FAQs

FAQs

You’ve got questions, we’ve got answers.

Unsure of the difference between a grace period and the carryover? Wondering what happens to your HSA if you switch employers or retire? Not sure which plan documents you need to ensure your group plan is compliant?

NueSynergy wants to make sure you understand the ins and outs of your benefit account, so we have put together a comprehensive list of the most common questions we receive about employee benefits.

Did we not answer your question? Contact our team to get the answers you need and help us improve our list.

 

Your group health plan can require you to pay for COBRA continuation coverage. The amount charged to qualified beneficiaries cannot exceed 102 percent of the cost to the plan for similarly situated individuals covered under the plan who have not incurred a qualifying event. In determining COBRA premiums, the plan can include the costs paid by employees and the employer, plus an additional 2 percent for administrative costs.

For qualified beneficiaries receiving the 11-month disability extension, the COBRA premium for those additional months may be increased to 150 percent of the plan's total cost of coverage for similarly situated individuals.

COBRA charges to qualified beneficiaries may be increased if the cost to the plan increases but generally must be fixed in advance of each 12-month premium cycle. The plan must allow you to pay the required premiums on a monthly basis if you ask to do so, and the plan may allow you to make payments at other intervals (for example, weekly or quarterly). The election notice should contain all of the information you need to understand the COBRA premiums you will have to pay, when they are due, and the consequences of late payment or nonpayment.

When you elect continuation coverage, you cannot be required to send any payment with your election form. You can be required, however, to make an initial premium payment within 45 days after the date of your COBRA election (that is the date you mail in your election form, if you use first-class mail). Failure to make any payment within that period of time could cause you to lose all COBRA rights. The plan can set premium due dates for successive periods of coverage (after your initial payment), but it must give you the option to make monthly payments, and it must give you a 30-day grace period for payment of any premium.

You should be aware that if you do not pay a premium by the first day of a period of coverage, but pay the premium within the grace period for that period of coverage, the plan has the option to cancel your coverage until payment is received and then reinstate the coverage retroactively back to the beginning of the period of coverage. Failure to make payment in full before the end of a grace period could cause you to lose all COBRA rights.

If the amount of a payment made to the plan is incorrect but is not significantly less than the amount due, the plan is required to notify you of the deficiency and grant a reasonable period (for this purpose, 30 days is considered reasonable) to pay the difference. The plan is not obligated to send monthly premium notices.

Some employers may subsidize or pay the entire cost of health coverage, including COBRA coverage, for terminating employees and their families as part of a severance agreement. If you are receiving this type of severance benefit, talk to your plan administrator about how this impacts your COBRA coverage or your special enrollment rights.

If you are enrolled in qualified High Deductible Health Plan (HDHP) - either through your employer or you have purchase and individual policy - you are most likely eligible to open and contribute to an HSA.

Additional eligibility criteria include:

  • You must have a valid Social Security Number (SSN) and a primary residence in the U.S.
  • You cannot be covered by any other type of health plan, including Medicare Part A or Medicare Part B.
  • You cannot be covered by TriCare.
  • You cannot have accessed your VA medical benefits in the past 90 days (to contribute to an HSA).
  • You cannot be claimed as a dependent on another person's tax return (unless it's your spouse).
  • You must be covered by the qualified HDHP on the first day of the month.

To be eligible for COBRA coverage, you must have been enrolled in your employer's health plan when you worked and the health plan must continue to be in effect for active employees. COBRA continuation coverage is available upon the occurrence of a qualifying event that would, except for the COBRA continuation coverage, cause an individual to lose his or her health care coverage.

In order to be entitled to elect COBRA continuation coverage, your group health plan must be covered by COBRA; a qualifying event must occur; and you must be a qualified beneficiary for that event.

Plan Coverage - COBRA covers group health plans sponsored by an employer (private-sector or state/local government) that employed at least 20 employees on more than 50 percent of its typical business days in the previous calendar year. Both full- and part-time employees are counted to determine whether a plan is subject to COBRA. Each part-time employee counts as a fraction of a full-time employee, with the fraction equal to the number of hours that the part-time employee worked divided by the hours an employee must work to be considered full time.

Qualifying Events - Qualifying events are events that cause an individual to lose his or her group health coverage. The type of qualifying event determines who the qualified beneficiaries are for that event and the period of time that a plan must offer continuation coverage. COBRA establishes only the minimum requirements for continuation coverage. A plan may always choose to provide longer periods of continuation coverage.

The following are qualifying events for covered employees if they cause the covered employee to lose coverage:

  • Termination of the employee's employment for any reason other than gross misconduct; or
  • Reduction in the number of hours of employment.

The following are qualifying events for the spouse and dependent child of a covered employee if they cause the spouse or dependent child to lose coverage:

  • Termination of the covered employee's employment for any reason other than gross misconduct;
  • Reduction in the hours worked by the covered employee;
  • Covered employee becomes entitled to Medicare;
  • Divorce or legal separation of the spouse from the covered employee; or
  • Death of the covered employee.

In addition to the above, the following is a qualifying event for a dependent child of a covered employee if it causes the child to lose coverage:

  • Loss of dependent child status under the plan rules. Under the Patient Protection and Affordable Care Act, plans that offer coverage to children on their parents' plan must make the coverage available until the adult child reaches the age of 26.

Qualified Beneficiaries - A qualified beneficiary is an individual covered by a group health plan on the day before a qualifying event occurred that caused him or her to lose coverage. Only certain individuals can become qualified beneficiaries due to a qualifying event, and the type of qualifying event determines who can become a qualified beneficiary when it happens. A qualified beneficiary must be a covered employee, the employee's spouse or former spouse, or the employee's dependent child. In certain cases involving the bankruptcy of the employer sponsoring the plan, a retired employee, the retired employee's spouse or former spouse, and the retired employee's dependent children may be qualified beneficiaries. In addition, any child born to or placed for adoption with a covered employee during a period of continuation coverage is automatically considered a qualified beneficiary. An employer's agents, independent contractors, and directors who participate in the group health plan may also be qualified beneficiaries.

• Dependent under the age of 13; or

• Dependent or spouse of employee who is mentally or physically disabled and whom the employee claims as a dependent on his or her Federal Income Tax return.

Any new plan year funds will pay first and the carryover funds will pay second. Employees get the best use of their funds by having the new plan year pay first, and the carryover funds pay second.

