Taxsaver
Plan Definitions:
This
list of definitions is intended to help you understand
your Flexible Spending Account.
1.
FSA: This is a shortened term for a Flexible
Spending Account. Flexible Spending Accounts allow
you to use pre-tax dollars that you elect to set
aside in an account to reimburse yourself for qualified
out of pocket expenses. The FSA account may be funded
solely with participant dollars or the Employer
may contribute dollars to the FSA accounts or there
may be a combination of both participant and Employer
dollars. There are 2 types of FSA accounts and both
accounts have a Use-It-Or-Lose it provision.
2. Health Care Reimbursement Account:
This is a FSA for eligible out of pocket health,
dental, vision, prescription and over the counter
expenses defined as "eligible" under your Employer’s
Plan. This is often referred to as a Health FSA.
3. Dependent Care Reimbursement Account:
This is a FSA for eligible day care expenses paid
so that you and your spouse can provide care for
your eligible tax dependents (Qualified Dependents)
while you are at work.
4. Health Reimbursement Arrangement (HRA):
A HRA should not be confused with a FSA. A HRA is
strictly funded with Employer dollars and it is
offered in conjunction with a HDHP – High
Deductible Health Plan. There may also be a carryover
provision under a HRA.
5. Health Savings Account (HSA):
A HSA is different from a HRA in that the account
can be funded with employee dollars or employer
dollars or a combination of both. A HSA is operated
by a trust and there is no requirement to substantiate
the expense when a withdrawal is made. Dollars may
be carried over from year to year, and unlike a
HRA, the account is portable, so you may take it
with you if you were to leave your Employer. These
accounts are also offered in conjunction with a
HDHP and if you are a participant in a HSA, your
eligibility for other benefits, like a FSA, may be
limited.
6. Qualified Dependent: A Qualified
Dependent is an individual who satisfies the requirements
defined by the IRS in Code Section 152 as a qualified
child or qualified relative of the participant in
the Plan. If your dependent does not qualify as
a qualified child or a qualified dependent, their
expenses will not be reimbursable under the FSA
Plan.
7. Plan Year: A Plan Year is designated
by your Employer. The Plan Year determines when
expenses may be incurred for reimbursement. A Plan
Year is never more than 12 months long, but it can
be less if your Employer offers a Short Plan Year.
8. Incur: This term is used to
determine when expenses are eligible for reimbursement.
The incur date is the service rendered date, not
the date that the bill is paid or the date that
the provider charges you for the service. The service
rendered date must fall within the Plan Year (some
exceptions may apply – see item 26).
9. Eligible Expense: An eligible
expense is an expense that has been defined as reimbursable
by the IRS under the Plan. A list of eligible expenses
can be found on the Taxsaver Plan website. Please
do not refer to Publication 502 as a guide, as many
expenses that can be deducted on your tax return
do not qualify for the FSA Plan. In general, eligible
expenses consist of services and items that are
used to prevent or alleviate a disease, condition
or malfunction of the body.
10. Open Enrollment: Open Enrollment
is the period of time that is designated by your
Employer as the time to elect your benefits for
the following Plan Year. This is the only time of
year when you may elect to make a change to any
of your pre-tax benefits without experiencing a
qualified Change In Status.
11. Change In Status: A Change
In Status is a qualified event, as defined by the
IRS that would allow a participant to make a change
to their pre-tax elections once the Plan Year has
begun. For all intents and purposes, once you have
made your election and the Plan Year has started,
you are locked into that election for the length
of the Plan Year. A qualified Change In Status,
if recognized by your Employer’s Plan, may
allow you some flexibility in changing your current
election mid Plan Year. This may involve revoking,
increasing or decreasing the election.
A Change In Status will result in
an election change only when the change directly
affects the eligibility of the current coverage
and when the change is consistent with the Change
In Status.
12. Claim Form: A Claim Form is
a signed form that should accompany your receipts
for reimbursement. Without a signed Claim Form,
Taxsaver Plan cannot accept the claim for processing.
Claim Forms are available on our website. If you
are submitting a receipt to substantiate a FSA debit
card expense, you are not required to complete a
claim form, but you should always include something
that identifies you and your Employer. Please do
not submit a receipt by itself.
13. Receipt: Receipts are required
to substantiate the FSA expenses. A receipt is defined
as a statement from a third party provider that
includes the date the service is rendered, the type
of service rendered or the items purchased and the
amount owed to the provider. Receipts should also
include the provider information. For dependent
care receipts from an individual provider, the signature
of the day care provider should always be included.
14. FSA Debit Card: A FSA Debit
Card is provided to participants by the Employer.
Not all Employers offer this card. A FSA Debit Card
is a credit card – Mastercard – that
is accepted at eligible providers as determined
by the Plan. Mastercard assigns the provider a
merchant code that determines whether the card
is accepted or denied at the point of sale.
