by admin | Oct 2, 2025 | Blog
As your company prepares to introduce a Health Flexible Spending Account (FSA), it’s essential to understand the legal documentation requirements that come with it. One key requirement under the Employee Retirement Income Security Act (ERISA) is the Summary Plan Description (SPD)—a document that outlines the plan’s terms and participants’ rights.
Why Is an SPD Required for a Health FSA?
A Health FSA is considered a group health plan under ERISA, meaning it must comply with SPD requirements regardless of your company’s size. There are no exemptions for small employers when it comes to welfare benefit plans.
What Must Be Included in the SPD?
The SPD must be written in a clear, understandable format and include:
- Plan Identification & Eligibility: Who can participate and when.
- Plan Benefits: What expenses are covered and under what conditions.
- Loss or Denial of Benefits: Circumstances that may affect reimbursement.
- Funding Sources: Whether contributions come from the employer, employee, or both.
- Claims Procedures: How to file claims and appeal denied claims.
- ERISA Rights Statement: A summary of participants’ legal rights.
- COBRA Information: If applicable, details on continuation coverage.
- QMCSO Compliance: Information on coverage for children under court orders.
Additional Health FSA-Specific Details
To help employees make informed decisions, your SPD should also explain:
- Contribution Limits: Minimum and maximum annual amounts.
- Election Change Restrictions: Rules around midyear changes.
- Use-It-Or-Lose-It Rule: What happens to unused funds.
- Eligible Expenses: What qualifies for reimbursement.
- Covered Individuals: Whose expenses can be reimbursed.
- Debit Card Program: If offered, how it works.
Best Practices for Employers
Many companies choose to have legal counsel draft or review the SPD to ensure full compliance. It’s also common to combine the SPD with documentation for related benefits like the cafeteria plan or Dependent Care Assistance Program (DCAP)—even though those are not subject to ERISA.
Finally, remember that ERISA also governs how and when SPDs must be distributed and updated. Staying compliant not only protects your company but also ensures transparency and trust with your employees.
Source: Thomson Reuters
by admin | Sep 16, 2025 | Blog
When a former employee receiving COBRA coverage is called to active military duty, employers may wonder how COBRA and USERRA apply. Here’s a quick breakdown of your obligations.
What is COBRA?
COBRA (Consolidated Omnibus Budget Reconciliation Act) allows employees and their families to continue group health coverage for a limited time after job loss or other qualifying events.
What is USERRA?
USERRA (Uniformed Services Employment and Reemployment Rights Act) protects the job and benefit rights of employees who leave work for military service. It includes health coverage continuation—but only for active employees, not those already separated and on COBRA.
Does USERRA Apply in This Case?
No. If the individual is no longer employed and is receiving COBRA, USERRA does not provide additional rights.
Can COBRA Be Terminated Due to TRICARE?
This is a gray area:
- IRS rules suggest COBRA may end if the person gains other group coverage (like TRICARE).
- DOL guidance says COBRA should not be terminated just because TRICARE is in place.
What Should Employers Do?
- Don’t automatically terminate COBRA due to TRICARE.
- Check with your insurer or stop-loss carrier to avoid coverage gaps.
- Document your decisions and stay updated on federal guidance.
USERRA doesn’t apply to former employees, but COBRA coverage should generally continue—even if TRICARE is now active. When unsure, consult legal or benefits experts to stay compliant.
Source: Thomson Reuters
by admin | Sep 4, 2025 | Blog
Under ERISA, plan administrators must provide requested plan documents—like the Summary Plan Description—within 30 days of a written request from a participant or beneficiary. If they fail to do so, a court may impose a penalty of up to $110 per day, starting on day 31.
How This Affects FSAs, HRAs, HSAs, and Other Benefits
Many employers don’t realize that Health FSAs, HRAs, and some HSAs are considered ERISA-covered welfare benefit plans. That means they are subject to the same documentation and disclosure rules as other ERISA plans. If a participant requests plan documents for one of these benefits and the employer fails to respond within 30 days, the same $110/day penalty could apply.
Even though HSAs are typically owned by the employee, employer-sponsored HSAs may still trigger ERISA obligations if the employer is too involved in managing the account.
Does the Penalty Increase Over Time?
