by admin | Feb 20, 2025 | Blog
Administering a Health Flexible Spending Account (FSA) can be challenging, especially when employees request midyear changes to their elections due to unforeseen medical circumstances. This blog post aims to clarify the rules surrounding midyear election changes and provide practical tips for employers to manage these situations effectively.
Can Employees Change Health FSA Elections Midyear?
Question: Can employees reduce their Health FSA contributions if they are prevented from receiving anticipated medical care after enrollment?
Answer: No, employees cannot change their Health FSA elections under these circumstances. According to IRS regulations, an employee’s Health FSA election is irrevocable during a plan year unless an event occurs that fits within one of the exceptions available under IRS regulations or other guidance. Changes in medical condition or a provider’s recommendation do not qualify as changes in status and do not fall within the other exceptions applicable to Health FSAs.
Examples of Non-Qualifying Situations
- Pregnancy and Laser Eye Surgery: If a doctor refuses to perform laser eye surgery on an employee who is pregnant, the employee cannot change their Health FSA election.
- Dental Work Changes: If an employee’s spouse does not undergo planned dental work because the dentist’s recommendation changed, the employee cannot adjust their Health FSA contributions.
These situations do not qualify as “mistakes” that would allow an election change. The IRS’s 2007 proposed cafeteria plan regulations include an example where an employee elects Health FSA salary reductions for the next plan year in anticipation of eye surgery. If the surgery cannot be performed after the plan year starts, the employee must forfeit the remaining balance under the use-or-lose rule if their other eligible medical expenses are less than the amount contributed.
Minimizing Employee Relations Issues
While election changes are not allowed under these circumstances, employers can take steps to minimize employee relations issues:
- Clear Communication: Ensure that enrollment and other materials clearly explain the limited reasons for midyear election changes. Including real-life examples can be helpful.
- Remind Employees of Eligible Expenses: Employees may still use the funds by submitting other eligible expenses for reimbursement.
- Plan Amendments: Consider amending your plan to allow Health FSA carryovers of up to $660 to the next plan year. The maximum carryover amount is indexed, so stay updated on the latest limits.
- Grace Period: Adopt a grace period to give employees extra time to use up remaining funds.
By proactively addressing these issues, employers can help employees better understand their Health FSA options and reduce frustration related to midyear election changes.
Source: Thomson Reuters
by admin | Feb 13, 2025 | Blog
When managing COBRA coverage, it’s important to know what happens if a qualified beneficiary pays less than the full premium amount. Here’s a simplified guide:
Timely Payments and Grace Periods
Qualified beneficiaries must make timely COBRA premium payments, with a 30-day grace period each month. If the full premium isn’t paid by the end of this period, coverage can be terminated. However, there are special rules for small shortfalls.
What is an Insignificant Shortfall?
An insignificant shortfall is a payment that is less than or equal to the lesser of $50 or 10% of the required premium. For example, if the premium is $490, a shortfall of up to $49 is considered insignificant.
Handling Insignificant Shortfalls
- Notify the Beneficiary: Inform them of the shortfall and give them a reasonable period (usually 30 days) to pay the difference.
- Grace Period: Allow the beneficiary to pay the remaining amount during this period to avoid termination.
- Accept Underpayment: Alternatively, the plan can accept the underpayment as full payment.
Best Practices
- Include Procedures: Clearly outline shortfall procedures in your COBRA plan.
- Prepare Notices: Have a standard notice ready for shortfalls.
- Prompt Notification: Send the notice as soon as a partial payment is received.
By following these steps, you can manage COBRA coverage effectively and ensure compliance with regulations. This helps prevent unnecessary termination and gives beneficiaries a fair chance to maintain their health benefits.
Source: Thomson Reuters
by admin | Feb 6, 2025 | Blog
Navigating the intricacies of Dependent Care Assistance Programs (DCAP) can be challenging, especially when it comes to understanding what expenses qualify for reimbursement. One common question that arises is whether application fees, deposits, and similar expenses can be reimbursed. Here, we break down the IRS regulations and provide clarity on this topic.
What Are Indirect Expenses?
Indirect expenses are costs that are not directly for care but are necessary to obtain care. Examples include application fees and deposits paid to day-care centers or preschools. According to IRS regulations, these expenses may qualify for reimbursement under a DCAP if they meet specific criteria.
Criteria for Reimbursement
To be eligible for reimbursement, indirect expenses must:
- Be Required for Care: The employee must be required to pay these expenses to obtain related care.
- Meet DCAP Rules: The expenses must comply with DCAP rules and the plan document.
- Relate to Provided Care: The care to which these expenses relate must actually be provided.