All “eligible employees” who received compensation during the previous year are included in nondiscrimination testing. Generally only union employees, non-resident aliens, leased employees and independent contractors can be excluded from nondiscrimination testing because they are not considered “eligible employees.”

 

 

They will be available on the first day of the new plan year unless you enroll in a Health Savings Account. Which will require your funds to carry-over into a limited purpose FSA. If this occurs, your funds will be available at the end of the current plan years run-out period.

As soon as full payment is received, NueSynergy will alert the employer so that coverage can be reinstated. From the point of reinstatement it could take the carrier up to seven to 10 days before coverage is actually activated in the system.

Once the Request for Termination is received by NueSynergy, election forms are mailed to the participant within one to two business days. COBRA law allows 14 days for a COBRA administrator to provide the election forms, but our internal process allows for a much quicker turnaround.

In most cases, you can sign up any time—the benefit will be effective for the first month possible after you make your election.

Your elections into the the Dependent Care FSA become available as they are contributed. As you incur daycare expenses, you will be reimbursed up to the amount that has been contributed thus far in the year.

For example: You elect $5,000 and have $208 taken out of each paycheck throughout the year. After two (2) pay periods you submit a daycare claim for $500. Your current dependent care balance is $416. You will be reimbursed $416 immediatley and following your next payroll contribution, you will be reimbursed the remaining $84.

The availability of carryover funds differs when carrying over between a healthcare to healthcare FSA versus from the healthcare to limited purpose FSA.

Healthcare to Healthcare: The carryover amount is available to the participant on the first day of the new plan year. This means that the carryover amount is simultaneously available to pay previous plan-year expenses and current plan-year expenses during the previous plan year run-out period.

Healthcare to Limited Purpose: The carryover amount is available to the participant on the first day following the end of the run-out period. This means any current-year dental or vision claims incurred during the run-out period that were not reimbursed by a current-year limited purpose election would be reimbursed once the carryover funds are available.

Form 1099-SA notifies the IRS of distributions made from your HSA during the tax year. Form 5498-SA notifies the IRS of contributions made to your HSA during the tax year. These forms will be available electronically for your NueSynergy HSA and can be found online under "Tax Forms" within the "My HSA" section.

The IRS sets the maximum contribution limits for the HSA each year. The maximum annual contribution limit for 2017 is $3,400 if you are enrolled in Individual coverage and $6,750 if you are enrolled in Family converage. Once you are over the age of 55, you can contribute an additional $1,000 above the standard annual maximum. (Note: if both spouses are over the age of 55, each spouse would need have their own HSA to contribute the $1,000 catch-up)

If your HDHP was effective on January 1st, the total amount you can contribute to your account is the maximum contribution amount set by the IRS.

If your HDHP is effective after the first day of the month, you may make or receive a full year's contribution to your HSA for partial year coverage as long as you maintain your HDHP enrollment for 12 months. If enrollment is less than 12 months, the tax benefit is lost and a 10% penalty is imposed.

The grace period is an additional 2.5 months following the plan-year close to incur expenses against the previous plan year's election. This gives employees some additional time to use remaining funds. If the carryover option is elected, it will replace the grace period option.

Both HSAs and FSAs allow you to pay for qualified medical expenses with pre-tax dollars. One key difference, however, is that HSA balances can roll over from year to year, while FSA money left unspent at the end of the year or after a designated grace period is forfeited. You may choose to use a Limited Purpose FSA to pay for eligible heath care expenses and save your HSA dollars for future health care needs. You may use Limited Purpose FSA dollars to reimburse yourself for expenses not covered by your high-deductible health plan, such as:

1. Vision expenses, including: Glasses, frames, contacts, prescription sunglasses, goggles, vision co-payments, optometrists or ophthalmologist fees, and corrective eye surgery

2. Dental expenses, including: Dental care, deductibles and co-payments, braces, x-rays, fillings, and dentures

A limited purpose FSA can only be used for vision and dental expenses. It is intended to work in conjunction with an HSA. A healthcare FSA covers all eligible medical expenses.

On October 31, 2013, the U.S. Department of the Treasury changed the “Use It or Lose It” rule, providing employers the ability to offer a Carryover option which allows for up to $500 of FSA balances remaining at the plan-year end to carry over for use during the next plan year. The Carryover option is available with healthcare and limited purpose FSAs.

Each year, the IRS requires companies with pre-tax reimbursement accounts to complete nondiscrimination testing. Nondiscrimination testing ensures that the business owners and Highly Compensated Employee(s) (HCE) do not receive a disproportionate benefit from a pre-tax plan compared to other employees.

COBRA, which stands for “Consolidated Omnibus Budget Reconciliation Act,” is a federal law that requires group health plans to provide a temporary continuation of group health coverage that otherwise might be terminated due to certain specific “qualifying events.”

COBRA requires continuation coverage to be offered to covered employees, their spouses, former spouses, and dependent children when group health coverage would otherwise be lost COBRA is often more expensive than the amount that active employees are required to pay for group health coverage since the employer usually pays part of the cost of employees' coverage and all of that cost can be charged to individuals receiving continuation coverage.

Above the line means you will reduce your taxable income regardless of whether you itemize or use the standard deduction on your income tax form. If you contribute to your HSA with after-tax dollars, you may deduct the contribution amount, subject to the maximum annual contribution limits from your taxes at filing time.

With a high-deductible health plan, you have the security of comprehensive health care coverage. Like a traditional plan, you are responsible for paying for your qualified medical expenses up to the in-network deductible; however, the deductible will be higher, and you can use HSA funds to pay for these expenses.

After the annual deductible is met, you are responsible only for a portion of your medical expenses through coinsurance or co-payments, just as with a traditional health plan. The deductible and maximum out-of-pocket expenses are indexed annually for inflation by the IRS and US Department of Treasury.

You may set aside pre-tax dollars to cover eligible medical expenses that are not covered by any other type of insurance. The account helps you budget for planned expenses such as deductibles, co-payments and prescriptions. You may refer to the FSA eligible expenses tool on this site for a list of eligible and ineligible expenses.

Health Savings Accounts (HSAs) are tax-advantaged medical savings accounts available to individuals who are enrolled in a Qualified High Deductible Health Plan (HDHP). HSAs are owned by the individual, unlike other types of benefit accounts such as  Health Reimbursement Arrangements (HRAs) and Flexible Spending Account (FSA). HSA funds also roll over and accumulate year over year if not spent, with the ability to earn tax-free interest on the account. HSA funds may be used to pay for qualified medical, dental and vision expenses tax-free at any time.