No. While some ERISA penalties are adjusted annually for inflation, the $110/day penalty for failing to provide plan documents is not subject to automatic inflation adjustments. It has remained unchanged since it was last increased from $100 in 1997.
Tips to Stay Compliant
- Ensure all ERISA-covered plans—including FSAs, HRAs, and HSAs—have up-to-date plan documents and SPDs.
- Respond to participant requests in writing and within the 30-day window.
- Train HR and benefits staff on ERISA disclosure rules.
- Keep documentation organized and easily accessible.
Source: Thomson Reuters
by admin | Aug 21, 2025 | Blog
Qualified transportation fringe benefits are a popular way for employers to support commuting costs while offering tax advantages. But what happens to unused balances when an employee leaves the company? If you’re considering implementing a qualified transportation plan, it’s crucial to understand the IRS rules governing these benefits—especially regarding terminations.
Key IRS Rules for Transportation Plans
Two primary IRS rules shape how balances are treated upon termination:
- No-Former-Employees Rule
Qualified transportation plans cannot reimburse expenses incurred after employment ends. This means terminated employees are ineligible for post-employment transit reimbursements.
- No-Refunds Rule
Unused balances—whether from employer contributions or pre-tax salary reductions—cannot be refunded to the employee. These funds must remain within the plan.
What Can Terminated Employees Do?
Employees who leave the company can still submit reimbursement requests for qualified transportation expenses incurred during employment, as long as they do so within the plan’s run-out period—a grace period for submitting claims after coverage ends.
However, if they:
- Don’t have enough eligible expenses,
- Miss the run-out deadline, or
- Have excess contributions,
…those unused funds are forfeited.
Minimizing Forfeiture Risk Through Plan Design
Employers can reduce forfeiture risk by designing the plan thoughtfully. For example:
- Limit monthly contributions to the cost of a transit pass.
- Send regular reminders to employees about their balances and deadlines.
- Allow election changes to avoid over-contributing.
What Happens to Forfeited Funds?
Your plan document should clearly state how forfeited balances are handled. Options include:
- Retaining funds to cover plan administration costs.
- Redistributing funds to other participants (within IRS limits).
- Complying with state escheat laws, especially if the plan is “funded” (i.e., money held in separate accounts).
Qualified transportation plans offer great benefits, but they come with strict IRS rules. By understanding the limitations and designing your plan carefully, you can support your employees while minimizing forfeitures and compliance risks.
by admin | Aug 12, 2025 | Blog
A new federal law—formerly known as the “One Big Beautiful Bill”—has introduced significant changes to employee benefits. These updates impact everything from dependent care, health savings accounts to Transportation benefits. Here’s a breakdown of the most important changes employers should prepare for.
Dependent Care Benefits Expanded
- DCAP Limit Increased: Starting in 2026, the maximum tax-free amount employees can receive through a Dependent Care Assistance Program (DCAP) increases from $5,000 to $7,500 (or from $2,500 to $3,750 for married individuals filing separately).
- Employer Childcare Credit Enhanced: Employers offering childcare services will benefit from a more generous tax credit, encouraging workplace-supported childcare solutions.
Health Savings Accounts (HSAs) Strengthened
- Telehealth Coverage Made Permanent: High-deductible health plans (HDHPs) can now permanently cover telehealth services before the deductible is met, without affecting HSA eligibility.
- New HSA-Compatible Plans: Starting in 2026, bronze and catastrophic Exchange plans will qualify as HDHPs.
- Direct Primary Care Allowed: These arrangements will not disqualify HSA eligibility if they meet specific criteria. Fees for such services are now considered qualified medical expenses.
Transportation Benefits Updated
- Bicycle Commuting Reimbursements Eliminated: Starting in tax years after 2025, reimbursements for bicycle commuting expenses will no longer qualify as tax-free transportation fringe benefits. This change makes permanent the suspension that has been in place since 2018.
- Inflation Adjustments Modified: Minor updates have been made to how exclusion limits for other qualified transportation benefits—such as transit passes and parking—are adjusted for inflation.
The new federal legislation significantly enhances several core employee benefits including HSAs and DCAPs. These updates not only expand eligibility and contribution limits but also provide permanent tax advantages for both employers and employees. By aligning benefit strategies with these changes, organizations can strengthen their offerings, improve employee satisfaction, and ensure compliance with growing federal standards.
Source: Thomson Reuters
