Benefits Concepts
A practical employee benefits reference library for benefits, payroll, HR, and total rewards professionals. Start with current-year figures, then go deeper into the rules and plan-administration distinctions that matter at work.
Reviewed July 29, 2026 · Source-led practitioner reference
Start with the 2026 reference
Health accounts and tax-favored benefits
Section 125Cafeteria PlansWhat the written plan does, which choices may receive pre-tax treatment, and where payroll administration commonly goes wrong.
Continuation coverage and fiduciary process
ERISAGroup Health Plan Fiduciary ResponsibilitiesFunctional fiduciary status, prudence, plan documents, provider monitoring, reasonable expenses, and documentation.
Health plan operations
Plan fundingFully Insured vs. Self-FundedUnderstand claims risk, ASO administration, stop-loss coverage, and regulatory boundaries.
EligibilityEligibility and Waiting PeriodsApply eligibility classes, the 90-day maximum, rehire rules, and system controls.
Enrollment changesLife Events and Midyear ChangesSeparate HIPAA special enrollment from Section 125 election-change rules.
2026 checklistBenefits Administration CalendarMap filings, notices, renewals, reconciliation, and recurring plan-year responsibilities.
Compliance, documents, and claims
ClaimsHealth Plan Claims and AppealsClassify claims, control deadlines, issue compliant notices, and oversee review.
ACA reportingForms 1094-C and 1095-CConnect ALE reporting to monthly HR, payroll, offer, and enrollment data.
MHPAEAMental Health Parity and NQTLsBuild comparative-analysis evidence and monitor plan and vendor operations.
Balance billingNo Surprises ActMap participant protections, cost-sharing, disclosures, directories, and disputes.
Retirement plan operations
Plan fundingContribution Types and 2026 LimitsSeparate deferrals, Roth, catch-ups, match, nonelective, and profit-sharing sources.
OwnershipVesting and ForfeituresApply service credit and vesting by money source, then control forfeiture use.
Benefit paymentsDistributions, Rollovers, and RMDsRoute payments through event, consent, tax, withholding, and rollover rules.
Annual compliance401(k) Nondiscrimination TestingUnderstand coverage, ADP, ACP, top-heavy, data, and correction controls.
GovernanceRetirement Plan Fiduciary OversightDocument provider, fee, investment, deposit, and operational monitoring.
Annual filings and administration controls
Medicare Part DCreditable Coverage NoticesControl participant notices and the separate CMS disclosure.
ACA feePCORI FeeIdentify applicable plans, count covered lives, select the rate, and file Form 720.
EligibilityDependent Eligibility AuditsVerify dependent status with consistent evidence, privacy, appeals, and reconciliation.
Monthly controlCarrier Invoice ReconciliationMatch HRIS, enrollment, payroll, and billing before payment.
From public reference to structured practice
The library is designed for quick, source-led answers. When you need lessons, practice questions, flashcards, progress tracking, and the complete GBA and RPA learning workflow, move into PrepToPay Benefits.
How to use this library
These articles are organized around practitioner questions rather than an exam outline. Use them to orient a real plan-administration issue, refresh a concept, or identify the agency and primary source that governs the next step. For structured lessons, practice, flashcards, and GBA/RPA review, use PrepToPay Benefits.
Keep building your Benefits reference system.
Use the public library for fast reference, then move into structured lessons and practice when you need repetition and application.