Examples of Reimbursable and Non-Reimbursable Expenses
- Reimbursable: If a DCAP participant pays a $100 application fee to secure a spot at a new day-care provider, this fee can be reimbursed once the care is provided.
- Non-Reimbursable: If a participant pays a $100 deposit to a preschool but later decides not to enroll the child, the deposit is not reimbursable since the care was not provided.
Timing of Reimbursement
The IRS does not specify whether indirect expenses can be reimbursed in full once care commences or if they must be reimbursed proportionately over the duration of the care agreement. To err on the side of caution, it is advisable to prorate the reimbursement over the agreement’s duration. For instance, if the agreement is month-to-month, the entire fee might be reimbursed after the first month of care. For longer agreements, the fee should be prorated accordingly.
Conclusion
Understanding the nuances of DCAP reimbursements for indirect expenses like application fees and deposits is crucial for both employers and employees. By ensuring these expenses meet the necessary criteria and timing the reimbursements appropriately, you can navigate the DCAP rules effectively and make the most of your benefits.
Source: Thomson Reuters
by Lexi Garcia | Jan 23, 2025 | Blog
In today’s competitive job market, offering attractive employee benefits is crucial for retaining top talent. One effective way to enhance your benefits package is by implementing matching Health Savings Account (HSA) contributions through your company’s cafeteria plan. This blog post will guide you through the process, ensuring compliance with relevant regulations and maximizing the benefits for your employees.
Understanding HSA Contributions and Cafeteria Plans
Health Savings Accounts (HSAs) are tax-advantaged accounts that allow employees to save for medical expenses. Contributions to HSAs can be made by both employees and employers. A cafeteria plan, also known as a Section 125 plan, allows employees to make pre-tax salary reduction contributions to various benefits, including HSAs.
Can Employers Make Matching HSA Contributions?
Yes, employers can make matching contributions to employees’ HSAs through a cafeteria plan. However, it’s essential to understand the regulatory requirements to avoid potential pitfalls.
Comparability Requirements vs. Nondiscrimination Rules
Employers’ HSA contributions are generally subject to comparability requirements, which mandate that contributions must be the same dollar amount or the same percentage of the high-deductible health plan (HDHP) deductible for all eligible employees. This standard effectively prohibits matching contributions, as they would trigger a 35% excise tax on the employer.
However, these comparability requirements do not apply to employer HSA contributions made through a cafeteria plan. Instead, such contributions are subject to the Code § 125 nondiscrimination requirements, which include the eligibility, contributions and benefits, and key employee concentration tests. These tests provide more flexibility for employers to vary HSA contributions on a nondiscriminatory basis.
Designing a Compliant Matching Contribution Plan
To ensure compliance with nondiscrimination rules, carefully design your matching contribution plan. Consider the following:
- Eligibility: Ensure that all eligible employees have the opportunity to participate in the HSA matching program.
- Contribution Limits: Be mindful of the annual dollar limitations for HSA contributions. All contributions made to an employee’s HSA, whether by the employee, employer, or another entity, must be aggregated for these limits.
- Nonforfeitable Contributions: Once made, matching HSA contributions are nonforfeitable. They cannot be subject to a vesting schedule or be returned to the employer if the employee terminates employment midyear.
Communicating the Plan to Employees
Effective communication is key to the success of your HSA matching program. Ensure that the details of the matching contributions are clearly outlined in the cafeteria plan document, summary plan description, and other employee communications, such as open enrollment materials.
Implementing matching HSA contributions through your company’s cafeteria plan can significantly enhance your employee benefits package. By understanding and complying with the relevant regulations, you can offer a valuable benefit that helps attract and retain top talent while providing employees with a tax-advantaged way to save for medical expenses.
For more information on setting up a compliant HSA matching program, reach out to Sales@NueSynergy.com.
Source: Thomson Reuters
by admin | Jan 9, 2025 | Blog
The IRS has released the optional standard mileage rates for 2025, providing important updates for businesses, medical care, and charitable activities. Here’s what you need to know about the new rates and vehicle value limits.
2025 Standard Mileage Rates
- Business Use: The standard mileage rate for business use of an automobile has increased to 70 cents per mile, up from 67 cents in 2024. This rate can be used instead of calculating actual expenses like depreciation, lease payments, and fuel costs.
- Medical and Moving Use: The rate for using an automobile to obtain medical care or for moving expenses remains unchanged at 21 cents per mile. This rate applies to variable expenses only, such as gas and oil, and does not include fixed costs like depreciation and insurance.
- Charitable Use: The rate for charitable use of an automobile remains at 14 cents per mile.
