Medicare Managed Care Manual (Pub. 100-16), Ch. 17b § 350.5
Special Rules for Individual Employee Status
350.5 - Special Rules for Individual Employee Status
(Rev. 4, 10-01-01)
In general, an individual who is not actively working is considered to have employee
status if the relationship is such that:
•
The individual is receiving payments from an employer which are subject to taxes
under the Federal Insurance Contributions Act (FICA), or would be subject to
such taxes except that the employer is one that is not required to pay such taxes
under the IRC;
•
The individual is termed an employee under State or Federal law or in accordance
with a court decision;
•
The employer pays the same taxes for the individual as he/she pays for actively
working employees;
•
The individual continues to accrue vacation time or receives vacation pay;
•
The individual participates in an employer’s benefit plan in which only employees
may participate;
•
The individual has rights to return to duty if his/her condition improves; and
•
The individual continues to accrue sick leave.