Compliance Q&A: Understanding Your Healthcare Rights: HSA Tactics, Subsidy Qualifications, and COBRA Premium Gaps

  • April 21, 2025
  • Posted by: Gus Altuzarra
  • Category: Compliance Q&A
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hra health plan

4.3.25 |  FRONT-LOADING HSA CONTRIBUTIONS

 

Q. Is it possible to “front load” contributions to an HSA so that the employee is mostly funded within the first 3-4 months of the year and then reduce the contribution amount to top up the residual amount over the remaining 8-9 months? The enrollment system only allows even deductions throughout the year.

A. The employee should be able to front load HSA contributions. Under the cafeteria plan rules, employers must give employees the ability to change their HSA elections on a monthly basis. Employees can change their HSA contributions for any reason. HSA contributions through a cafeteria plan are not subject to normal restrictions that apply to other cafeteria plan elections.

 

4.10.25 |  ELIGIBILITY FOR ACA MARKETPLACE SUBSIDY

 

Q. An employee has employee-only coverage on the company’s ACA compliant medical plan. Can the employee’s spouse and child buy individual medical coverage through the ACA marketplace, and if so, are they eligible for a subsidy since the employee’s medical plan is ACA compliant? The spouse is not employed.

A. Previously, a family would not be eligible for marketplace subsidies if the employee’s employer offered an affordable plan (just for the employee). This was called the “family glitch.” Under the rules effective in 2022, if the employer’s coverage is affordable for the employee but not the family, the family members can qualify for a subsidized plan on the marketplace. If the employer’s plan is affordable for the entire family, no subsidies will be available for any family member.

 

4.17.25 |  COBRA FOR PREMIUM NON-PAYMENT DURING LEAVE

 

Q. An employer requires its employees to continue weekly payroll deductions for coverage while they are no leave. The employer offers a four-week grace period before coverage is terminated. If coverage is terminated due to premium non-payment, should the employee be offered COBRA?

A. No. Non-payment of premiums is not a qualifying event under COBRA. If an employee fails to timely pay the premiums as required by the plan and the employer’s policy, coverage can be terminated and COBRA is not offered.

 

Answers to the Question of the Week are provided by Kutak Rock LLP. Kutak Rock provides general compliance guidance through the UBA Compliance Help Desk, which does not constitute legal advice or create an attorney-client relationship. Please consult your legal advisor for specific legal advice.



Author: Gus Altuzarra
Gus is the CEO of Aston Sharp Insurance Services. In 2012, Gus founded Aston Sharp to start offering a larger scope of insurance products to his clients. With extensive history in life, disability, and long-term care planning, Gus acts as a full service insurance advisor. Gus initially started working with group employers offering assistance with the new changes mandated by the ACA (Affordable Care Act). The in-flow of new technology in recent years has created an opportunity to revolutionize an outdated industry. Gus now works to consolidate Employee Benefits, HR, Payroll, Work Comp, and ACA compliance all under one roof – delivering an easy-to-use technology driven solution to his clients.

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