FSA & HRA Administration

A cafeteria plan can pass every test in January and fail by December. Testing belongs inside the plan year.

Nondiscrimination tests look at who actually elected and who actually received benefits, and those numbers move all year. We track testing and substantiation while the plan runs, so a routine FSA or HRA does not become an audit risk or a surprise tax bill for your executives.

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The Tests

Several tests, each asking a different question about who benefits.

The tests compare highly compensated and key employees with everyone else. Each can fail for a different reason, which is why we run them separately instead of as a single checkbox.

Eligibility

Who is allowed to participate. A plan that excludes groups where rank-and-file employees cluster, such as part-time staff, can fail before anyone elects. We review eligibility first because it is the easiest thing to fix before the year starts. Eligibility review is the first step in cafeteria plan nondiscrimination testing.

Contributions and Benefits

Who actually elects, and how much. A plan can be open to everyone and still fail if executives use it heavily and others do not, which is why participation matters as much as design. Participation drives the contributions and benefits test.

Key Employee Concentration

Benefits going to key employees cannot exceed a set share of the plan’s total. In a small company where owners contribute heavily, this is the test that tends to bite, so we watch it from the first payroll. Key employee concentration testing matters most for owner-heavy small businesses with a cafeteria plan.

Dependent Care Average Benefits

Average dependent care benefits for non-highly compensated employees must be at least 55 percent of the average for highly compensated employees. Few employees use dependent care, so a handful of large elections can fail it. Dependent care FSA testing deserves early attention.

How nondiscrimination testing works across your plans →

When a Test Fails

Failing a test does not end the plan. It changes who pays tax.

When a cafeteria plan fails, the usual consequence is that the affected highly compensated or key employees lose the tax exclusion while rank-and-file employees keep theirs. That is why the fix is aimed at the right people, early.

Testing Early

We run a preliminary test after enrollment, when elections are known and there is still time to act. A problem found in the first quarter can be corrected; one found after year end can only be reported. Early testing turns a failure into a fixable warning.

Mid-Year Corrections

Where the plan allows, elections of highly compensated employees can be reduced going forward so the plan passes. We identify the adjustment and the people it affects, and your counsel confirms the approach before anyone is told. Timely corrections help a cafeteria plan pass.

Year-End Documentation

We keep the final results with the plan records. If the plan is ever examined, the question is not only whether it passed but whether you can show that it did. Documented test results protect a cafeteria plan in any IRS examination, and they cost little to keep.

How we bring in your CPA and counsel →

Substantiation

Every reimbursement needs proof. Card swipes are not an exception.

IRS rules treat unsubstantiated reimbursements as a problem for the plan, not only for one claim. We monitor substantiation continuously rather than at year end.

Open Card Transactions

Swipes that could not be verified at the point of sale stay open until a receipt arrives. We track them and send reminders, so open transactions do not pile up into a year-end problem. Consistent follow-up keeps FSA and HRA substantiation compliant.

Correcting Improper Payments

When a swipe turns out to be ineligible, the plan follows a set sequence: suspend the card, seek repayment, offset against later claims and, as a last resort, treat the amount as wages. We follow it in order, because skipping steps is what puts the plan at risk.

Document and Platform Match

The platform should enforce exactly what the plan document says. We compare the two every year, because a setting that has drifted from the document is an operational failure even when each claim looks reasonable. Annual comparison keeps plan operations compliant.

How employees get help with a denied reimbursement →

Common Questions

What employers ask about FSA and HRA compliance.

Do small employers have to test?

Yes. The tests apply regardless of size, and small employers fail them more easily, because a few owners can outweigh everyone else in the plan. Small employers should test early each plan year, before a few large elections decide the result.

Who counts as highly compensated?

It turns on ownership and prior-year pay above an IRS threshold, with a separate definition for key employees. We apply the definitions to your payroll data each year and flag edge cases for your CPA. Accurate classification is the foundation of FSA and cafeteria plan nondiscrimination testing.

Is there a safe harbor for small employers?

A simple cafeteria plan can be treated as meeting certain tests if eligible small employers meet its contribution and eligibility requirements. Whether it suits you is a cost question we can model. A simple cafeteria plan can help eligible small employers pass FSA testing.

How FSA and HRA plans are run end to end →

Sources

Where the Rules Come From.

The laws and rules named on this page link to the statute or regulation they come from. This is general information, not legal or tax advice, and rules change, so check the current text.

Cafeteria Plans (26 U.S.C. 125)

The tax code section that lets employees pay certain benefit premiums before tax.

Read the Text

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.

Switch to CFH. Unhappy with your broker? Your employees won’t notice. You will. →

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