Open Enrollment FAQ for Employers and Brokers

Annual Limits

What is the federal maximum contribution for the Medical FSA and Limited Purpose FSA? (plan must begin 01/01/2018 or later to apply)

    The current federal maximum for these plans is $2650.00.

What is the federal maximum contribution for the Dependent Care FSA?

    The current federal maximum allowable for Dependent Care FSA is $5000 per household in a calendar year.

What is the federal maximum contribution for the Transportation FSA and Parking FSA? (plan must begin 01/01/2018 or later to apply)

    The current federal maximum for Transit and Parking plans is $260 per month.

Plan Setup & Design

Can an employer contribute to employees’ accounts?

  • Employers can contribute up to $500 unmatched to a participant’s General Purpose Medical FSA account.
  • Employers may also contribute to Limited Purpose FSAs, Dependent Care FSA and Transportation accounts as well.

How do I report an employer contribution to employees’ accounts?

What is the difference between grace, rollover, and filing period?

    The Grace Extension period allows up to 75 days after the plan year ends to incur expenses to spend down prior year funds.
    FSA Rollover allows for participants to roll over up to $500 (dependent on plan parameters) of any remaining funds at the end of the plan year into the next plan year. The rollover funds become part of their new plan year election. Participants do not necessarily have to elect for the new plan year to access rollover funds, providing they are still eligible for FSA benefits.
    The Filing Period is the timeframe after the plan year ends that allows participants to file any claims against the prior plan year for services incurred within that plan year.

Can a FSA plan have both rollover and a grace extension?

    No, the Medical FSA or Limited Purpose FSA cannot have both a rollover and a Grace Extension applied. However, a filing period is typically applied in addition to a rollover or grace extension.

Which plans can allow a grace extension?

    Grace Extensions can be applied to Medical FSA, Limited Purpose FSAs and Dependent Care FSA plans.

Which plans can rollover apply to?

  • Rollover can be applied to Medical and Limited Purpose FSA plans.
  • Dependent Care FSA plans are not eligible for rollover.
  • Transportation plan balances will rollover month-to-month so long as the participant is an active employee.

What is a short plan year and why would I need one?

    A short plan year is a plan year that is not a full twelve months. They are typically used to align an FSA/HRA plan year to a new benefit plan year or when a renewal date for a benefits plan year changes.
    FSA Short Plan Year rules:

    • Short plan years must be proceeded and followed by a 12 month plan year.
    • Plan year maximums must be pro-rated.

How do I request a short plan year?

What is an EDI Vendor?

    EDI stands for Electronic Data Interface. An EDI vendor is typically a payroll company or other third party who sends demographic and enrollment updates to Admin America, Inc electronically through use of a file feed.

Open Enrollment Materials

What forms do I need for open enrollment?

  • For open enrollment forms click HERE and scroll down to the Broker & Employer Resources section.

I would like access to a list of eligible expenses for the Medical FSA, Limited Purpose FSA, and HSA

  • A quick list of common Medical FSA Eligible/Ineligible expenses can be accessed here.
  • A comprehensive list of IRS eligible Medical FSA and Limited Purpose FSA expenses can be accessed here.
  • A comprehensive list of IRS eligible HSA expenses can be accessed here.

Do I need to submit summary of benefits (SBCs) every year? Why?

    Yes. SBCs are utilized by Admin America to help substantiate copays and reduce documentation requests for FSA plans. They also allow us to update carrier information in TPA Stream. For HRA, they help integrate plan design with the Medical Plan and assist with understanding how the plans work together.

What is PHI?

    PHI stands for Protected Health Information and refers to sensitive individually identifiable health information. Protecting PHI is a major provision of the Heath Insurance Portability and Accountability Act (HIPAA.)

What is a PHI Form and why is it needed?

    The PHI Form is a form that allows the participant to grant permission for another, such as a spouse or dependent, to inquire and receive information regarding their account. Admin America will not release information specific to the participant’s account to another without a PHI form on file specifically naming those authorized to receive information.

Does the employee need to sign a PHI form for providers?

    No, Medical providers are considered Covered Entities under HIPAA law and as such are a direct source of PHI and have a direct relationship already with individuals with regards to their PHI. Admin America will not require additional permission to release information to them. However, providers require permission from a participant to release information to Admin America directly.

Does the employee need to sign a PHI form for the employer or broker?

    No, as the Plan Sponsor or a Business Associate, both are required to be HIPAA compliant and required to safeguard PHI.

What is non-discrimination testing? How do I request my plan be tested?

    Non-Discrimination Testing is done to ensure that your flexible benefits plan is in compliance with the various nondiscrimination requirements imposed by the Internal Revenue Service. Exemptions can apply.
  • Information is required to perform the testing. The test form would need to be completed and emailed to
    enroll@adminamerica.com
    • You can access the test form here
  • Is my plan exempt from non-discrimination testing?

      If you have fewer than 100 employees and contribute towards premiums for a group health plan that is made available to your employees, this testing does not apply to you.

    I would like access to the FSA & HSA Store fliers

    I would like to request open enrollment posters for my office

    Can I submit open enrollment material after the dates listed on the open enrollment calendar?

      You may submit Open Enrollment information after the dates listed on the open enrollment calendar, however please be aware that there may be delays in when the cards are mailed, or when the elections become available for use dependent on when the information is received.

    Where do the Admin America, Inc open enrollment calendar dates come from?

      Enrollment dates are determined by Admin America based on a number of factors, including but not limited to:

      • Vendor/Card Fulfillment deadlines
      • Renewal Dates
      • Known Enrollment Volume