Midyear Health FSA Election Changes: Essential Guidelines for Employers and Employees

Midyear Health FSA Election Changes: Essential Guidelines for Employers and Employees

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:

  1. Clear Communication: Ensure that enrollment and other materials clearly explain the limited reasons for midyear election changes. Including real-life examples can be helpful.
  2. Remind Employees of Eligible Expenses: Employees may still use the funds by submitting other eligible expenses for reimbursement.
  3. 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.
  4. 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

Midyear Health FSA Election Changes: Essential Guidelines for Employers and Employees

Understanding Employee Benefit Acronyms: A Quick Guide

Employee benefits often include a lot of acronyms. What do these and other acronyms mean? They are primarily used in Cafeteria PlansConsumer-Driven Health CareERISA 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

Midyear Health FSA Election Changes: Essential Guidelines for Employers and Employees

Traveling This Holiday Season? Don’t Forget These 5 FSA/HSA Eligible Essentials!

The holiday season is a time for celebration, but it can also bring its share of stress—especially when it comes to travel. To help you stay healthy and prepared, here are the top five FSA (Flexible Spending Account) and HSA (Health Savings Account) eligible items you should pack for your holiday adventures.

1. First Aid Kit

A well-stocked first aid kit is essential for any traveler. Look for kits that include band-aids, antiseptic wipes, and other basic supplies. Many first aid kits are FSA/HSA eligible, ensuring you’re ready for minor injuries or ailments while on the road.

2. Sunscreen

Protecting your skin is crucial, even in winter. Sunscreen is often FSA/HSA eligible and perfect for those sunny holiday destinations. Choose a broad-spectrum SPF to shield your skin from harmful UV rays, whether you’re skiing or lounging by the beach.

3. Pain Relievers

Over-the-counter pain relievers like ibuprofen or acetaminophen are must-haves for any trip. These items are typically FSA/HSA eligible and can help you manage headaches, muscle aches, or any discomfort that might arise during your travels, ensuring you can enjoy your holiday without interruptions.

4. Thermometer

A digital thermometer is a handy tool to have, especially during flu season. Keeping track of your health is easier with this essential item. Many thermometers qualify for FSA/HSA reimbursement, making it a smart addition to your travel kit.

5. Allergy Medications

If you suffer from allergies, packing your allergy medications is essential. Antihistamines and nasal sprays are often FSA/HSA eligible and can help you manage symptoms while traveling. Whether it’s pollen, pet dander, or dust, having your allergy meds on hand will keep you comfortable and ready to enjoy the festivities.

Traveling during the holiday season doesn’t have to be stressful, especially when you’re prepared. By packing these five FSA/HSA eligible items, you can ensure a healthier, more enjoyable trip. Remember, taking care of your health is the best gift you can give yourself this holiday season. Safe travels!

For a full list of FSA/HSA eligible items, click here.

Midyear Health FSA Election Changes: Essential Guidelines for Employers and Employees

Understanding Employer Contributions to Health FSAs: What You Need to Know

When managing employee benefits, grasping the intricacies of Health Flexible Spending Accounts (FSAs) is essential, especially if your company is considering adding employer contributions like matching or seed contributions. You may be curious about how these contributions impact the IRS contribution limits.

Contribution Limits Overview

For plan years starting in 2024, the IRS sets the limit for health FSA salary reduction contributions at $3,200, which will increase to $3,300 in 2025. It’s important to note that this limit applies solely to contributions made through employee salary reductions.

Do Employer Contributions Count?

The good news is that nonelective employer contributions, such as matching or seed contributions, typically do not count toward this limit. However, there’s an important caveat: if employees can choose to receive these contributions in cash or as a taxable benefit, they will be considered salary reductions and will count toward the limit if contributed to the health FSA.

Compliance Considerations

Introducing employer contributions can also bring additional compliance challenges. For example, if contribution amounts differ among employees, your plan might violate the nondiscrimination rules outlined in the Internal Revenue Code.

Additionally, to qualify as an excepted benefit, the maximum benefit payable for the year must not exceed either twice the employee’s health FSA salary reduction election or the salary reduction election plus $500, whichever is greater. If employer contributions are included, it’s crucial to ensure they don’t push the health FSA beyond this maximum benefit threshold.

While employer contributions can enhance your benefits package, they require careful planning to maintain compliance with IRS regulations. By understanding how these contributions interact with the limits and other compliance issues, you can make informed decisions that benefit both your employees and your organization.

If you have any further questions or need assistance with your cafeteria plan, feel free to reach out!

Source: Thomson Reuters