by Lexi Garcia | Mar 23, 2023 | Blog
The IRS has issued FAQs that explain when certain costs related to nutrition, wellness, and general health are medical expenses under Code § 213 that may be paid or reimbursed under a health FSA, HSA, or HRA. As background, Code § 213 defines medical care as amounts paid for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting a structure or function of the body. The FAQs explain that medical expenses must be primarily to alleviate or prevent a physical or mental disability or illness, and do not include expenses that are merely beneficial to general health.
The FAQs confirm that the costs of dental, eye, and physical exams are medical expenses that can be paid or reimbursed by a health FSA, HSA, or HRA because these exams diagnose whether a disease or illness is present. The costs of smoking cessation programs and programs that treat drug-related substance use or alcohol use disorders are also medical expenses because they treat a disease. For the cost of therapy to be a medical expense, the therapy must treat a disease—thus, amounts paid for therapy to treat a diagnosed mental illness are medical expenses, while amounts paid for marital counseling are not. Likewise, the costs of nutritional counseling and weight-loss programs are medical expenses only if the counseling or program treats a specific disease diagnosed by a physician (e.g., obesity or diabetes); otherwise, these costs are not medical expenses. The cost of a gym membership is a medical expense only if the membership was purchased for the sole purpose of affecting a structure or function of the body (e.g., a prescribed plan for physical therapy to treat an injury) or treating a specific disease diagnosed by a physician (e.g., obesity or heart disease). However, the cost of exercise for the improvement of general health is not a medical expense, even if recommended by a doctor.
The FAQs also explain the circumstances under which the cost of food or beverages purchased for weight loss or other health reasons will qualify as medical expenses, and that the cost of non-prescription drugs can be paid or reimbursed by a health FSA, HSA, or HRA even though these items (except for insulin) are not deductible under Code § 213. The FAQs confirm that the cost of nutritional supplements is not a medical expense unless the supplements are recommended by a medical practitioner as treatment for a specific medical condition diagnosed by a physician.
Source: Thomson Reuters
by Lexi Garcia | Mar 21, 2023 | Blog
QUESTION: Our company sponsors a high-deductible health plan (HDHP) in conjunction with employee HSAs. Can the medical expenses of our employees’ adult children who otherwise qualify for tax-free coverage under the HDHP be reimbursed tax-free from the employees’ HSAs?
ANSWER: Not necessarily—it depends on whether the adult children qualify as tax dependents under the HSA rules. As group health plans, HDHPs that provide dependent coverage of children must make the coverage available until a child turns age 26. (The age 26 mandate does not generally apply to HSAs because they are not group health plans.) The income exclusion for employer-provided health coverage includes employees’ children who are under age 27 as of the end of the taxable year, regardless of whether those children qualify as tax dependents. But similar provisions do not appear in the HSA tax-free reimbursement rules. Instead, whether an adult child’s medical expenses can be reimbursed tax-free from a parent’s HSA depends on whether the child qualifies as a tax dependent for HSA distribution purposes—i.e., whether the adult child is a qualifying child (for example, due to disability) or a qualifying relative (where the parent provides over one-half of the child’s support). Distributions from a parent’s HSA that reimburse a nondependent adult child’s medical expenses are taxable and may be subject to an additional 20% tax.
Thus, the medical expenses of some adult children who are enrolled as dependents in your company’s HDHP will not qualify for tax-free reimbursement from the employee-parent’s HSA. It is possible, however, that these children may be HSA-eligible themselves. If they cannot be claimed as tax dependents and they meet the other HSA eligibility requirements, they could open HSAs of their own.
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 14, 2022 | Blog
In the spring, NueSynergy touched on how to utilize the FSA Store to take advantage of FSA-eligible items. With the 2022 calendar year ending, now is a good time to detail the utilization of the HSA Store.
The HSA Store is akin to the FSA Store, as it’s an outlet for consumers to buy eligible products to fit their Health Savings Account needs. This online store carries over 2,500 products — from first-aid kits, orthodontia to pregnancy tests.
To best utilize the HSA Store, search any HSA eligible item you need for purchase. From there, add a promo code to any purchased HSA eligible item. All promo codes can be turned into points for future purchases.
The smallest denomination of points that can be redeemed for later use is 350 ($10) and largest is 1,500 ($50). You cannot redeem fewer than 350 points at a time. Balances under 350 points cannot be exchanged for a partial value dollar reward. Points expire six months (180 days) following your last order date. To learn about all HSA Store eligible items, look here.
by admin | Nov 30, 2022 | Blog
A Health Savings Account (HSA) is an individually owned, tax-favored account that allows participants to pay for qualified healthcare expenses, such as pregnancy test kits, eyeglasses, and more. Here is an overview of the five potential benefits that an HSA provides.
Benefit #1: HSAs provide triple-tax coverage; meaning contributions are made tax-free, grow tax-free, and can be withdrawn tax-free. This is possible if it’s coupled with a High Deductible Health Plan (HDHP).
Benefit #2: Unused HSA funds are rolled over annually, enabling them to be used for future expenses.
Benefit #3: Contribution limits continue to increase with this account. Participants can now use up to $3,850 in annual funds to pay for healthcare expenses individually. If participants wish to use up funds for family coverage, the annual limit is now $7,750.
Benefit #4: Participants who are Medicare eligible, but not enrolled in Medicare, can contribute to an HSA to save for retirement. If 65 or older, HSA funds can also be used without a penalty.
Benefit #5: Even if a participant loses employment, HSA funds can still be used to pay for qualified expenses. However, the ability to continue contributing depends on if the participant chooses to enroll in an HSA qualified health insurance plan either through COBRA, their new employer or an individual policy.
