HRC Total Solutions, your total solutions provider of HR Solutions, flexible spending accounts, health savings accounts, commuter plans, COBRA, & wellness. Flexible Spending Accounts (FSA/LPFSA/DCA) What is a Healthcare Flexible Spending Account (FSA)? A Flexible Spending Account (FSA) allows you to set aside part of your pre-tax wages to pay for certain eligible healthcare expenses for yourself, your spouse, and your eligible dependents. Eligible expenses under the FSA Account include prescriptions, contact lenses as well as other medical, dental, and vision services. FSA Accounts are a great way to use pre-tax dollars and reduce your out-of-pocket medical expenses! How do Healthcare Flexible Spending Accounts (FSA) work? Before the effective date of an FSA plan year (determined by your employer), an employee will calculate how much money their household will spend during the plan year on medical, dental, and vision services. This annual number is divided by the number of payrolls during the plan year and this amount will be deducted from the employee's payroll each pay period and deposited into their FSA. For example: If you wanted to put $520 in the account and you are paid on a weekly basis, then $520 divided by 52 payrolls would equal $10 per paycheck. This money comes out before Federal Tax, FICA Tax, and State Tax. Check out our FSA Calculator here . Each plan year gives you the opportunity to change your FSA election. Also if there is a qualifying event such as marriage, death, divorce, legal separation, adoption, or birth in the immediate family, they can increase or decrease the annual election within a 30-day period following the event. What is a Dependent Care Account (DCA)? A Dependent Care Account allows you to set aside pretax dollars to help with the cost of care for eligible dependents, children under the age of 13 or aging parents while you’re at work. Examples of eligible care include: Preschool, Daycare, Babysitting, Summer Day Camp, After School Programs and Adult Care. Please Note: Kindergarten is not an eligible expense under the Dependent Care Account. How does the Dependent Care Account (DCA) work? A Dependent Care Account works similarly to a Health Care FSA Account. The difference with the Dependent Care Account (DCA) is the funds accrue upon the payrolls, credited to the Dependent Care Account. The maximum reimbursement limit is $5000 per year or $2500 if married and filing separately. All of these limits apply to the date the services incur, not the date billed or paid. What is a POP Plan? A Premium Offset Plan is a provision under the Internal Revenue Code Section 125 that enables employers to allow their employees to have certain premiums that they have to pay out of their paycheck, to be taken out before the employee pays tax. These premiums would be taken out before the Federal tax, FICA tax, and State tax. The POP also allows employers to save on the matching FICA that they would have had to contribute to this amount. What Premiums Qualify? • Health • Prescriptions • Dental • Vision • Disability • Cancer • Accident • Hospital Indemnity • Medicare Supplement • Employee Group Term Life (up to $50,000)

Sublingual immunotherapy is eligible with a flexible spending account (FSA), health savings account (HSA) and a health reimbursement arrangement (HRA). Sublingual immunotherapy reimbursement is not eligible with a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA). HRA HSA FSA Limited Purpose FSA Dependent Care FSA HRA HSA FSA Limited Purpose FSA Dependent Care FSA Eligible Eligible with Rx Eligible with LMN Eligible Eligible with Rx Eligible with LMN < Back Sublingual Immunotherapy Sublingual immunotherapy is eligible with a flexible spending account (FSA), health savings account (HSA) and a health reimbursement arrangement (HRA). Sublingual immunotherapy reimbursement is not eligible with a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA). Learn More Previous Next

Diabetic supplies such as test strips, monitors, etc. are eligible OTC items that do not require a prescription, although are also eligible when prescribed. Diabetic supplies reimbursement is eligible with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Diabetic supplies reimbursement is not eligible with a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA). HRA HSA FSA Limited Purpose FSA Dependent Care FSA HRA HSA FSA Limited Purpose FSA Dependent Care FSA Eligible Eligible with Rx Eligible with LMN Eligible Eligible with Rx Eligible with LMN < Back Diabetic Supplies Diabetic supplies such as test strips, monitors, etc. are eligible OTC items that do not require a prescription, although are also eligible when prescribed. Diabetic supplies reimbursement is eligible with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Diabetic supplies reimbursement is not eligible with a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA). Learn More Previous Next

