IRS Approves Two New Mid-Year Changes To Cafeteria Plan Elections

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The Internal Revenue Service (IRS) recently announced that employees may change their pre-tax health plan payment elections mid-year pursuant to their employer’s cafeteria plan under two new circumstances.  First, if an employee has been in a position that is reasonably expected to average at least 30 hours of service per week, and there is a change in that employee's status so that the employee will reasonably be expected to average less than 30 hours of service per week, that employee may change his or her election when his or her hours are reduced below 30 per week.  This revocation is conditioned on the employee’s intention to enroll in another group health plan that provides minimum essential coverage.  The new coverage must be effective no later than the first day of the second month following the month in which the employer-sponsored coverage is dropped.  Under the second new election change event option, an employee who is eligible to enroll in coverage through a government-administered Marketplace during the Marketplace open enrollment period, or as a result of a special enrollment event, may drop his employer’s group health plan coverage midyear.  The change must correspond to the employee’s intended enrollment in Marketplace coverage that is effective beginning no later than the day immediately following the last day of the employer-sponsored coverage.  Under both options, the cafeteria plan administrator may rely on an employee’s reasonable representation about the intended enrollment.  These two new election change events are optional, employers are not required to amend their cafeteria plans to adopt these new election change events.  However, if an employer decides to adopt these changes, an amendment to the cafeteria plan will be necessary.  Before adopting either or both of these new election change events, employers should carefully consider the impact of these new election change events on their group health plans and for large employers, their strategies to avoid or mitigate Employer Shared Responsibility Mandate penalties.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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