FSA / HRA / HSA
FSA Reimbursement for Non-Covered Spouse
Health FSA funds may generally be used to reimburse eligible medical expenses for a spouse or qualifying dependents even if they are not enrolled in the employer's health plan.
FSA / HRA / HSA
Question of the Week - DFSA and Disabled Child
Q.- An employee is asking if day care expenses for her intellectually disabled 16 year old child are eligible for reimbursement from her Dependent Care FSA. What information do we
Q.- An employee is asking if day care expenses for her intellectually disabled 16 year old child are eligible for reimbursement from her Dependent Care FSA. What information do we need to request to check disability so she can be reimbursed for his eligible expenses?
A.- For a child’s expenses to be eligible for reimbursement after age 13, the child must be someone who (1) is physically or mentally incapable of caring for themselves and (2) has the same principal place of abode as the taxpayer for more than half of the year.
IRS Publication 503 explains “incapable of self-care” as : “persons who cannot dress, clean, or feed themselves because of physical or mental problems,” or “who must have constant attention to prevent them from injuring themselves or others.”
Ultimately it is the employee’s responsibility to determine and document that the individual for whom expenses are being reimbursed is an eligible dependent. The employee (not the FSA plan)has to keep records or other evidence to substantiate dependent care FSA expenses.
The plan could either (a) take the employee’s direction since the employee attests when submitting the expense that it is an eligible expense for an eligible dependent; or (b) if the plan wants to get documentation from the employee before allowing the reimbursement, review a doctor’s letter stating the child is physically or mentally incapable of self-care.
Benefit Allocation Systems (BAS) provides online solutions for: Employee Benefits Enrollment; COBRA; Flexible Spending Accounts (FSAs); Health Reimbursement Accounts (HRAs); Leave of Absence Premium Billing (LOA); Affordable Care Act Record Keeping, Compliance & IRS Reporting (ACA); Group Insurance Premium Billing; Property & Casualty Premium Billing; and Payroll Integration.
MyEnroll360 integrates with major insurance carriers for enrollment eligibility management (e.g., Blue Cross, Blue Shield, Aetna, United Health Care, Kaiser, CIGNA and others), and with leading payroll platforms for enrollment deduction management (e.g., Workday, ADP, Paylocity, PayCor, UKG, and others).
This article is for informational purposes only and is not intended as legal, tax, or benefits advice. Readers should not rely on this information for taking (or not taking) any action relating to employment, compliance, or benefits. Always consult with a qualified professional before making decisions based on this content.
Topics
COBRA
COBRA Offering to Retirees
When a covered employee becomes entitled to Medicare before retiring, a covered spouse may receive up to 36 months of COBRA continuation from the date of Medicare entitlement.
COBRA
COBRA Offering to Retirees
When a covered employee becomes entitled to Medicare before retirement, the spouse may be eligible for up to 36 months of COBRA continuation coverage.