Elder care reimbursement is not eligible with a flexible spending account (FSA), health savings account (HSA), a health reimbursement arrangement (HRA) or a limited-purpose flexible spending account (LPFSA). Elder care may qualify under a dependent care flexible spending account (DCFSA) when the elder lives with the account holder for 8 or more hours per day. HRA HSA FSA Limited Purpose FSA Dependent Care FSA HRA HSA FSA Limited Purpose FSA Dependent Care FSA Eligible Eligible with Rx Eligible with LMN Eligible Eligible with Rx Eligible with LMN < Back Elder Care Elder care reimbursement is not eligible with a flexible spending account (FSA), health savings account (HSA), a health reimbursement arrangement (HRA) or a limited-purpose flexible spending account (LPFSA). Elder care may qualify under a dependent care flexible spending account (DCFSA) when the elder lives with the account holder for 8 or more hours per day. Learn More Previous Next

Melatonin may be eligible with a Letter of Medical Necessity for reimbursement with a flexible spending account (FSA), health savings account (HSA), or a health reimbursement arrangement (HRA). Melatonin is not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA). HRA HSA FSA Limited Purpose FSA Dependent Care FSA HRA HSA FSA Limited Purpose FSA Dependent Care FSA Eligible Eligible with Rx Eligible with LMN Eligible Eligible with Rx Eligible with LMN < Back Melatonin Melatonin may be eligible with a Letter of Medical Necessity for reimbursement with a flexible spending account (FSA), health savings account (HSA), or a health reimbursement arrangement (HRA). Melatonin is not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA). Learn More Previous Next

An HRA is an arrangement that employers set up and completely funds to cover certain out of pocket, co-pays, co-insurance, and/or deductible expenses employees may incur associated with their health insurance plan. What is a Healthcare Reimbursement Arrangement? An HRA is an arrangement that employers set up and completely funds to cover certain out of pocket, co-pays, co-insurance, and/or deductible expenses employees may incur associated with their health insurance plan. It is an arrangement whereby employers promise to pay certain expenses on behalf of the employee to help reduce their cost of medical expenses, for themselves, their spouse, and dependent children. This arrangement is 100% paid for, funded, and designed by the employer for the employee’s benefit. Why would a company consider an HRA plan? Companies consider implementing HRA as a way to reduce the cost of health insurance premiums. By increasing the deductible of the health insurance plan, the premium to purchase the coverage can be reduced considerably. How does an HRA work? HRA’s are designed to work in conjunction with a high co-pay, high co-insurance, or high deductible health plan offered by the employer. Traditional health insurance plans have low co-pays, low co-insurance, and/or low deductibles, but because the health insurance rates and medical expenses continue to rise, employers are deciding to design and implement HRAs to reduce employees’ costs. By increasing the co-pay, co-insurance, and/or deductible, the cost of your health insurance premiums will decrease, but an employee’s out-of-pocket costs may increase. This is why employers implement an HRA to help employees reduce their potential out-of-pocket expenses while still providing them with a health insurance policy that offers complete coverage. HRA’s are effective in managing employees’ expenses, but they will be required to submit receipts or understand how to get reimbursed for an eligible expense covered by the HRA. How does the deductible get paid? There are several ways an employee can get reimbursed from the HRA depending on the options an employer allows. To the right are examples of how to get reimbursed. Many insurance companies will provide the claims data directly to HRC so employees will not have to submit to HRC for reimbursement. This will allow HRC to process and pay the claim directly back to the employee without them ever having to submit any paperwork to us for reimbursement. After the claim has been processed, the funds will be disbursed in accordance to the methods as outlined by your plan. An employee can submit a claim online, mail it, fax it, or drop the claim off to us along with the proper documentation necessary to prove they have incurred the expense. Proper documentation may consist of a letter that they will receive from the health insurance company. This letter is called a letter of explanation of benefits (EOB). In some cases, a receipt from the pharmacy may be all they need to submit. The proper documentation will be outlined by the employer. An employer may authorize the use of claims submission through the use of a Visa card. If an employer authorizes this form of reimbursement, an employee will receive a Visa card from HRC after they are enrolled. To use the Visa card, an employee simply presents it at an eligible location for an eligible expense. They may only use this card for eligible expenses and they must keep receipts, they may be contacted to verify the expense. Should an employer outsource the administration? There are many factors to consider when deciding to outsource the administration of paying the deductibles. Though pricing is important, it isn’t the only consideration to focus on. The employees will be submitting their claims for deductible reimbursement, and all of their personal information about what they had done will be on the EOB. Many employees will find this information private and may not want it shared with their employers. By outsourcing, the employer can get the claims paid, and the employee can rest assured that their information is kept confidential. It is also important to consider a Third Party Administrator who is set up for paying these types of claims. Employees are going to need an efficient streamlined process to receive their deductible money. Failure to reimburse an employee expediently could result in the employee receiving additional charges from their provider. Employers should consider using a TPA that can offer debit card processing for reimbursing the deductible. This would allow the employee to pay for their deductibles directly to the provider without having to submit claims for reimbursement.

