The BRCC is announcing a new white paper analytic series titled “Nondiscrimination in Action”. This series will feature monthly publication of nondiscrimination standards and testing rules across the spectrum of health and welfare plan testing requirements. The series includes the following topics:
- Overview of nondiscrimination Testing (“NDT”) under the Internal Revenue Code (“IRC”);
- NDT for Self-funded Health & Welfare Plans;
- NDT for Cafeteria Plans;
- NDT for Group Long-Term Health Insurance;
- NDT for Health Savings Accounts;
- NDT for Voluntary Employees Beneficiary Associations;
- NDT for Dependent Care FSAs;
- NDT for Education Assistance Plans;
- NDT for Adoption Assistance Plans;
- NDT for Wellness Plans, including HIPAA, GINA & the ADA; and,
- NDT Related Penalties.
Each forthcoming monthly edition of the Baldwin Bulletin will feature one of the above-referenced topics.
For this month, we’re launching the services with an overview of nondiscrimination requirements contained within the IRC. This information is detailed in the following sections of this article.
Part I: Overview
Tax Benefits and Consequences. Many employer-provided benefits are excluded from an employee’s gross income as a result of particular federal tax incentives; thus, they are not subject to income tax respecting the actual value of the workplace benefits that are received by the employee. These are referred to as “tax advantaged” arrangements, and they require an employer’s steadfast diligence as to the compliant design, implementation, administration, and termination of these types of benefit programs.
Nondiscrimination in Favor of Highly Compensated Participants and Key Employees. One category of structural requirements relates to prohibitions against employee benefit plans that are designed to favor highly compensated participants and key employees with respect to plan benefits, rights, and features afforded to other plan participants. Consequently, it is imperative that the range of applicable nondiscrimination provisions within the IRC are both understood and properly administered throughout the lifespan of a tax-advantaged benefit plan or program. Accordingly, this guide is designed to offer employers summaries, outlines, overviews, and other significant resources designed to make the business of nondiscrimination compliance assuredness for tax-advantaged benefit plans more digestible and actionable for the plan sponsor.
Part II: Rules Vary by Benefit
Applicable Plans. There is no universal set of standardized nondiscrimination rules or testing requirements; rather, these requirements vary for each type of benefit that is subject to a nondiscrimination requirement under the IRC. Specifically, the types of welfare benefit plans and programs that are subject to individualized nondiscrimination requirements include each of the following:
- Self-funded health insurance maintained under IRC §105(h);
- Health Care Flexible Spending Accounts maintained under IRC §105;
- Group term life insurance offered under IRC §79;
- Cafeteria Plans administered under IRC §125;
- Voluntary Employee Beneficiary Associations (“VEBA”) administrated under IRC §505(b);
- Dependent Care Flexible Spending Accounts (“DCAP”) maintained under IRC §129;
- Adoption Assistance Plan maintained under IRC §137;
- Education Assistance Plans maintained under IRC §127; and
- Health Savings Accounts (HSA) maintained under IRC §223.
Part III: Key Concepts of Nondiscrimination Compliance
Key Concepts of Nondiscrimination. Key concepts that are often associated with nondiscrimination testing include:
- Prohibited Group. Who is in the prohibited group? This is the group that a plan cannot discriminate in favor of. It generally consists of highly compensated participants and key employees, but the definitions for these categories of employees vary by benefit. Highly compensated participants include highly compensated individuals (“HCI”) and highly compensated employees (“HCE”).
- Eligibility Classifications. What eligibility classification standards apply? This usually refers to the percentage of the employee population that is eligible for, or receives a benefit from, the plan.
- Employee Exclusions. Which employees can be excluded from the testing population? For purposes of satisfaction of the applicable nondiscrimination rules, certain employees can be excluded from the employee population count – usually those that have not met age or service requirements or for those employees that are collectively-bargained.
- Discrimination Outcomes. What is the consequence of a finding of discrimination? When discrimination is indicated, generally speaking, the participants of the prohibited group will not be eligible to receive the tax benefit associated with the value of the underlying benefit plan or program. Sometimes, though, all employees are penalized, and all benefits received under the plan may be subject to income taxation by the IRS.
Types of Benefits Subject to Testing. The remainder of this document discusses the types of employee welfare benefits that must comply with nondiscrimination rules.
