OK here we go.
They'll meet the less than 100 rule under these conditions:
A small welfare plan has less than 100 enrolled employees on the first day of the plan year and has no trust.
A (1) welfare plan that (2) covers fewer than 100 participants as of the beginning of the plan year and is (3) unfunded, fully insured, or a combination of insured and unfunded is not required to file Form 5500.
Who is a “participant”?
1. Active employees covered by the plan.
2. Retired employees covered by the plan. This includes former employees who are receiving group health continuation coverage benefits under COBRA.
3. Deceased former employees who had one or more beneficiaries who are receiving benefits under the plan.
Dependents are considered neither participants nor beneficiaries. A child who is entitled to health benefits under a qualified medical child support order should not be counted as a participant.
And they will be considered voluntary plans under the following criteria:An employer has a voluntary plan where:
- no contributions are made by an employer;
- participation in the program is completely voluntary;
- the sole functions of the employer with respect to the program are, without endorsing the program, to permit the carrier to publicize the program to employees and to collect premiums through payroll deductions and to remit them to the carrier; and
The employer receives no consideration in the form of cash or otherwise in connection with the program (other than reasonable compensation, excluding any profit, for administrative services actually rendered in connection with payroll deductions).
The third bullet point is key. Endorsing a program may include defining eligibility, recommending the program, allowing contributions to go through a cafeteria plan, selecting the carrier, negotiating the terms, or assisting participants with claims. Any of this employer involvement may cause the plan not to be voluntary.
And finally, can be looked at as separate plans following these criteria:A plan sponsor could create (1) one plan providing major medical benefits, dental benefits, and vision benefits, (2) two plans with one providing major medical benefits and the other providing self-insured dental and vision benefits, or (3) three separate plans. Governing documents and actual operations should be reviewed to determine whether welfare benefits are being provided under a single plan or separate plans.
If you don't use a wrap document to advise of these plans, and if employee communications refer to these plans as different arrangements, then you have a small, voluntary plan for the dental and vision. and would not need to do the schedule A.
If you've administered these plans as parts of the same plan, and the insurance company is not simply providing ASO services only, then you'll need to do the schedule A.