Flexible Spending Account  Services

Changes to Health Flexible Spending Accounts (HFSAs): Frequently Asked Questions

 

The landmark health care reform law enacted in March 2010 made changes to HFSAs. Below are some frequently asked questions regarding its effects on HFSAs.

 

Questions about the general impact of health care reform on HFSAs 

 

Questions on change in eligibility of OTC expenses 

 

Questions on ďadult childrenĒ as eligible individuals 

 

 

Questions about the general impact of health care reform on HFSAs

 

What changes can I expect to my HFSA as a result of the recently passed health care reform laws?

 

Under the new laws enacted in March 2010, there are three important changes:

 

  1. Effective January 1, 2011, in order to be reimbursed for over‐the‐counter (OTC) drugs and medicines from your HFSA, you must obtain a prescription and provide supporting documentation, such as a Ceridian Physicianís Statement form; and

  2. Effective January 1, 2013, if you participate in an HFSA, your contributions will be limited to $2,500 per year.

  3. Your employer has the option of covering a new category of individuals under your HFSA Ė adult children up to age 26.

 

How will these new changes affect me, specifically as a participant in my companyís HFSA plan?

 

If requesting reimbursement for an OTC drug purchased on January 1, 2011, or later, you will need to submit one of the following:

 

  1. The receipt alone if it includes an RX number for the OTC drug expense.

  2. The receipt plus Ceridianís Physicianís Statement form, which has been modified to include a physicianís attestation that the OTC drug has been prescribed in accordance with state law. NOTE: The expense listed on Ceridian Physicianís Statement form must be specific and exactly match the expense listed on the receipt. Substitutions or equivalent items will not be accepted.

     

Example 1:  a Tylenol prescription cannot be filled with another brand of acetaminophen.

Example 2: Broad descriptive terms such as Ďdecongestantsí will not be accepted as valid prescriptions.

 

You can obtain a Ceridian Physicianís Statement form by accessing the "Forms" tab of our participant website.

Effective 3/30/2010, your employer may allow you to be reimbursed for eligible medical expenses incurred by your adult children. If you generally elect less than your plan maximum or the statutory maximum of $2,500, you should review the medical expenses of your adult children to determine if this change in tax law would benefit you. home

 

Questions on change in eligibility of OTC expenses

 

What are some examples of OTC "drugs and medicines" that require supporting documentation, such as a Ceridian Physicianís Statement form, for reimbursement from my HFSA?

 

OTC drugs and medicines include, but arenít limited to, the following: cough, cold and flu medicines, stomach remedies, antibiotics, pain relievers, digestive aids, allergy and sinus medicines and sleep aids.

 

Will I still be able to purchase over‐the‐counter supplies and equipment, such as bandages?

 

Yes, many of those kinds of items available at drugstores and pharmacies, including first‐aid kits, hearing aid supplies, foot therapy supplies and diabetic management supplies, and will remain eligible without a need for additional supporting documentation..

 

Is there a list of expenses that will help me determine what OTC expenses are eligible without additional supporting documentation and which require additional documentation?

 

Yes, Ceridian provides an expense eligibility list to help you determine which expenses are eligible for reimbursement under your HFSA, including additional documentation requirements.

 

Will I need supporting documentation to be reimbursed for my insulin purchases?

 

No. Insulin receives special treatment and remains eligible without additional supporting documentation.

 

Is there a special form I should use to request reimbursement of an OTC drug or medicine?

 

If your pharmacist fills your OTC drug you can submit a receipt with the RX number; you donít need to submit a form. If you canít submit a receipt with an RX number, you must submit a completed Ceridianís Physician Statement form along with the receipt. You must use Ceridianís Physicianís Statement form, which includes the necessary language to establish the expense was prescribed under state law.

 

My doctor wants me to take an aspirin each day. Canít I be reimbursed for this over‐the‐counter purchase?

 

Yes. The new law specifies that OTC drugs and medicines, including common pain relievers such as aspirin, will be eligible for reimbursement with supporting documentation such as a Ceridian Physicianís Statement form or evidence that a prescription has been filled for the OTC expense.

 

My plan offers a benefits card. Will I be impacted?

 

Effective January 1, 2011, benefits cards linked to health care FSAs and other tax‐advantaged health accounts will be prohibited from automatically approving or substantiating OTC drug and medicine purchases unless you present a prescription to the pharmacist and request that they fill the OTC item as a prescription behind the counter. Once filled, you may use your benefits card to purchase your prescribed medicine(s). home

 

 

Questions on "adult children" as eligible individuals

 

What is the definition of an "adult child?"

 

The new category of adult child is similar to but distinct from a tax dependent: an adopted or natural son, daughter, stepson, stepdaughter or foster child of the participant until the end of the calendar year in which the adult child turns 26.

 

My adult child no longer lives with me. Can I still be reimbursed for my out‐of‐pocket cost for their medical care?

 

Yes, even though your adult child no longer resides with you, you may be reimbursed from your HFSA for the eligible expenses you incurred on their behalf.

 

How do I know whether my HFSA covers adult children?

 

Your employer is allowed but not required to provide HFSA coverage to adult children. Contact your human resources department to determine whether your HFSA includes this coverage. home

 

 

 

 

Revised 6/10/2011