by admin | Aug 1, 2024 | Blog
As the back-to-school season approaches, parents and students are preparing for the new academic year. Beyond the usual school supplies, there are many health-related items eligible for purchase using your Flexible Spending Account (FSA) or Health Savings Account (HSA). These tax-advantaged accounts can help you save money on essential health products that support your child’s well-being throughout the school year.
1. First Aid Supplies
Accidents happen, especially on the playground or during sports activities. Stock up on first aid essentials like bandages, antiseptic wipes, and cold packs. These items are crucial for handling minor injuries promptly.
2. Contact Solution
If your child uses contact lenses, ensuring they have the right contact solution is essential for maintaining eye health and comfort. Both prescription glasses and contact lenses are eligible expenses, so make sure they have a clear view of the blackboard and their textbooks.
3. Over-the-Counter Medicines
Having a stock of over-the-counter (OTC) medicines can be a lifesaver for managing common ailments like colds, allergies, and headaches.
4. Acne Treatment
Managing acne is crucial for your child’s confidence and skin health. Various acne treatments, including creams, gels, and cleansers, are eligible for purchase with your FSA or HSA.
5. Sunscreen
Protecting your child’s skin from harmful UV rays is important year-round. Ensure you have an adequate supply of sunscreen, particularly if your child spends a lot of time outdoors.
Leveraging your FSA or HSA for back-to-school shopping not only ensures your child is well-prepared but also helps you save on essential health-related products. By planning ahead and purchasing these eligible items, you can take advantage of the tax benefits these accounts offer.
For a complete list of eligible FSA and HSA back-to-school items click here.
For more information on all FSA and HSA eligible items, visit the FSA Store.
by Lexi Garcia | Jul 18, 2024 | Blog
In the complex world of healthcare benefits, understanding the requirements for Medicare Part D disclosure notices can be a challenge, especially for start-ups venturing into offering health plans. This article aims to shed light on the requirements for Health Reimbursement Arrangements (HRAs) and Health Flexible Spending Accounts (Health FSAs).
Medicare Part D and Creditable Coverage
Medicare Part D is a federal program that provides prescription drug coverage to individuals who are eligible for Medicare. Plan sponsors that offer prescription drug coverage must disclose to covered Part D-eligible individuals and to the Centers for Medicare & Medicaid Services (CMS) whether their drug coverage is “creditable.” Coverage is considered creditable if its actuarial value equals or exceeds that of defined standard Part D coverage.
HRAs and Medicare Part D Disclosure Notices
The term “group health plan” for disclosure purposes includes “account-based medical plans” such as HRAs. Therefore, sponsors of HRAs that offer prescription drug coverage must provide disclosure notices to Part D-eligible individuals, advising whether the HRA’s prescription drug coverage is creditable. CMS officials have informally stated that a single, combined disclosure notice covering both an HRA and another group health plan offered by the same employer is permitted. Thus, if all of the HRA participants are also participants in your company’s major medical plan, you could avoid separate notices for your HRA entirely.
Health FSAs and Medicare Part D Disclosure Notices
On the other hand, sponsors of health FSAs are not required to provide disclosure notices to Part D-eligible individuals. This is due to a specific exception in CMS guidance, which states that health FSAs are not taken into account when determining whether employer-provided prescription drug coverage is creditable.
Conclusion
Understanding the requirements for Medicare Part D disclosure notices is crucial for companies planning to offer health benefits. While HRAs generally require these notices, health FSAs do not. As always, it’s essential to stay informed and consult with a benefits advisor to ensure compliance with all regulations.
Source: Thomson Reuters
by Lexi Garcia | Jun 27, 2024 | Blog
As a plan sponsor of a self-insured health plan, it’s crucial to maintain accurate records and ensure that all enrolled employees meet the eligibility criteria. However, situations can arise where outdated information leads to ineligible employees being enrolled in the health plan. If you’ve discovered that employees working 25 hours per week have been enrolled based on old handbook information, while your plan documents and Summary Plan Description (SPD) correctly state a 30-hour threshold, swift and strategic action is required.
Immediate Steps for Plan Sponsors
Upon discovering such errors, you must act promptly to minimize complications and potential liabilities. Here are two primary options to consider:
Allow Ineligible Employees to Remain Enrolled:
- Fairness Consideration: Allowing employees to remain in the plan for the rest of the plan year can be seen as fair, especially if they relied on the outdated handbook information. This approach reduces the risk of employees seeking equitable relief due to miscommunication.
- Stop-Loss Insurance Risk: Check with your stop-loss insurer before proceeding. Stop-loss coverage typically adheres to the terms in the plan document, not ancillary documents like handbooks. Without insurer approval, claims from these employees might not be covered under your stop-loss policy.