An HRA is a reimbursement account set up and funded by your employer to cover eligible healthcare expenses as defined in the HRA Summary Plan Document. Unlike a healthcare FSA where the IRS defines the eligible services, your employer defines the services eligible for reimbursement from an HRA. Typically, an employer will reimburse deductible, coinsurance and copay expenses from your HRA but not services such as medical, dental or over the counter drugs. An HRA can also cover all or a portion of your prescription drug expenses. Check your employer's HRA Summary Plan Document to see what types of services are covered under the HRA being offered by your employer.

You can use pre-tax dollars to cover eligible work-related dependent care expenses for qualified dependents, or if you are married, while you and your spouse work or your spouse attends school full-time.

Commuter benefits help you to pay for the public transportation, vanpool, or parking that you need to get to and from work with pre-tax money – money you deduct from your paycheck before you pay taxes. Vanpool applies to transit with more than five passengers and parking benefits must be used for parking at or near work, or at or near a place where you take public transportation to work (such as at a Park and Ride).

When you participate in a payroll deduction program through your employer, deductions can be taken from your payroll before calculating your taxable federal income, FICA (Social Security and Medicare) tax and for most states, taxable state income. By taking deductions pre-tax, you reduce the dollars on which you are taxed and, as a result, reduce your total tax bill.

There are two main types of supporting documentation for health FSA claims:
i. Explanation of Benefits (EOB):
Each time you submit claims to your health insurance carrier, you will receive this statement detailing what the health plan will pay and what you must pay. For expenses that are partially covered under another insurance plan, you must attach a copy of both of the EOBs.

ii. Itemized Bills:
For expenses that are not submitted to another insurance plan, you must attach a copy of an itemized billing containing the following information:
- Name of patient
- Name and address of provider
- Description of service
- Date of service
- Amount of service

Request for Reimbursement Form: Complete the Dependent Care section of the Request for Reimbursement Form and have your daycare provider sign and date.

  • Receipt: The receipt must include the following information:
  • Name, address and Tax Identification # of provider
  • From/through dates of service
  • Amount of charge

The week following month-end, NueSynergy will mail a COBRA Participant Report to each client. The report lists all participants and check amounts received for the previous 30 days. Additionally, clients receive a check issued by NueSynergy for the collective amount of all COBRA payments received the prior month. Payments may reflect coverage for three to four months back, due to variances in election period and payment schedules.

At age 65 and older, your funds continue to be available without federal taxes or state tax (for most states) for qualified medical expenses; for instance, you may use your HSA to pay certain insurance premiums, such as Medicare Parts A and B, Medicare HMO, or your share of retiree medical coverage offered by a former employer. Funds cannot be used tax-free to purchase Medigap or Medicare supplemental policies.

If you use your funds for qualified medical expenses, the distributions from your account remain tax-free. If you use the monies for non-qualified expenses, the distribution becomes taxable, but exempt from the 20 percent penalty. With enrollment in Medicare, you are no longer eligible to contribute to your HSA. If you reach age 65 or become disabled, you may still contribute to your HSA if you have not enrolled in Medicare.

Your HSA is an inheritable account. What happens to your HSA when you die depends who you named as your beneficiary.

  1. Spouse designated beneficiary. If your spouse is your designated beneficiary, the account will be treated as your spouse's HSA after your death. The account will continue to be tax-free for qualified medical distributions. If your spouse is covered by a qualified HDHP, contributions to the account may also be made tax-free, up to maximum annual contribution limits.
  2. Other than Spouse designated beneficiary. If you designate someone other than your spouse as the beneficiary of your HSA:
  • The account stops being an HSA on the date of your death;
  • The fair market value of the HSA becomes taxable to the beneficiary in the year in which you die (without penalties); and
  • The amount taxable to a beneficiary (other than your estate) is reduced by any qualified medical expenses you incurred prior to your death that are paid from the HSA by the beneficiary within one year after the date of death.
  1. Your estate is the beneficiary. If your estate is the beneficiary of your HSA, the value of your account is included on your final income tax return.
  2. NO designated beneficiary on file. If you do not have a beneficiary on file, the funds are payable to the accountholders estate.

Since you own your HSA, you will be able to keep your account, even if you change health plans or change employers. However, if you no longer are enrolled in an qualfied HDHP you are not eligible to make future contributions to your HSA, but you may continue to use your HSA to pay for qualified medical, dental or vision expenses.

 

 

Once you are no longer enrolled in a qualified HDHP, you will stop being able to contribute additonal funds to your HSA. The maximum contribution to your HSA for that tax yeart would be determined by the number of months you were enrolled in the qualfied HDHP.  To determine your pro-rated contribution amount,  you would divide the full annual individual or family maximum contribution amount allowed for that tax year by 12 months  You would then multiply the number of months you were enrolled in the qualified HDHP by the montly pro-rated maximum to determine you allowed maximum contribution for that tax year. (Example: 2017 individual max $3,400 ÷ 12 months = $283.33 montly pro-rated maximum contribution. If you were enrolled in a qualified HDHP for 5 months your maximum contribution for that tax year would be 5 x $283.33 = $1,416.66.)

REMEMBER: You can continue to use any remaining funds in your HSA to pay for qualified medical, dental or vision expenses tax-free even if you are not enrolled in a qualified HDHP.

 

You have until the end of the run-out period to submit claims for the reimbursement of eligible expenses incurred during the previous plan year. Funds that remain unsed after the run-out period would return back to your employer.

No. However, you can continue to submit claims incurred prior to your termination date before the end of the run-out period (defined in your Summary Plan Description).

For example: Your plan has a 90-day run-out period following termination. Your termination date is September 13th. Your physician sees you on September 12th, but you do not receive the Explanation of Benefits from your insurance carrier until October 31st. You can still submit this expense as it was incurred prior to your termination date, and prior to the end of the 90-day run-out period following your date of termination. Any expense incurred after September 13 is not eligible.

Depending on your HRA's plab design, an HRA can be set up to roll your funds from one plan year to the next. If your employer offers "fund rollover" it will be described in your Summary plan documents.

