit notices required under ERISA can be up to $200 per notice, per day, per participant or beneficiary. Some notices have a penalty of up to $1,000 per participant or beneficiary.
  • Prepare current model notices according to DOL, PPACA, ERISA, ACA, and CMS standards.
  • Report to CMS on behalf of group for Medicare Part D notices and data
  • Optional print and mail service, additional cost applies
  • Employer will be required to provide an employee census with employee address information if print and mail service is requested

ACA Reporting

Pricing for ACA Reporting starting at $4,380.
Contact Stearns HR for more information.

Employers subject to the “play or pay” mandate are required to file Form 1095-C to each employee and Form 1094-C to the IRS to show that the health coverage they offer to their employees is compliant with ACA requirements. At Stearns HR, we partner with a leading health benefits management affiliate to provide an affordable, white glove service for your ACA Reporting.

  • Under the Affordable Care Act (ACA) and the ACA Employer Shared Responsibility Mandate, reporting for applicable large employers (employers with 50 or more full-time and full-time equivalent employees in the previous year) that provide health insurance to their employees must submit information to the IRS reporting on individual’s health insurance coverage. The returns include Form 1094-C and Form 1095-C. The 1094-C is the form used to report information to the IRS about whether or not the employer offers affordable minimum essential health coverage (MEC). Form 1095-C is the form distributed to employees and provides important information needed to complete their individual tax returns.
  • Designated and knowledgeable ACA Analyst at CXC Solutions who is PPACA certified and works alongside the employer providing step-by-step support and assistance during the ACA service
  • ACA Analyst will determine the information requirements that will need to be provided from the employer to perform the service and filter and cleanse the gathered data
  • ACA Analyst will determine the risk to any potential penalties and prepare the 1094 and 1095 files for IRS filing
  • Tool will leverage the affordability safe harbors when assessing employees rate of pay and benefit contributions
  • Guidance provided on reducing potential penalty exposure
  • Tool calculates ACA Full Time status based on hours of service for variable hour employees
  • Creates and tracks multiple measurement groups
  • Transmit and e-file the 1094 and 1095 forms with the IRS
  • Service available, extra cost applies, to print and mail the employee forms
  • Failure to file Form 1094-C by the IRS deadline date will result in a penalty of $250 per form, not exceeding $3 million per year.
  • Failure to file and distribute information on Form 1095-C by the IRS deadline date will result in a penalty of $500 per form.

Form 5500 Filing

Pricing for Form 5500Xpress Service starting at $750 per Form 5500.
Contact Stearns HR for more information.

Form 5500 is required reporting under ERISA and is the primary source of information reported to the government about employee benefit plans. Form 5500 is used for ERISA and benefit plan enforcement, research, and disclosure. At Stearns HR, we partner with a leading health benefits management affiliate to provide an affordable, attorney reviewed, white glove service for your Form 5500 filing needs.

  • Form 5500 is an annual report for applicable employee benefit plans. The Form 5500 is used to satisfy the annual reporting requirements for the DOL and IRS. The Form 5500 is the primary source of information for the government about employee benefit plans.
  • Designated and qualified account representative at CXC Solutions that will provide step-by-step guidance throughout the service.
  • Ability to import past year filings
  • Attorney reviewed process and tool
  • Service tool is validated for errors
  • Easy E-filing
  • Ability to store documents and yearly filings
  • Employers who offer group benefit plans, including pension plans with 100 or more participants on the first day of the Plan Year are required to file Form 5500 on an annual basis. The employers annual due date to file Form 5500 will depend on the date the Plan Year ended. Form 5500 is required to be filed no later than by the end of the 7th month after the end of the plan year. Information required in order to File 5500 include: Schedule A Forms for each benefit plan, Schedule A Forms are requested by the employer from the insurance carrier and previous years Form 5500 Filing for information purposes.
  • Failure to file a Form 5500 can include civil penalties against the Employer of up to $2,140 per day from the date of the administrator’s failure or refusal to file. Criminal penalties for willful violation of any provision of Part 1 of Title I of ERISA is a fine of not more than $500,000 and/or imprisonment for not more than ten years. Each reporting failure, by year, is treated as a separate violation.
  • Employers cannot contract away reporting liability by contracting with a third party administrator (TPA) to prepare the Form 5500, this does not relieve the Employer’s liabilities.
  • The DOL does not usually follow a statute of limitations with respect to the Form 5500, they have assessed penalties reaching back more than 10 years.