15. Merchant Code: A merchant code
is a 4 digit number that is assigned by Mastercard
to any vendor that accepts Mastercard. For a listing
of merchant codes that are allowed under a FSA Plan,
please refer to the Debit Card page on Taxsaver
Plan’s website.
16. IIAS: IIAS stands for Inventory
Information Approval System. IIAS' are found in pharmacies,
grocery stores, retail stores and discount stores that sell
FSA eligible items, like prescriptions and over the counter
items. Items are pre-determined to be FSA eligible by Sigis,
an organization of professionals in the healthcare and payment
industry. When the item is scanned at the register, the SKU code
is recognized as an FSA eligible item and the FSA Debit Card will
accept the item. No receipt documentation is required after-the-
fact.
17. Receipt Notification: A receipt
notification is a notice sent by Taxsaver Plan after
a FSA debit card has been used at an eligible provider.
The IRS requires that FSA debit card swipes be substantiated
when the swipe does not match the co-pay for that
service under the Employer’s health plan.
A receipt notification is sent via email or mail,
depending on your Employer. You are given a 35 day
window of time to submit your receipts.
18. Recurring Charge: A recurring
charge is defined as a charge seen on the FSA Debit
Card from the same vendor in the same amount. A
recurring charge can only be determined to be recurring
after the charge has been paid for with the FSA
Debit Card two (2) times.
19. A Completed FSA Debit Card Transaction:
If you view your account on the Taxsaver Plan website,
the FSA Debit Card transactions are listed at the
bottom of the screen. If the transaction shows to
be completed, this means that Taxsaver Plan is not
in need of a receipt for that expense or you have
submitted the requested receipt at that time.
20. A Pending FSA Debit Card Transaction:
If you view your account on the Taxsaver Plan website,
the FSA Debit Card transactions are listed at the
bottom of the screen. If the transaction shows to
be pending, this means that Taxsaver Plan is in
need of a receipt for that expense. If you have
submitted the requested receipt, please contact
Taxsaver Plan to verify that the receipt was received
and that we were able to
process it.
21. Account Balance: An account
balance available in your account is the dollars
remaining in the Health FSA. This amount is derived
by taking the total annual election and subtracting
the total dollars distributed from the Plan for
eligible expenses submitted for reimbursement.
22. Cash Balance: The cash balance
available in your account is the cash remaining
in the FSA account. This amount is derived by taking
the dollars that you have contributed to the Plan
and subtracting the total dollars distributed from
the Plan for eligible expenses submitted for reimbursement.
Please note that it is possible to show a negative
cash balance in the Health FSA at anytime during
the Plan Year. It is not possible to show a negative
cash balance in the Dependent Care FSA.
23. Runoff Period: A runoff period
is the amount of time after the Plan Year has ended
that your Employer allows participants to submit
expenses that were incurred during the previous
Plan Year.
24. Use-It-Or-Lose-It: This is
a term used to explain the forfeiture procedure
at year end. After the Runoff Period ends, any unclaimed
dollars will be forfeited back to the Employer.
25. Cash In/Cash Out: This term
is used to describe how Dependent Care claims are
paid. A participant in the Dependent Care Account
will never be reimbursed more than they have contributed
to the Plan at any given time during the Plan Year.
Much like a bank account, claims remain pending against
the account until more dollars are contributed to
the account.
26. 2 ½ Month Extension:
This is a provision of the Plan that may or may
not be offered by your Employer. Should your Employer
offer this provision, you will be allowed an additional
2 ½ months after the Plan Year ends to incur
expenses. When you incur an eligible expense during
the first 2 ½ months of the new Plan Year
and if you submit that expense during those first
2 ½ months, the claim will be reimbursed first
from the previous Plan Year balance, if you have
a remaining balance. If you do not have any dollars
remaining in the previous Plan Year, the claim incurred
and submitted during the 2 ½ month extension
period will be reimbursed from the current Plan
Year dollars.
27. Terminated Participant: A Terminated
Participant is a person that is no longer eligible
to participate in the Plan based on the Employer’s
eligibility requirements. A person may become a
Terminated Participant due to a layoff, a change in
hours, a change in classification or a resignation.
28. COBRA: COBRA is a continuation
of existing coverage. COBRA is offered to Health
FSA participants who have not been reimbursed the
total amount contributed to the Plan during the
Plan Year. A COBRA election allows the Terminated
Participant to remain an active participant in the
Plan. The Terminated Participant who elects COBRA
will be able to continue to submit expenses incurred
after the date of termination, assuming that the
Terminated Participant makes the scheduled payments
as outlined in the COBRA agreement. The COBRA offering
for Health FSA participants is not in conjunction
with any other COBRA offerings. COBRA contributions
for Health FSA Plans are generally made on an after-tax
basis. The COBRA election ends on the last day of
the Plan Year, assuming that you continue making
your after-tax payments through the end of the Plan
Year, as scheduled.
|