Saline nasal spray is eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), or a health reimbursement arrangement (HRA). Saline nasal spray is not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA). HRA HSA FSA Limited Purpose FSA Dependent Care FSA HRA HSA FSA Limited Purpose FSA Dependent Care FSA Eligible Eligible with Rx Eligible with LMN Eligible Eligible with Rx Eligible with LMN < Back Saline Nasal Spray Saline nasal spray is eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), or a health reimbursement arrangement (HRA). Saline nasal spray is not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA). Learn More Previous Next

A CPAP machine is eligible with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). CPAP machine reimbursement is not eligible with a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA). HRA HSA FSA Limited Purpose FSA Dependent Care FSA HRA HSA FSA Limited Purpose FSA Dependent Care FSA Eligible Eligible with Rx Eligible with LMN Eligible Eligible with Rx Eligible with LMN < Back CPAP Machine A CPAP machine is eligible with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). CPAP machine reimbursement is not eligible with a limited-purpose flexible spending account (LPFSA) or a dependent care flexible spending account (DCFSA). Learn More Previous Next

Dental reconstruction is eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), health reimbursement arrangement (HRA) and a limited-purpose flexible spending account (LPFSA). Dental reconstruction reimbursement is not eligible with a dependent care flexible spending account (DCFSA). HRA HSA FSA Limited Purpose FSA Dependent Care FSA HRA HSA FSA Limited Purpose FSA Dependent Care FSA Eligible Eligible with Rx Eligible with LMN Eligible Eligible with Rx Eligible with LMN < Back Dental Reconstruction Dental reconstruction is eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), health reimbursement arrangement (HRA) and a limited-purpose flexible spending account (LPFSA). Dental reconstruction reimbursement is not eligible with a dependent care flexible spending account (DCFSA). Learn More Previous Next

Medicated lip treatments are eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), a health reimbursement arrangement (HRA). Medicated lip treatments are not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA). HRA HSA FSA Limited Purpose FSA Dependent Care FSA HRA HSA FSA Limited Purpose FSA Dependent Care FSA Eligible Eligible with Rx Eligible with LMN Eligible Eligible with Rx Eligible with LMN < Back Medicated Lip Treatments Medicated lip treatments are eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), a health reimbursement arrangement (HRA). Medicated lip treatments are not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA). Learn More Previous Next

Lactation aids are eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), or a health reimbursement arrangement (HRA). Lactation aids are not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA). HRA HSA FSA Limited Purpose FSA Dependent Care FSA HRA HSA FSA Limited Purpose FSA Dependent Care FSA Eligible Eligible with Rx Eligible with LMN Eligible Eligible with Rx Eligible with LMN < Back Lactation Aids Lactation aids are eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), or a health reimbursement arrangement (HRA). Lactation aids are not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA). Learn More Previous Next

Special foods with a Letter of Medical Necessity (LMN) are eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), a health reimbursement arrangement (HRA). Special foods are not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA). HRA HSA FSA Limited Purpose FSA Dependent Care FSA HRA HSA FSA Limited Purpose FSA Dependent Care FSA Eligible Eligible with Rx Eligible with LMN Eligible Eligible with Rx Eligible with LMN < Back Special Foods Special foods with a Letter of Medical Necessity (LMN) are eligible for reimbursement with a flexible spending account (FSA), health savings account (HSA), a health reimbursement arrangement (HRA). Special foods are not eligible with a dependent care flexible spending account (DCFSA) or a limited-purpose flexible spending account (LPFSA). Learn More Previous Next