Here's how HRA fund rollover typically works: at the end of the plan year, you will have a certain amount of time ("run-out period") to submit claims for services incurred during the prior year. At the end of the run-out period, or at a date set by your employer, all or a portion of your remaining funds may rollover to the next plan year or to a carryover account. Your employer may set the following rules:

1) A Percentage of remaining funds may rollover, such as 50%. So, if you have $512 on the fund rollover date, you can rollover $256.

2) A Maximum amount may rollover, such as $250. Taking the example above, only $250 would rollover of the remaining $512.

3) A Percentage up to a Maximum, such as 50% up to $250. Again, $250 would rollover, using the example above. If you had $300 remaining, then only $150 would rollover (50% of $300).

4) All funds - all remaining funds may rollover to the next plan year.

You may withdraw the excess amount and any earnings on the excess amount prior to April 15th of the following year. However, you must pay income tax on your excess contributions and income tax on any earnings of the excess contribution. If you believe you have exceeded your allowable contribution amount, you should contact us at 855-890-7239 to help you correct the over contribution.

A short pay notice is mailed to the COBRA participant. The notice informs the participant that they have until the end of their 45-day (initial payment) or 30-day (consecutive payment) window to make full payment. If full payment is not received by the deadline, the payment will be returned to the participant and steps will be taken to terminate coverage.

If a participant terminates employment, participation in the plan will also terminate. 

The law generally applies to all group health plans maintained by private-sector employers with 20 or more employees, or by state or local governments. The law does not apply to plans sponsored by the Federal Government or by churches and certain church-related organizations.

In addition, many states have “state continuation” laws similar to COBRA, including those that apply to health insurers of employers with less than 20 employees (sometimes called mini-COBRA). Check with your state insurance commissioner's office to see if such coverage is available to you.

  • Your HSA funds can be used tax-free to pay for out-of-pocket qualified medical expenses, even if the expenses are not covered by your HDHP. This includes expenses incurred by your family.
  • There are hundreds of qualified medical expenses, including many you might not expect: over-the-counter medications; dental visits; orthodontics; glasses; long-term care insurance premiums; cost of COBRA coverage; medical insurance premiums while receiving federal or state unemployment compensation and post age-65 premiums for coverage other than Medigap or Medicare supplemental plans.
  • In addition, HSA funds may be used to pay your Medicare Parts A and B premiums and for employer-sponsored retiree plans.
  • All of these expenses may be paid for with your HSA funds, free from federal taxes or state tax (for most states). Refer to IRS Publication 502 for a more complete list of qualified medical expenses.
  • Tolls
  • Taxis
  • Gas/fuel
  • Mileage
  • Business trip costs
  • Airport parking fees
  • Parking fees at your home

Eligible expenses are parking, mass transit and/or vanpooling expenses incurred by a participant for the purpose of commuting to and from a place of work. Spouse and/or dependent commuter expenses are not eligible. Expenses submitted through this benefit cannot be resubmitted through an income tax return. 

Parking must be on or near the premises of the participant's employer or on or near a location from which the participant commutes. Parking on or near property used by the participant for residential purposes is not permitted. Metered parking is permitted.

Mass transit/vanpooling expenses must be incurred through public transportation or by a carpool or vanpool service.

Depending on your HRAs plan design that are two possible types of supporting documentation for HRA claims:
i. Explanation of Benefits (EOB):
Each time you submit claims to your health insurance carrier, you will receive this statement detailing what the health plan will pay and what you must pay. For expenses that are partially covered under another insurance plan, you must attach a copy of both of the EOBs.

ii. Itemized Bills:
For expenses that are not submitted to another insurance plan, you must attach a copy of an itemized billing containing the following information:
- Name of patient
- Name and address of provider
- Description of service
- Date of service
- Amount of service

• Change in legal marital status (marriage, death of spouse, divorce, legal separation, annulment)
• Change in number of tax dependents (birth, death of dependent, adoption or placement for adoption)
• Change in dependent’s eligibility
• Change in employment status of employee, spouse or dependents
• Other changes that may permit an election change under the Dependent Care FSA are:

     ○ Change of dependent care provider
     ○ Change of rate charged by unrelated dependent care provider
     ○ Child attaining age 13

Election changes must be consistent with the event. If you experience a Change in Status, please review your Summary Plan Description, as it will provide you with important information on the deadline for reporting this event.

There are no tax penalties for closing an HSA. However, if you use HSA funds for other than qualified medical expenses, those distributions will be subject to ordinary income tax, and in some cases, a 20 percent penalty.

  1. Tax-advantaged:
  • Contributions you may make through payroll deposits are made with pretax dollars, meaning they are not subject to federal (or state, for most states) income taxes.
  • Contributions to your HSA made with after-tax dollars can be deducted from your gross income, meaning you pay less income tax at the end of the year.
  • The interest you earn on your HSA balance is not taxed.
  • Withdrawals from your HSA for qualified medical expenses are not subject to federal income tax. As long as you use your HSA funds for qualified medical expenses, you will not have to pay federal (or state, for most states) income taxes.
  • Employers may make contributions to your account; these contributions are excluded from your gross income.
  1. Flexible:
  • The money is yours; it grows and remains with you, even when you change medical plans, change employers or retire. There are no "use it or lose it" rules. Even if you are no longer eligible to make contributions, funds in your account may still be used to pay for qualified medical expenses tax-free. And after age 65, or in cases of disability, the funds in the account can be used for nonqualified expenses.
  1. Portable:
  • Accounts move with you when you change medical plans, change employers or retire.
  1. Savings mechanism for future health needs:
  • Unused funds can grow through interest and investment earnings and can be "banked" for future medical expenses.
  1. Contributions can come from multiple sources:
  • As long as you are covered by a qualified HDHP, you, your employer, family members, or anyone else may contribute to your HSA up to the maximum annual contribution limit.

If you elect continuation coverage, the coverage you are given must be identical to the coverage currently available under the plan to similarly situated active employees and their families (generally, this is the same coverage that you had immediately before the qualifying event). You will also be entitled, while receiving continuation coverage, to the same benefits, choices, and services that a similarly situated participant or beneficiary is currently receiving under the plan, such as the right during open enrollment season to choose among available coverage options. You will also be subject to the same rules and limits that would apply to a similarly situated participant or beneficiary, such as co-payment requirements, deductibles, and coverage limits. The plan's rules for filing benefit claims and appealing any claims denials also apply.