Part IV: Summary of Specific Internal Revenue Code Nondiscrimination Tests
Employee Benefit | Regulatory Source | Testing Components | Prohibited Group | Excluded Employees* |
Fully Insured Medical Plans | Code §§9815(a); 105(h)(2) PHS Act §2716 | Eligibility Test Benefits Test | Highly Compensated Individuals (HCIs) – One of five highest paid officers – > 10% shareholder – Among highest paid 25% of all employees | If excluded from participation: – Employees with < 3 yrs. of service – Those < age 25 – Part-time, seasonal, and leased employees – Collective bargained employees – Nonresident aliens with no US source income |
Self-Insured Health Plans | IRC §105(h) | Eligibility Test Benefits Test | HCIs – One of five highest paid officers – > 10% shareholders – Among highest paid 25% of all employees | If excluded from participation: – Employees with < 3 yrs. of service – Those < age 25 – Part-time, seasonal, and leased employees – Collective bargained employees – Nonresident aliens with no US source income |
Health Care Flexible Spending Account (“FSA”) | IRC §105 | Eligibility Test Benefits Test | HCIs – One of five highest paid officers – > 10% shareholders – Among highest paid 25% of all employees | If excluded from participation: – Employees with < 3 yrs. of service – Those < age 25 -Part-time, seasonal, and leased employees – Collective bargained employees – Nonresident aliens with no US source income |
Group Term Life Insurance | IRC §79 | Eligibility Test Benefits Test | Key Employees – Officer with annual compensation (prior year look-back) more than threshold amount indexed ($220,000 for 2024), up to 50 employees, or if less, the greater of three employees, or 10% of the employees – > 5% owner (or his/her spouse or dependent) – More than 1% owner (or his/her spouse or dependent) with annual compensation more than $150,000 | – Not applicable to those with “simple cafeteria plans”, or church plans If excluded from participation: – Employees with < 3 yrs. of service – Those < age 25 – Part-time and seasonal employees – Collective bargained employees – Nonresident aliens with no US sourced income |
Cafeteria Plans | IRC §125 | Eligibility Test Contributions and Benefits Test Key Employee Concentration Test Safe Harbor Test for Premium-Only Plans | HCIs/Highly Compensated Employees (“HCEs”) -Shareholder owning > 5% voting power or value of all classes of employer’s stock -> 5% owner during current or prior plan year -Compensation in excess of IRC §414(q)(1)(B) threshold amount during prior plan year (for 2024 based on 2023 look-back amount of $150,000); New hires use current year compensation ($155,000 for 2024) -Officer (no limit on number) -Spouse or dependent (as defined in IRC §152) of above employees or owners Key Employees -Officers with annual compensation (prior year look-back) > the threshold amount indexed ($220,000 for 2024), up to 50 employees, or if less, the greater of three employees, or 10% of the employees -> 5% owner (or his/her spouse or dependent) -> 1% owner (or his/her spouse or dependent) with annual compensation more than $150,000 | Eligibility Test: -If excluded from participation: -Non-Key Employees covered by a collective bargaining agreement -Non-resident aliens with no U.S. source income – COBRA employees participating the cafeteria plan Contributions and Benefits Test – Non-eligible employees are not included Key Employee Concentration Test -Those who don’t elect qualified benefits are not included |
Voluntary Employee Benefit Association (“VEBA”) | IRC §505(b) | -Nondiscriminatory classification test -As long as another test applies for a benefit in the VEBA, the VEBA will be treated as relying on those tests to meet the requirements under IRC §505(b) | HCIs -Compensation > IRC §414(q)(1)(B) threshold amount during prior plan year (for 2024 based on 2023 look-back amount of $150,000); and if election made by the employer, employees in the 20% top- paid group. ->5% owners | -Employees with <3 yrs. of service -Those < age 21 -Seasonal employees and those working < than half-time -Collective bargained employees -Nonresident aliens with no US source income |
Dependent Care FSA | IRC §129 | -Eligibility Test -Contributions and Benefits Test -More-than-5% Owners Concentration Test -55% Average Benefits Test | More than 5% owners -> 5% owner during current or preceding plan year, incorporating ownership attribution rules under IRC §318 HCEs -Compensation > than IRC §414(q)(1)(B) threshold amount during prior plan year (for 2024 based on 2023 look-back amount of $150,000); and if election made by the employer, employee was in the 20% top- paid group -Spouse or dependent of an owner or high earner | Eligibility Test -If the plan excludes from participation: – Those < age 21 – Those with < than 1 year of service – – Collectively bargained employees Contribution and Benefits Test N/A More than 5% Owners Concentration Test N/A 55% Average Benefits Test -Employees making < than $25,000 may be disregarded -If plan excludes from participation: -Those who are < than age 21 -Those who have < than 1 year of service -Collectively bargained employees |
Adoption Assistance Plans | IRC §137 | Eligibility Test More-than-5% Owners | -HCEs, including their spouses and dependents who are also employees -> 5% owners and shareholders | Collectively bargained employees if the plan excludes them from participation |
Educational Assistance Programs | IRC §127 | Nondiscriminatory Classification Test/ Eligibility Test ->5% Owners | HCEs, including their spouses and dependents who are also employees -> 5% owners and shareholders | Collectively bargained employees if the plan excludes them from participation |
Health Savings Accounts (“HSAs”) | IRC §223 | -Comparability rules for employer contributions (if employee contributions are made outside of the cafeteria plan) -Both employer and employee HSA contributions are tested under §125 cafeteria plan nondiscrimination testing | Making different comparable contributions to different employee classifications other than (1) current full-time employees; (2) current part-time employees; or (3) former employees | -Collectively bargained employees -Employees who are not HSA-eligible -Former employees who have elected COBRA coverage under the employer’s HDHP |
Part V: Questions & Additional Support
Additional Resources
To obtain additional support for performance of these and other nondiscrimination related requirements, as mandated by the Internal Revenue Code, please reach out to your local service colleague or your client advisor. The Baldwin Group maintains an extensive suite of support solutions and advisory guidance capabilities respecting an employer plan sponsor’s performance of its IRS nondiscrimination related compliance assuredness activities. The Baldwin Regulatory Compliance Collaborative (the “BRCC”) also offers a carefully curated range of consultative and advisory support solutions related to the administration of US-based employee benefit plans, programs, and other offerings.
For more information
We’re ready when you are. Get in touch and a friendly, knowledgeable Baldwin advisor is prepared to discuss your business or individual needs, ask a few questions to get the full picture, and make a plan to follow up.
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