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.

 

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.”

 

 

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.

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.

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.

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.

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.

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.

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

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

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.

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.

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.