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Employer Flex Credits under the ACA

ACAThe following article explains why it is important to qualify as an excepted benefit plan when it comes to FSAs using Employer Flex Credits under the ACA.




ACA Creates Issues For Some Health FSAs With Employer Flex Credits

Dec 09, 2013

Jamie Scott

Prior to 2014, flexible spending accounts (FSAs) have been exempt from many group health plan rules, such as COBRA and HIPAA portability, by qualifying as an “excepted benefit” under applicable guidance. Because most FSAs qualify as an excepted benefit, the actual requirements for the exemption have received little attention. However, in 2014 it will become more important for an FSA to qualify as an excepted benefit so that the FSA is not subject to the mandates of the Affordable Care Act (ACA). FSAs normally are not able to satisfy the ACA mandates on benefit limits and preventive services and so failing to qualify as an excepted benefit could trigger excise taxes on the plan sponsor of $100 per participant per day.

One of the requirements for an FSA to qualify as an excepted benefit is that the participant’s salary reductions plus any employer contributions to the FSA must not exceed the greater of (i) two times the participant’s salary reduction and (ii) the participant’s salary reduction plus $500.

Identifying what is an employer contribution for this test is not as easy as you might think. Contributions credited by the employer directly to the FSA are employer contributions and would be limited to the amount of the participant’s salary reduction contributions or, if greater, $500. Flex dollars that the employer credits and that participants may choose to allocate to the FSA or receive in cash are actually treated as participant salary reduction contributions for this test and would not cause the FSA to fail to qualify as an excepted benefit.

But, the problem arises if the employer flex dollars are not allowed to be cashed out at 100%. Many cafeteria plans provide for a forfeiture of half (or some other percentage) of any flex dollars that are cashed out of the plan. If flex dollars are not available to be cashed out at 100%, any of those dollars allocated to the FSA are treated as employer contributions and must be capped so that when they are combined with the participant’s salary reduction, the FSA can still qualify as an excepted benefit.

Think of this situation. An employer provides $1,000 of flex dollars that a participant may use to purchase health insurance, contribute to the participant’s FSA or be cashed out. Participant A waives health insurance coverage and elects to have all $1,000 of flex dollars contributed to the FSA along with his own salary reduction contribution of $600. If Participant A had the option to cash out all $1,000 of flex dollars, the contribution of those dollars to the FSA would be treated as additional salary reduction contributions and would not jeopardize the excepted benefit status of the FSA. If, however, the plan’s cash out provision included a forfeiture of any portion of the cash that could have been elected by Participant A, then Participant A’s allocation to the FSA would be treated as an employer contribution and would prevent the FSA from qualifying as an excepted benefit.

Employers that make flex dollar contributions should review the cash out provisions of the cafeteria plan to make sure they do not cause the FSA to be subject to the requirements of the ACA.

Source Blog Post at Graydon Head Legal Counsel

Jamie D. Scott

Graydon Head Legal Counsel, since 1871

Jamie serves as Chair of the firm’s Employee Benefits and Executive Compensation Practice Group. He has worked with clients of all sizes to design and implement qualified retirement plans (including ESOPs), nonqualified deferred compensation plans and incentive compensation plans. Jamie also works on welfare benefit plan issues, including health care reform and HIPAA privacy and security. He has significant experience in working with the Internal Revenue Service and Department of Labor on compliance issues. From 2010-2014, Jamie has been named an “Ohio Super Lawyer” by Super Lawyers Magazine for his work in Employee Benefits/ERISA law. Based on the grading and comments of his peers, Jamie is recognized with an AV Rating, the highest rating given to lawyers by Martindale-Hubbell.


After reading Employer Flex Credits under the ACA, go to these other Core Documents’ blog posts:

Defining Group Health Plans: Key issues

Impact of ACA (ObamaCare) on HRAs, health FSAs, and employer payment plans

Employers must prepare an ERISA Wrap SPD to supplement the Certificate of Insurance

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