Any change made to the plan's terms that apply to similarly situated active employees and their families will also apply to qualified beneficiaries receiving COBRA continuation coverage. If a child is born to or adopted by a covered employee during a period of continuation coverage, the child is automatically considered to be a qualified beneficiary receiving continuation coverage. You should consult your plan for the rules that apply for adding your child to continuation coverage under those circumstances.

No. The carryover funds can be used anytime for expenses incurred in the new plan year in addition to any new elections. If any funds remain at the end of the current plan year, up to $500 is carried over into each new plan year as long as the participant remains an active employee.

Employers can choose to allow a carryover of any amount up to $500 per participant per plan year. NueSynergy encourages employers to allow the full carryover amount.

Under COBRA, participants, covered spouses and dependent children may continue their plan coverage for a limited time when they would otherwise lose coverage due to a particular event, such as divorce (or legal separation). A covered employee's spouse who would lose coverage due to a divorce may elect continuation coverage under the plan for a maximum of 36 months. A qualified beneficiary must notify the plan administrator of a qualifying event within 60 days after divorce or legal separation. After being notified of a divorce, the plan administrator must give notice, generally within 14 days, to the qualified beneficiary of the right to elect COBRA continuation coverage.

If you waive COBRA coverage during the election period, you must be permitted later to revoke your waiver of coverage and to elect continuation coverage as long as you do so during the election period. Then, the plan need only provide continuation coverage beginning on the date you revoke the waiver.

In addition, certain Trade Adjustment Assistance (TAA) Program participants have a second opportunity to elect COBRA continuation coverage. Individuals who are eligible and receive Trade Readjustment Allowances (TRA), individuals who would be eligible to receive TRA, but have not yet exhausted their unemployment insurance (UI) benefits, and individuals receiving benefits under Alternative Trade Adjustment Assistance (ATAA) or Reemployment Trade Adjustment Assistance (RTAA), and who did not elect COBRA during the general election period, may get a second election period. This additional, second election period is measured 60 days from the first day of the month in which an individual is determined eligible for the TAA benefits listed above and receives such benefit. For example, if an individual’s general election period runs out and he or she is determined eligible for TRA (or would be eligible for TRA but have not exhausted UI benefits) or begin to receive ATAA or RTAA benefits 61 days after separating from employment, at the beginning of the month, he or she would have approximately 60 more days to elect COBRA. However, if this same individual does not meet the eligibility criteria until the end of the month, the 60 days are still measured from the first of the month, in effect giving the individual about 30 days. Additionally, a COBRA election must be made not later than 6 months after the date of the TAA-related loss of coverage. COBRA coverage chosen during the second election period typically begins on the first day of that period. More information about the Trade Act is available at doleta.gov/tradeact/.

No. In order to be considered an eligible expense, the expense must be incurred prior to your termination date. However, you may be able to continue your Health FSA coverage under COBRA.

No. Even though you are covered by an HDHP, since you are also covered by a low-deductible plan too, you are not eligible for an HSA. Only those individuals covered by an HDHP only can contribute to an HSA.

No. Any funds remaining in an individual’s current plan year FSA will be automatically rolled into the new plan year even if the employee didn’t elect to participate in a new plan year FSA. The participant now has the chance to spend up to $500 of his/her carryover money on out-of-pocket healthcare expenses in the following year.

If year-to-date contributions exceed the amount of reimbursements and there is a remaining balance, the employee has a COBRA election available for the remainder of the plan year. If they do not elect COBRA, then expenses can only be submitted up to the end of their termination run-out period after which and funds remaining would be forfeited.

Medicare is the Federal health insurance program for people who are 65 or older and certain younger people with disabilities or End-Stage Renal Disease. If you are enrolled in Medicare as well as COBRA continuation coverage, there may be special coordination of benefits rules that determine which coverage is the primary payer of benefits. Check your Summary Plan Description to see if special rules apply or ask your plan administrator. For more information on Medicare, visit Medicare.gov or call 1-800-MEDICARE.

It would not. Carryover allows amounts in a healthcare FSA – limited purpose or otherwise – to carry over into the next plan year. The Carryover option will follow the participant’s choice. If a participant elects a limited purpose FSA for the current plan year, and has a carryover, the carryover will follow them into the limited purpose FSA for the new plan year. Similarly, if the participant elects a healthcare FSA in the current plan year and has a carryover, the carryover will follow them into a healthcare FSA for the new plan year.

However, if a participant elects to participate in an HSA for the new plan year, and currently has a healthcare FSA, the participant should either spend all amounts in the healthcare FSA before the plan year ends, or enroll in a limited purpose FSA for the new plan year so they can contribute to the new HSA on the first day of the following plan year.

You will receive an email indicating the reason for the denial along with instructions for submitting the requested documentation.

COBRA requires that continuation coverage extend from the date of the qualifying event for a limited period of 18 or 36 months. The length of time depends on the type of qualifying event that gave rise to the COBRA rights. A plan, however, may provide longer periods of coverage beyond the maximum period required by law.

When the qualifying event is the covered employee's termination of employment or reduction in hours of employment, qualified beneficiaries are entitled to 18 months of continuation coverage.

When the qualifying event is the end of employment or reduction of the employee's hours, and the employee became entitled to Medicare less than 18 months before the qualifying event, COBRA coverage for the employee's spouse and dependents can last until 36 months after the date the employee becomes entitled to Medicare. For example, if a covered employee becomes entitled to Medicare 8 months before the date his/her employment ends (termination of employment is the COBRA qualifying event), COBRA coverage for his/her spouse and children would last 28 months (36 months minus 8 months). For more information on how entitlement to Medicare impacts the length of COBRA coverage, contact the Department of Labor's Employee Benefits Security Administration at askebsa.dol.gov or by calling 1-866-444-3272.

For other qualifying events, qualified beneficiaries must be provided 36 months of continuation coverage.

The participant has 45 days from the election date to make full payment (payment must be inclusive, timing back to date of loss of coverage). Consecutive monthly payments must be made within 30 days.

A completed election form must be received by NueSynergy within 60 days of loss of coverage or the date on which paperwork was sent (whichever is longer). If an election form is postmarked by the 60th day but isn’t received until the 62nd day, the election is valid.  Payment coupons to participant are then issued within one to two business days.

