by Lexi Garcia | Feb 28, 2023 | Blog
QUESTION: For 2023, an employee elected $2,400 of health FSA coverage under our calendar-year cafeteria plan, which is funded solely through employee salary reductions and does not provide for carryovers or include a grace period. The employee has already incurred medical expenses equal to this amount in 2023 and wants to be reimbursed for the expenses now, even though she has only made health FSA salary reductions of $400 to date. Do we have to reimburse all of these expenses right away, or can we limit reimbursements to the amount our employee has already contributed and ask her to resubmit the remaining expenses as additional contributions are made?
ANSWER: Your employee must be reimbursed for all of her expenses now, assuming that the expenses are otherwise eligible for reimbursement (e.g., they are for medical care incurred during the current period of coverage, and appropriate substantiation has been provided). That’s because IRS requirements for health FSAs include a “uniform coverage” rule under which the maximum amount of reimbursement must be available at all times during the plan year (or other period of coverage), reduced only for any prior reimbursements for the same period. Reimbursement is deemed “available” under the uniform coverage rule if claims are paid at least monthly, or when an employee’s submitted claims reach a reasonable plan minimum (e.g., $50). Thus, reimbursements cannot be restricted to the amount of the employee’s contributions.
The uniform coverage rule also prohibits accelerating an employee’s salary reductions based on health FSA claims submitted or paid. Note that the uniform coverage rule does not apply to DCAPs, so reimbursements under a DCAP can be limited to the amount that has been contributed, less expenses already reimbursed.
Source: Thomson Reuters
by Lexi Garcia | Feb 21, 2023 | Blog
Everyone in the employee benefits field uses acronyms like COBRA, FSA, and CDHC. What do these and other employee benefit acronyms stand for?
Here’s an explanatory list of common employee benefit acronyms used:
ACA – Patient Protection and Affordable Care Act
AHP – Association Health Plan
ASG – Affiliated Service Group
ASO – Administrative-Services-Only
ATIN – Adoption Taxpayer Identification Number
BA – Business Associate
CDHC – Consumer-Driven Health Care
CE – Covered Entity
COB – Coordination of Benefits
COBRA – Consolidated Omnibus Budget Reconciliation Act
COLA – Cost-of-Living Adjustment
CONUS – Continental United States
DCAP – Dependent Care Assistance Program
DOL – Department of Labor
EIN – Employer Identification Number
EAP – Employee Assistance Plan
EBHRA – Expected Benefit HRA
EBSA – Employee Benefits Security Administration
EEOC – Equal Employment Opportunity Commission
EFAST2 – ERISA Filing Acceptance System II
EOB – Explanation of Benefits
EOI – Evidence of Insurability
ePHI – Electronic Protected Health Information
ERISA – Employee Retirement Income Security Act
FICA – Federal Insurance Contributions Act
FLSA – Federal Labor Standards Act
FMLA – Family and Medical Leave Act
FSA – Flexible Spending Amount
FUTA – Federal Employment Tax Act
GHP – Group Health Plan
HCE – Highly Compensated Employee
HCP – Highly Compensated Participants
HDHC – High Deductible Health Coverage
HDHP – High Deductible Health Plan
Health FSA – Health Flexible Spending Arrangement
HHS – Department of Health and Human Services
HIPPA – Health Information Technology for Economic and Clinical Health Act
HMO – Health Maintenance Organization
HRA – Health Reimbursement Arrangement
HSA – Health Savings Account
ICHRA – Individual Coverage HRA
IIAS – Inventory Information Approval System
MCC – Merchant Category Code
PBM – Pharmacy Benefit Manager
PCOR Fees – Fees for Patient-Centered Outcomes Research
PEO – Professional Employer Organization
POP – Premium-Only Plan
PPO Plan – Preferred Provider Organization Plan
QB – Qualified Beneficiary
QE – Qualifying Event
QMCSO – Qualified Medical Child Support Order
QSEHRA – Qualified Small Employer Health Reimbursement Arrangement
R&C – Reasonable and Customary
RRE – Responsible Reporting Identity
SBC – Summary of Benefits and Coverage
SMM – Summary of Material Modification
SPD – Summary Plan Description
TPA – Third Party Administrator
UCR Rate – Usual, Customary, and Reasonable Rate
VEBA – Voluntary Employees’ Beneficiary Association
by admin | Dec 15, 2022 | Blog
A Commuter Benefits Flexible Spending Account (FSA) is an employer-sponsored account that allows participants to set aside pre-tax funds to pay for qualified mass transit and parking expenses associated with their work commute. There are two Commuter Benefit accounts: transportation and parking. Each of these accounts may receive a monthly contribution limit of $300, starting in 2023.
What to know about this account
- You must have funds in a commuter benefits account before using
- Any unused funds in a transportation and/or parking account will be lost at the end of the plan year
- Adjustments to a contribution can be made at any time; termination included
- You can manage this account online at www.NueSynergy.com or via the NueSynergy smart mobile app
Questions to consider
Why should I enroll in a Commuter Benefits account?
This account is ideal if you expect to incur commuter expenses that won’t be reimbursed by another plan. Money contributed to a Commuter Benefits account is free from federal and state taxes and remains tax-free when spent on eligible expenses.
What expenses are eligible for this account?
This all depends on which commuter account you plan on choosing. For a transportation account, expenses such as transit passes, tokens, fare cards, vouchers or items entitling you to ride a mass vehicle are eligible. For a parking account, eligible expenses consist of parking expenses incurred at/near place of work and out-of-pocket parking fees for parking meters and lots.
How do I use my Commuter Benefits FSA to pay for eligible expenses?
You can either use the NueSynergy smart debit card or pay your personal funds and submit a claim reimbursement.
by admin | Dec 13, 2022 | Blog
A Limited Purpose Flexible Spending Account (LPFSA) is an account designed to allow participants to set aside pre-tax dollars for dental, vision and orthodontia expenses for themselves and their dependents. As mentioned earlier, the benefits of enrolling in a LPFSA are limitless.
Below is a list of eight pre-taxable items a participant can use to fund their Limited Purpose FSA.
1. Artificial teeth
2. Dental treatment: x-rays, fillings, dentures, root canals
3. Dental co-insurance, co-payments, and deductibles
4. Eye surgery (includes cataract and LASIK)
5. Vision co-insurance, co-payments, and deductibles
6. Prescription eyeglasses, sunglasses, and over-the-counter reading glasses
7. Contact lenses, solution, equipment, and materials
8. Occlusal guards
To learn even more about LPFSA-eligible items, check out our extensive list.
by admin | Nov 29, 2022 | Blog
With the contribution limits set to increase for Flexible Spending Accounts (FSAs) in 2023, now is a good time to debunk any myths that are often associated with FSAs. Here are easy to understand answers to common FSA questions.
Will I lose the money in my FSA if I don’t use it?
Not if you plan properly. You can utilize the carryover option, which allows you to carryover as much as $610 in unused funds from an existing plan to the next.
How is my FSA funded?
It is funded by your employer. Based on how much you decide to contribute (up to $3,100), your employer then places the contributed amount into your account and deducts equal amounts from your paycheck each pay period.
When is my FSA funded?
Your full year’s contribution is available on the first day of the plan year, even though you pay it back through payroll deductions throughout the year. Think of it as an interest-free loan.
Who owns my FSA?
Your employer. However, any unused funds go back to them if you leave the company.
What expenses are eligible for my FSA?
Eligible expenses include out-of-pocket costs not covered by an insurance plan, notably copayments, deductible expenses, coinsurance, and prescriptions. Costs for healthcare products and services are also eligible.