Remove Ineligible Employees from the Plan:
- Consistency with Plan Terms: Removing these employees aligns with the plan document and SPD, mitigating the risk of significant uncovered claims under your stop-loss policy.
- Prospective Removal: Ensure the removal is prospective, not retroactive, to avoid the impermissible “rescission” of coverage. Retroactive removal could lead to significant legal and ethical issues.
- Equitable Relief Risk: Be aware of the potential for employees to claim equitable relief for lost benefits due to reliance on the outdated handbook.
Ensuring Compliance and Fair Treatment
Consistency is key in handling such situations. Treat all similarly situated employees alike to avoid claims of discrimination under various laws. Disparate treatment can lead to claims of discrimination based on sex, race, age, or health status. Additionally, adhere to the nondiscrimination rules under Code § 105(h) for self-insured health plans.
Discovering ineligible employees enrolled in your health plan requires careful consideration and prompt action. Whether you decide to keep the employees enrolled for the remainder of the plan year or remove them, ensure that your actions are consistent with plan terms and fair to all employees. By addressing the issue swiftly and consulting with your stop-loss insurer, you can mitigate potential risks and maintain the integrity of your health plan.
Source: Thomson Reuters
by Lexi Garcia | May 31, 2024 | Blog
Summer is right around the corner (June 21)! Whether you have plans to travel or are staying closer to home, your Flexible Spending Account can help you stock up on summer essentials without breaking the bank. Depending on your activity, your FSA can provide a variety of products! Below is a list of the top items to not only enhance your summer experience but also ensure your health and wellness.
Sunscreen
Sunscreen is a no-brainer when it comes to summer. With more time spent outdoors, protecting your skin from harmful UV rays is crucial. The last thing you want to worry about before heading to the beach or the pool is sunscreen. Buying sunscreen while on vacation can also be more expensive. Click here for all FSA eligible sunscreen bundle options.
First Aid
Whether you are dealing with mosquito bites, blisters from those long summer walks, or minor cuts and scrapes, accidents happen and being prepared is key. Click here for all FSA eligible medicine and treatment care.
Shoe Inserts
Comfortable footwear is essential for enjoying summer activities. A shoe insert can help reduce foot pain offering extra padding and improve blood circulation. Click here for all FSA eligible foot care options.
Eye Care
Protecting your eyes is just as important as protecting your skin. If you wear contact lenses, you want them to stay comfortable and clean. The FSA store offers a variety of contact lens solution and eye drops to make sure your eyes don’t get irritated throughout the days. Let’s not forget about the UV rays! The FSA store also offers sunglasses with or without prescription!
Your FSA is more than just a healthcare benefit; it’s a gateway to a healthier, more enjoyable summer. By investing in these FSA-eligible essentials, you’re not only making smart financial choices but also ensuring that you and your family can fully embrace all the joys that summer has to offer. So, dive into the season with confidence, knowing that you’re covered for every sunny day ahead.
For all FSA eligible items, or other HRA and HSA eligible items, click here.
Note: The products mentioned are based on the latest available information and are subject to change. Always check with your FSA provider for the most current eligibility list.
by Lexi Garcia | May 23, 2024 | Blog
Understanding cafeteria plan election changes can be complex, especially when dealing with domestic partner relationships. Here’s what you need to know about whether such relationships qualify for election changes under cafeteria plan rules.
Domestic Partner Relationship and Election Changes
The commencement of a domestic partner relationship does not qualify as a “change in marital status” under cafeteria plan rules. Legal marital status changes include marriage, death of a spouse, divorce, legal separation, and annulment. While the list is not exhaustive, the IRS does not recognize the start or end of a domestic partner relationship as equivalent to these events.
Alternative Election Change Event: Change in Coverage Under Another Employer Plan
However, another permitted event, “change in coverage under another employer plan,” may allow for an election change. If your plan includes this provision, your employee can drop major medical coverage upon becoming covered under their partner’s employer plan. This event does not restrict changes to the plans maintained by the employer of a spouse or dependent but does not allow changes to health FSA elections.
Key Takeaways
- Domestic Partner Relationship: Does not qualify as a change in marital status for election changes.
- Change in Coverage: Employees can change their election if covered under a partner’s employer plan.
- Documentation: Required to prove new coverage under the partner’s employer plan.
- Plan Specifics: Check your specific cafeteria plan terms for detailed rules and procedures.
Conclusion
While domestic partner relationships don’t qualify for election changes under marital status rules, a change in coverage under another employer plan can allow adjustments. Always consult your cafeteria plan specifics and seek professional advice for compliance.