If you are entitled to elect COBRA coverage, you must be given an election period of at least 60 days (starting on the later of the date you are furnished the election notice or the date you would lose coverage) to choose whether or not to elect continuation coverage.

Each of the qualified beneficiaries for a qualifying event may independently elect COBRA coverage. This means that if both you and your spouse are entitled to elect continuation coverage, you each may decide separately whether to do so. The covered employee or spouse must be allowed to elect on behalf of any dependent children or on behalf of all of the qualified beneficiaries. A parent or legal guardian may elect on behalf of a minor child.

  1. To be eligible to contribute to an HSA, you must be covered by a qualified high-deductible health plan (HDHP) and have no other first dollar coverage (insurance that provides payment for the full loss up to the insured amount with no deductibles).
  2. You may use your HSA to help pay for medical expenses covered under a high-deductible health plan, as well as for other common qualified medical expenses.
  3. Unused HSA funds rollover from year to year, and may be able to be invested in a choice of investment options, providing the opportunity for funds to grow.
  • HSAs work in conjunction with an HDHP. All the money you (or your employer) deposit into your HSA up to the maximum annual contribution limit is 100% tax-deductible from federal income tax, FICA (Social Security and Medicare) tax, and in most states, state income tax.
  • You can use your HSA to pay for expenses not covered under your HDHP until you have met your deductible. The insurance company then pays covered medical expenses above your deductible, except for any co-insurance. Any coinsurance costs you incur can be paid for using your HSA. In addition, you can use your HSA to pay for qualified medical expenses not covered by the HDHP, such as dental, vision and alternative medicines.
  • If the funds in your account are used for other, nonmedical expenses, your dollars are subject to ordinary tax, plus a 20% penalty if you are under age 65.
  • The 20% penalty does not apply if the distribution occurs after you reach age 65, become disabled or die; however ordinary income tax may still apply.
  • Choosing which expenses use your HSA dollars vs. which to pay out-of-pocket with after-tax dollars is entirely up to you.

Participants can fax, email or mail claims and supporting documentation for their parking expenses directly to NueSynergy. You may also submit claims online through the participant online portal. Supporting documentation can be a receipt, a bill, and/or a signed affidavit validating the submitted expense. After the claim has been reviewed and the expense approved, payment is then issued to the participant via direct deposit or a check. Claims are processed daily and payments are issued at least once per week. Mass transit expenses must be paid for using the NueSynergy benefits card.

Participants may pay for certain parking, mass transit and/or vanpooling expenses with pre-tax dollars. Each dollar that goes into the plan is free from federal, state and (in most cases) Social Security taxes.

Once you make your annual election, your employer will deduct this amount from your paycheck in equal amounts throughout the year, before taxes are taken out.

You will receive an email indicating the reason for the denial along with instructions for submitting the requested documentation.

Group health plans must provide covered employees and their families with certain notices explaining their COBRA rights. Your COBRA rights must be described in the plan's Summary Plan Description (SPD), which you should receive within 90 days after you first become a participant in the plan. In addition, group health plans must give each employee and spouse who becomes covered under the plan a general notice describing COBRA rights, also provided within the first 90 days of coverage.

Before a group health plan must offer continuation coverage, a qualifying event must occur, and the plan must be notified of the qualifying event. Who must give notice of the qualifying event depends on the type of qualifying event.

The employer must notify the plan if the qualifying event is the covered employee's termination or reduction of hours of employment, death, entitlement to Medicare, or bankruptcy of a private-sector employer. The employer must notify the plan within 30 days of the event.

You (the covered employee or one of the qualified beneficiaries) must notify the plan if the qualifying event is divorce, legal separation, or a child's loss of dependent status under the plan. The plan must have procedures for how to give notice of the qualifying event, and the procedures should be described in both the general notice and the plan's SPD. The plan can set a time limit for providing this notice, but it cannot be shorter than 60 days, starting from the latest of: (1) the date on which the qualifying event occurs; (2) the date on which you lose (or would lose) coverage under the plan due to the qualifying event; or (3) the date on which you are informed, through the furnishing of either the SPD or the COBRA general notice, of the responsibility to notify the plan and procedures for doing so.

If your plan does not have reasonable procedures for how to give notice of a qualifying event, you can give notice by contacting the person or unit that handles your employer's employee benefits matters. If your plan is a multiemployer plan, notice can also be given to the joint board of trustees, and, if the plan is administered by an insurance company (or the benefits are provided through insurance), notice can be given to the insurance company.

When the plan receives a notice of a qualifying event, it must give the qualified beneficiaries an election notice which describes their rights to continuation coverage and how to make an election. This notice must be provided within 14 days after the plan receives notice of the qualifying event.

To enroll in an HRA you must elect the option through your employer. With some plans, HRA coverage is automatically provided when you enroll in a specific health plan option, such as a deductible based PPO. Check with your employer's benefit department for more details.

To enroll in the Health and/or Dependent Care FSA, you simply need to fill out the Enrollment Form or enroll online, if available, before the beginning of each Plan Year.

That's the best part of an HRA - you don't need to contribute any money to your HRA as the funds are provided by your employer to offset certain out-of-pocket healthcare expenses.

Eligible employees complete and return an enrollment form prior to the beginning of the plan period. This "election" is divided into equal installments that are payroll deducted on a pre-tax basis each pay period. Participants then use the prepaid benefits card or submit requests and receive reimbursements for approved expenses incurred throughout the plan period, as needed.

Eligible employees elect how much they want to contribute on a pre-tax basis to one or both of the plans and then use the NueSynergy benefits card for approved expenses as they are incurred. You may also submit claims for reimbursement of expenses if you are unable to use your card.

Money may be deposited to your HSA through payroll deduction, if your employer allows, or you may make deposits directly to your account. Deposits may be made periodically or in a lump sum, but only up to the contribution limits set by the IRS.

  • Payroll deductions: If your employer offers the option, you may specify a regular contribution to be deducted from your paycheck. This contribution will be made before Social Security, federal, and most state income taxes are deducted.
  • After-tax contributions: You may choose to make all or part of your annual account contributions to your HSA by making “after-tax” contributions to your account. These contributions, which you can make by writing a personal check, may be deducted on your income tax return, using IRS Form 1040 and Form 8889.

Employers may make contributions to your account as well; while you do not take a deduction for these contributions, they are excluded from your gross income.