Understanding the Rates
The standard mileage rates offer a simplified method for taxpayers to deduct automobile expenses. For business use, the rate covers both fixed and variable costs, while for medical and moving purposes, only variable costs are deductible. Parking fees and tolls related to medical or moving expenses can be deducted separately.
Vehicle Value Limits
The IRS has also set the maximum vehicle values for 2025, which determine the applicability of certain valuation rules for employer-provided vehicles:
- Cents-Per-Mile Rule: This rule values personal use of an employer-provided vehicle by multiplying the business standard mileage rate by the number of personal miles driven.
- Fleet-Average Valuation Rule: Employers with a fleet of 20 or more vehicles can use an average annual lease value for each vehicle in the fleet.
For vehicles first made available for personal use in 2025, the maximum vehicle value under both rules is $61,200, down from $62,000 in 2024. This value also sets the maximum standard automobile cost for reimbursement allowances under a fixed and variable rate (FAVR) plan.
These updates from the IRS provide clarity and consistency for taxpayers planning their 2025 automobile expenses. By understanding and utilizing the new standard mileage rates and vehicle value limits, individuals and businesses can better manage their tax deductions and compliance.
by admin | Dec 12, 2024 | Blog
Employee benefits often include a lot of acronyms. What do these and other acronyms mean? They are primarily used in Cafeteria Plans, Consumer-Driven Health Care, ERISA Compliance, COBRA, HIPAA, and Group Health Plan Mandates manuals. The list below provides a comprehensive collection of all the acronyms used.
AD&D Plan – Accidental Death and Dismemberment Plan
ADA – Americans with Disabilities Act
ASG – Affiliated Service Group
ASO – Administrative-Services-Only
ATIN – Adoption Taxpayer Identification Number
CE – Covered Entity
CMS – Center for Medicare and Medicaid Services
COB – Coordination of Benefits
COBRA – Consolidated Omnibus Budget Reconciliation Act
COLA – Cost-of-Living Adjustment
CONUS – Continental United States
DCAP – Dependent Care Assistance Program
DCTC – Dependent Care Tax Credit
DFVC Program – Delinquent Filer Voluntary Compliance Program
DOL – Department of Labor
EAP – Employee Assistance Plan
EBHRA – Excepted Benefit HRA
EBSA – Employee Benefits Security Administration
EDI – Electronic Data Interchange
EFAST2 – ERISA Filing Acceptance System II (electronic submission of Form 5500s)
EIN – Employer Identification Number
EOB – Explanation of Benefits
EOI – Evidence of Insurability
EPP – Employer Payment Plan
ERISA – Employee Retirement Income Security Act
ePHI – Electronic Protected Health Information
FAVR – Fixed and Variable Rate
FICA – Federal Insurance Contributions Act
FITW – Federal Income Tax Withholding
FLSA – Fair Labor Standards Act
FMLA – Family and Medical Leave Act
FSA – Flexible Spending Arrangement
FUTA – Federal Unemployment Tax Act
GCPCA – Gag Clause Prohibition Compliance Attestation
GHP – Group Health Plan
GTL Insurance – Group Term Life Insurance
HCE – Highly Compensated Employee
Source: Thomson Reuters
HCI – Highly Compensated Individual
HCP – Highly Compensated Participant
HDHP – High-Deductible Health Plan
Health FSA – Health Flexible Spending Arrangement
HHS – Department of Health and Human Services
HIPAA – Health Insurance Portability and Accountability Act
HMO – Health Maintenance Organization
HRA – Health Reimbursement Arrangement
HSA – Health Savings Account
ICHRA – Individual Coverage HRA
IIAS – Inventory Information Approval System
LTCI – Long-Term Care Insurance
LTD Plan – Long-Term Disability Plan
MACRS – Modified Accelerated Cost Recovery System
MCC – Merchant Category Code
MEWA – Multiple Employer Welfare Arrangement
OCR – Office for Civil Rights
PBM – Pharmacy Benefit Manager
PCORI – Patient-Centered Outcomes Research Institute
PEO – Professional Employer Organization
PHI – Protected Health Information
POP – Premium-Only Plan
PPO Plan – Preferred Provider Organization Plan
PTO – Paid Time Off
QB – Qualified Beneficiary
QE – Qualified Event
R&C – Reasonable and Customary
RRTA – Railroad Retirement Tax Act
SAR – Summary Annual Report
SBC – Summary of Benefits and Coverage
SIFL – Standard Industry Fare Level
SIHP – Self-Insured Health Plan
SMM – Summary of Material Modification
SPD – Summary Plan Description
STLDI – Short-Term, Limited-Duration Insurance
TPA – Third-Party Administrator
UCR Rate – Usual, Customary, and Reasonable Rate
VEBA – Voluntary Employees’ Beneficiary Association
