Administration & technology

A spending account only saves money if the paperwork behind it works.

Flexible spending and health reimbursement arrangements are simple in concept and easy to administer badly. Almost every employee complaint in this area traces back to one of three things: a substantiation request nobody explained, a deadline nobody published, or a card that stopped working in a pharmacy. None of those are plan design problems. They are administration problems.

Have your accounts reviewed

The rules that bite

Four mechanics decide whether an account runs quietly.

These are the provisions employees feel, and the ones most often left at whatever the prior administrator had set.

Substantiation

Card transactions that are not automatically matched have to be documented. An account that does not chase substantiation promptly ends the year with suspended cards and, eventually, amounts that have to be treated as taxable income.

Carryover or grace period, not both

A health FSA may allow a limited carryover of unused funds into the next year or a grace period to incur new expenses — it cannot have both. Employers regularly believe they have both because nobody ever read the document.

Runout, which is different again

The runout period is time to submit claims already incurred, not time to spend. Explaining those three windows clearly at enrollment prevents most of the forfeitures employees are angry about later.

How an FSA interacts with an HSA →

HRAs

An HRA is a plan, not a perk.

Health reimbursement arrangements are employer-funded and employer-owned, which makes them flexible — and makes them a group health plan with the obligations that follow.

Design choices that matter

What it sits behind (deductible, copays, specific categories), whether unused amounts roll forward, and who is eligible. A deductible-gap HRA can deliver a richer employee experience than a lower-deductible plan at a lower total cost — if the utilization assumption is honest.

It carries plan obligations

An HRA generally brings continuation rights, plan documents and disclosure duties with it, and the PCORI fee is typically owed on it. Employers who treat it as a reimbursement practice rather than a plan discover this late.

Ownership structures

Section 105 arrangements for small-business and farm ownership structures can be legitimate and valuable, and they are also the designs most often built wrong. They get documented properly or not at all.

The individual-coverage version →

Testing and administration

Routine plans become audit risks quietly.

Nondiscrimination testing

Cafeteria plans and self-funded arrangements are subject to testing that compares benefits for highly compensated and key employees against everyone else. A plan that has never been tested is not a plan that passes.

Plan documents that match practice

The document, the enrollment material and what the administrator actually does have to say the same thing. Where they diverge, the document governs and the employee is unhappy.

Employees reach a person

An employee calling about a denied reimbursement gets someone who can explain the rule, not a ticket number. That is most of the perceived value of these accounts.

The other pre-tax accounts →

Let’s get to work

Send us your renewal.

We’ll tell you whether it looks competitive, where we see opportunity, and the five questions we’d put to your carrier. No cost, and no obligation to move anything.

What to send

The renewal letter
Your current plan summary
Contribution split by tier
Enrolled counts by tier

Four documents — two more if your group is 50 or more. Nothing else; every extra one is a reason to postpone.

CFH Insurance Consultants

An independent employee benefits consulting firm. We look at the entire benefits program — cost, plan performance, risk and administration.

Michigan41000 Woodward Ave, Suite 350 East
Bloomfield Hills, MI 48304
248.370.8853
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719.425.2649
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281.404.5670

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