Note: You will use IRS Form 1040 for your HSA contributions, not the short form 1040A or 1040EZ. This deduction is taken “above the line”: you do not need to itemize contributions on Schedule A in order to claim the deduction for HSA contributions.

Generally, no; however, if the camp is day camp and your dependent attends to allow you and your spouse (if married), to work, look for work or attend school full-time, then yes this would be an eligible expense. Overnight camps are specifically excluded.

No. Participants can still choose to contribute the full FSA annual maximum allowed for that plan year, even if they carry over $500 from the previous plan year.

Yes. Your HSA funds earn interest. Any earnings on your HSA funds are also tax free.

No. However, you are required to submit his/her Tax Identification Number or Social Security Number when filing your Federal Income Tax return.

No. Each year you will have to re-enroll before the beginning of the Plan Year. At that time, you will have the opportunity to evaluate the need to participate in the Plan as well as budget for all health care and/or dependent care expenses. You may decide to keep the same election, change your election or in some cases waive participation.

Distributions from your HSA used exclusively to pay for qualified medical expenses for you, your spouse, or dependents are excluded from your gross income. Your HSA funds can be used for qualified expenses and will continue to be free from federal taxes and states taxes (for most states) even if you are not currently eligible to make contributions to your HSA.

If you take a non-qualified distribution, you are subject to ordinary income tax and a 20 percent penalty tax. If you are age 65 or older, disabled, or for the year in which you die, the 20 percent penalty may not apply.

Yes, unsued will carryover into the next year. There is no limit or cap on how large the balance can grow in your HSA. However, the annual limit you can contribute to the HSA may not exceed the maximum contribution amount set by the IRS each year, plus the "catch up" contribution for those ages 55 to 65.

Yes, if you can change your contribution amount monthly if you need to, depending on if you’ll be traveling or if you’ll use other ways to get to work.

No, only one person can be named the account owner. If both you and your spouse have qualified HDHP coverage, and want to both make pre-tax HSA contributions or take advantage of the catch controbution once you are 55 or older, then you would each need to open an HSA.

If both you and your spouse have family coverage under qualified high-deductible health plans, the maximum total tax-deductible HSA contribution both of you can make (including employer contributions) is the IRS limit for family coverage.  This contribution can be divided between you and your spouse however you wish. If you and/or your spouse are eligible to make catch-up contributions, you may each contribute your eligible catch-up contribution to your individual HSA.

The government does allow a one-time transfer of funds from an IRA to an HSA. However, you can only roll your HSA funds into another HSA not an IRA.

  • The transferred amount, when combined with other HSA contributions for the year, may not exceed your annual maximum contribution.
  • Also, after making such a transfer, you must continue to participate in a qualifying high-deductible health plan for 13 consecutive months, beginning in the month of the IRA-to HSA transfer. If you do not, you will be subject to income taxes and a 20 percent penalty tax on the transferred amount, except in the case of death or disability.
  • Such a transfer may be an option if you incur significant medical expenses and find yourself unable to afford to make the maximum HSA contribution.

The Family and Medical Leave Act (FMLA) requires an employer to maintain coverage under any group health plan for an employee on FMLA leave under the same conditions coverage would have been provided if the employee had continued working. Coverage provided under the FMLA is not COBRA coverage, and taking FMLA leave is not a qualifying event under COBRA. A COBRA qualifying event may occur, however, when an employer's obligation to maintain health benefits under FMLA ceases, such as when an employee taking FMLA leave decides not to return to work and notifies an employer of his or her intent not to return to work. Further information on the FMLA is available on the Website of the U.S. Department of Labor's Wage and Hour Division at dol.gov/whd or by calling toll-free 1-866-487-9243.

Yes. You always have the option to choose when and when not to use your HSA dollars. You may pay for qualified medical expenses with after-tax dollars, allowing your HSA balance to grow tax-free.

Many HSA participants elect to pay smaller expenses with after-tax dollars, allowing their balances to grow for the future. In fact, you can reimburse yourself at anytime in the future for eligible expenses you paid for using after-tax dollars as long as they were incurred while you had an open and funded HSA.

Yes, you may have more than one HSA and you may contribute to them all, as long as you are currently enrolled in an HDHP. However, this does not give you any additional tax advantages, as the total contributions to your accounts cannot exceed the annual maximum contribution limit. Contributions from your employer, family members, or any other person must be included in the total.

If you are entitled to an 18 month maximum period of continuation coverage, you may become eligible for an extension of the maximum time period in two circumstances. The first is when a qualified beneficiary is disabled; the second is when a second qualifying event occurs.

Disability - If any one of the qualified beneficiaries in your family is disabled and meets certain requirements, all of the qualified beneficiaries receiving continuation coverage due to a single qualifying event are entitled to an 11-month extension of the maximum period of continuation coverage (for a total maximum period of 29 months of continuation coverage). The plan can charge qualified beneficiaries an increased premium, up to 150 percent of the cost of coverage, during the 11-month disability extension.

The requirements are:

  1. that the Social Security Administration (SSA) determines that the disabled qualified beneficiary is disabled before the 60th day of continuation coverage; and
  2. that the disability continues during the rest of the 18-month period of continuation coverage.

The disabled qualified beneficiary or another person on his or her behalf also must notify the plan of the SSA determination. The plan can set a time limit for providing this notice of disability, but the time limit cannot be shorter than 60 days, starting from the latest of: (1) the date on which SSA issues the disability determination; (2) the date on which the qualifying event occurs; (3) the date on which the qualified beneficiary loses (or would lose) coverage under the plan as a result of the qualifying event; or (4) the date on which the qualified beneficiary is informed, through the furnishing of the SPD or the COBRA general notice, of the responsibility to notify the plan and the procedures for doing so.

The right to the disability extension may be terminated if the SSA determines that the disabled qualified beneficiary is no longer disabled. The plan can require qualified beneficiaries receiving the disability extension to notify it if the SSA makes such a determination, although the plan must give the qualified beneficiaries at least 30 days after the SSA determination to do so.

The rules for how to give a disability notice and a notice of no longer being disabled should be described in the plan's SPD (and in the election notice if you are offered an 18-month maximum period of continuation coverage).

