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Small Business Employee Benefits and HR Blog

3 Reasons Employers Should Use Defined Contribution Admin Software

Many employers that self-administer a defined contribution health plan, or who simply give raises or bonuses for health insurance, often overlook important compliance obligations that put them at financial risk. Failure to comply with the minimum administration requirements is common and can be costly. And, if an employer does take the extra steps to fully comply, the administrative cost will likely outweigh the benefits.

Here are the top three reasons employers should consider using Defined Contribution Admin Software to self-administer a defined contribution health plan:

  1. IRS Compliance and Tax Savings
  2. Federal Compliance
  3. Ease-of-Use

1. Defined Contribution Admin Software Creates Tax Savings

If an employer pays for employees' individual health insurance premiums without utilizing Defined Contribution Software, such payments might need to be reported as taxable income to the employees.

Employees receive dollars 100% tax-free

The IRS requires that plan documents be established in order for employees to deduct the individual health insurance premiums from taxable income on their annual W-2.

Defined Contribution Admin Software (and the associated tax benefits) increase the ability of employers to recruit and retain good employees.

Employers deduct reimbursements as a non-taxable business expense

An IRS-compliant defined contribution health plan will ensure the tax deductibility of employee's individual health insurance premiums.

2. Federal Compliance

The federal government has guidelines for employers who want to contribute to employee's IRS-qualified health insurance expenses. An IRS/ERISA/HIPAA/ACA-compliant defined contribution health plan will ensure compliance with federal law.

HIPAA Compliancedefined_contribution_admin_software

Using Defined Contribution Admin Software:

Employees submit claims for health insurance premiums online, via fax, or mail.

Once submitted, claims are processed by the software provider, and employers click a button periodically to reimburse employees via check, payroll addition, or direct deposit.

All reimbursements go directly from the employer to the employee at the time and method chosen by the employer.

All claims are kept HIPAA-protected and all receipts are stored digitally in compliance with HIPAA for 10 years as required by the IRS for company and personal audit purposes.

ERISA Compliance

Some companies might want to pay directly for an employee's individual health insurance plan without utilizing an ERISA and HIPAA-compliant defined contribution health plan, but doing so will put the employer out of compliance with federal regulations and increase the employer's (and employee's) tax liability.

There are two major reasons an employer should never pay for its employee's individual health insurance plan:

(1) When an employer pays directly for an individual health insurance plan, they effectively endorse each employee's individual insurance plan as part of an employer-sponsored group health benefit offering. In other words, according to federal law, the employer is treating the individual plan as part of an employee welfare benefit plan regulated by ERISA. Because most individual health insurance plans do not meet minimum ERISA group plan requirements, the employer is out of compliance.

(2) Separately, an employer is not allowed to know the details of employees HIPAA-protected medical expenses. This includes individual health insurance details. When an employer pays for the individual policy, they can violate HIPAA-privacy requirements because they know the details of a HIPAA-protected employee expense.

ACA Compliance 

The Affordable Care Act (ACA) introduced new requirements for Defined Contribution Health Plans including how benefit information is presented to employees (Summary of Benefits & Coverage, or SBC), new reporting forms (720/5500), and new plan design requirements (ex: prohibition on annual limits). Defined Contribution Admin Software ensures employers have the appropriate documents, data, and plan settings in place to be ACA compliant.

3. Ease of Use

Defined Contribution Admin Software allows an employer to administer the employee health benefits program in less than 5-minutes per month. The process is completely online and paperless.

Pre-taxing occurs via payroll

Defined Contribution Admin Software does not require a Third Party Administrator (TPA) to touch the employer's money. All reimbursements go directly from the employer to the employee at the time and method chosen by the employer (typically via payroll).

What are your questions about Defined Contribution Admin Software?

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