Second Qualifying Event - If you are receiving an 18-month maximum period of continuation coverage, you may become entitled to an 18-month extension (giving a total maximum period of 36 months of continuation coverage) if you experience a second qualifying event that is the death of a covered employee, the divorce or legal separation of a covered employee and spouse, a covered employee's becoming entitled to Medicare (in certain circumstances), or a loss of dependent child status under the plan. The second event can be a second qualifying event only if it would have caused you to lose coverage under the plan in the absence of the first qualifying event. If a second qualifying event occurs, you will need to notify the plan.

The rules for how to give notice of a second qualifying event should be described in the plan's SPD (and in the election notice if you are offered an 18-month maximum period of continuation coverage). The plan can set a time limit for providing this notice, but the time limit cannot be shorter than 60 days from the latest of: (1) the date on which the qualifying event occurs; (2) the date on which you lose (or would lose) coverage under the plan as a result of the qualifying event; or (3) the date on which you are informed, through the furnishing of either the SPD or the COBRA general notice, of the responsibility to notify the plan and the procedures for doing so.

Once you make an election, you may not change your election unless you experience an IRS “Change in Status” or “qualified life event.” If you do experience a qualified life event or change in status (such as marriage, adoption, divorce, etc.) your election change must be consistent with the Change in Status event. For example, if you adopt a child then you may increase your Dependent Care FSA election due to the newly eligible dependent.

A group health plan may terminate coverage earlier than the end of the maximum period for any of the following reasons:

  • Premiums are not paid in full on a timely basis;
  • The employer ceases to maintain any group health plan;
  • A qualified beneficiary begins coverage under another group health plan after electing continuation coverage;
  • A qualified beneficiary becomes entitled to Medicare benefits after electing continuation coverage; or
  • A qualified beneficiary engages in conduct that would justify the plan in terminating coverage of a similarly situated participant or beneficiary not receiving continuation coverage (such as fraud).

If continuation coverage is terminated early, the plan must provide the qualified beneficiary with an early termination notice. The notice must be given as soon as practicable after the decision is made, and it must describe the date coverage will terminate, the reason for termination, and any rights the qualified beneficiary may have under the plan or applicable law to elect alternative group or individual coverage.

If you decide to terminate your COBRA coverage early, you generally won't be able to get a Marketplace plan outside of the open enrollment period. For more information on alternatives to COBRA coverage, see question 4 above.

Yes, an adult may qualify as a dependent provided that the employee is providing more than half of that individuals support for the year, and the dependent lives with the employee and is physically and/or mentally incapable of caring for him/herself.

If you become entitled to elect COBRA continuation coverage when you otherwise would lose group health coverage under a group health plan, you should consider all options you may have to get other health coverage before you make your decision. There may be more affordable or more generous coverage options for you and your family through other group health plan coverage (such as a spouse's plan), the Health Insurance Marketplace, or Medicaid.

Under the Health Insurance Portability and Accountability Act (HIPAA), if you or your dependents are losing eligibility for group health coverage, including eligibility for continuation coverage, you may have a right to special enroll (enroll without waiting until the next open season for enrollment) in other group health coverage. For example, an employee losing eligibility for group health coverage may be able to special enroll in a spouse's plan. A dependent losing eligibility for group health coverage may be able to enroll in a different parent's group health plan. To have a special enrollment opportunity, you or your dependent must have had other health coverage when you previously declined coverage in the plan in which you now want to enroll. You must request special enrollment within 30 days from the loss of your job-based coverage.

Losing your job-based coverage is also a special enrollment event in the Health Insurance Marketplace (Marketplace). The Marketplace offers "one-stop shopping" to find and compare private health insurance options. In the Marketplace, you could be eligible for a tax credit that lowers your monthly premiums and cost-sharing reductions (amounts that lower your out-of-pocket costs for deductibles, coinsurance and copayments), and you can see what your premium, deductibles, and out-of-pocket costs will be before you make a decision to enroll.

Eligibility for COBRA continuation coverage won't limit your eligibility for Marketplace coverage or for a tax credit. You can apply for Marketplace coverage at HealthCare.gov or by calling 1-800-318-2596 (TTY 1-855-889-4325). To qualify for special enrollment in a Marketplace plan, you must select a plan within 60 days before or 60 days after losing your job-based coverage. In addition, during an open enrollment period, anyone can enroll in Marketplace coverage. If you need health coverage in the time between losing your job-based coverage and beginning coverage through the Marketplace (for example, if you or a family member needs medical care), you may wish to elect COBRA coverage from your former employer's plan. COBRA continuation coverage will ensure you have health coverage until the coverage through your Marketplace plan begins.

Through the Marketplace you can also learn if you qualify for free or low-cost coverage from Medicaid or the Children's Health Insurance Program (CHIP). You can apply for and enroll in Medicaid or CHIP any time of year. If you qualify, your coverage begins immediately. Visit HealthCare.gov or call 1-800-318-2596 (TTY 1-855-889-4325) for more information or to apply for these programs. You can also apply for Medicaid by contacting your state Medicaid office and learn more about the CHIP program in your state by calling 1-877-KIDS-NOW (543-7669) or visiting insurekidsnow.gov.

If you or your dependent elects COBRA continuation coverage, you will have another opportunity to request special enrollment in a group health plan or a Marketplace plan if you have a new special enrollment event, such as marriage, the birth of a child, or if you exhaust your continuation coverage. To exhaust COBRA continuation coverage, you or your dependent must receive the maximum period of continuation coverage available without early termination. Keep in mind if you choose to terminate your COBRA continuation coverage early with no special enrollment opportunity at that time, you generally will have to wait to enroll in other coverage until the next open enrollment period for the new group health plan or the Marketplace.

Yes, you may be reimbursed for expenses incurred for you, your spouse and any IRS dependents, regardless of where you are insured. For example, you might have coverage through your spouse’s employer’s plan (rather than your employer's) and you may still submit your family out-of-pocket expenses to be reimbursed under the Health FSA.

It depends on plan design. Frequently an HRA is offered is a reimbursement account to cover healthcare expenses incurred by you or your family members covered under the employer's insurance plan. Check with your employer's benefit department for more details.

No. You can be reimbursed for expenses provided by an individual providing care for your dependent in your home as long as the expenses are incurred for you and your spouse (if married), to work, look for work or attend school full-time.

If there is no longer a health plan, there is no COBRA coverage available. If, however, there is another plan offered by the company, you may be covered under that plan. Union members who are covered by a collective bargaining agreement that provides for a medical plan also may be entitled to continued coverage.