FSA_HSA_HRA_Renewal

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1Employer Details

2Benefits: Basics

3Contact Details

4Benefits: Advanced

5Renewal: Payroll Changes

6Renewal: Preferences

7Submission Summary

8Renewal: Confirmation

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Employer Details

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Open Enrollment FAQ for Employers and Brokers

Employer Name*

Benefits: Basics

Open Enrollment FAQ for Employers and Brokers

Which benefits do you have with Admin America, Inc.?

Check all that apply

Medical FSA

Dependent Care FSA

Limited Purpose FSA

Transit / Parking FSA

HRA

HSA

Enrollment Census templates and Election forms can be found here:

Broker & Employer Resources

Admin America FSA Benefit Renewal Date

Do you need to Change your Renewal Date?

FSA Plan Years can be a maximum of 12 months. If you need to adjust a renewal year, a short plan year may be required. FSA plan years are often aligned with Medical Insurance renewal.

Short PY Start Date

Should be your current Renewal Date

Short PY End Date

Date short plan should end. Should be day prior to the new target Renewal date.

Will you allow new elections for the Short PY?

FSA Max Election amounts must be pro-rated for Short plan years.

Admin America HRA Benefit Renewal Date

Admin America HSA Benefit Renewal Date

Which of the below applies to this renewal?

Our Admin America Inc benefits have NOT changed and should be continued "as-is" (note: this excludes election and enrollment changes)

Our payroll schedule(s) have NOT changed

Our main contacts have NOT changed

Should the plans be adjusted to reflect the updated IRS Maximum

Yes- update to new IRS maximum

No- Leave at current maximum

Other

Pre-Tax Benefits: Choose benefits that are offered by the employer and taken from employee pay before taxes.

Medical Insurance

Dental Insurance

Vision Insurance

Accident Insurance

Hospital Indemnity Insurance

Critical Illness Insurance

Cancer Insurance

Group Term Life Insurance

Short-Term Disability Insurance

Long-Term Disability Insurance

Adoption Assistance

Other

Contact Details

Open Enrollment FAQ for Employers and Brokers

Contact Name

First Last

Contact Type

Broker Contact

Employer Contact

Contact Title

Contact Email

Contact Phone

Contact Phone Extension

Benefits: Advanced

Open Enrollment FAQ for Employers and Brokers

Do you allow your participants to elect up to the IRS maximum for the Medical FSA benefit?

What is the maximum amount you allow your participants to contribute to the Medical FSA per plan year?

Do you allow your participants to elect up to the IRS maximum for the Dependent Care FSA benefit?

What is the maximum amount you allow your participants to contribute to the Dependent Care FSA per plan year?

Do you allow your participants to elect up to the IRS maximum for the Limited Purpose FSA benefit?

What is the maximum amount you allow your participants to contribute to the Limited Purpose FSA per plan year?

Do you allow your participants to elect up to the IRS maximum for the Transit / Parking FSA benefit?

What is the maximum amount you allow your participants to contribute to the Transit / Parking FSA per month?

Does the employer contribute to any FSA benefit?

Yes

Is the employer contribution uniform or conditional / variable?

How much does the employer contribute to the Medical FSA benefit for the benefit year?

How much does the employer contribute to the Dependent Care FSA benefit for the benefit year?

How much does the employer contribute to the Limited Purpose FSA benefit for the benefit year?

How much does the employer contribute to the Transit / Parking FSA benefit for the benefit year?

How long is your run out?

Run out refers to the final filing date, or how many days after the plan year end date participants may submit prior year claims for reimbursement.

Do you allow rollover for your Medical FSA participants?

Yes

I want to learn more about roll over

How much will you allow to rollover to the following plan year?

IRS Maximum

Other

Do you allow grace for your Medical FSA participants?

Yes

I want to learn more about grace extension

Note, your run out must be equal to or greater than your grace period

How long is your grace period?

2 1/2 months (~75 days)

Other

Do you allow rollover for your Limited Purpose FSA participants?

Yes

No

How much will you allow to rollover to the following plan year?

IRS Maximum

Other

I want to learn more about roll over

Do you allow grace for your Limited Purpose FSA participants?

Yes

I want to learn more about grace extension

How long is your grace period?

2 1/2 months (~75 days)

Other

Do you allow grace for your Dependent Care FSA participants?

Yes

I want to learn more about grace extension

How long is your grace period?

2 1/2 months (~75 days)

Other

Would you like any Medical FSA rollover to enter into a Limited Purpose FSA account (the Medical FSA benefit year, Limited Purpose FSA benefit year, and/or the HSA benefit year must have the same benefit year start date in order to be eligible for this option)

This option applies to all participants moving from a Medical FSA plan into an HSA plan. This option must be uniform and cannot be applied on an individual basis.

Yes

Not Applicable

Which of the following apply to this renewal?

The medical insurance plan has changed

The medical insurance carrier has changed

The employee HRA responsibility has changed

The employee HRA reimbursement has changed

None of these apply

Other

Please complete an HRA Amendment Form
HRA Plan Amendment Abstract

Do you allow HRA funds to rollover to the next year?

Yes

How much do you allow to rollover?

Remaining Balance

Other

Is there a maximum HRA balance (including any rollover amounts)?

Yes

What is the maximum HRA balance (including any rollover amounts)?

Individual Maximum

Individual + Spouse

Individual + Child(ren)

Family

Renewal: Payroll Changes

What is the first paycheck date after the start of the benefit year that deductions will be taken?

All deduction dates must occur within the corresponding benefit year

Date

Payroll Frequency

Which payroll frequency has changed?

Old Payroll Frequency

New Payroll Frequency

Renewal: Preferences

Open Enrollment FAQ for Employers and Brokers

Do you have a file feed with an outside EDI Vendor setup with Admin America, Inc for your benefits?

Yes

What is an EDI Vendor?

Who is your EDI Vendor?

EDI Vendor Name

Please review your plan settings with Employee Navigator. If you send COBRA data through Employee Navigator and you are setup with COBRA only, your open enrollment information will need to be submitted to Admin America, Inc. outside of Employee Navigator.

Are all of your Admin America, Inc benefits setup with EDI?

Yes

Which Admin America, Inc benefits do you have setup with EDI?

Medical FSA

Dependent Care FSA

Limited Purpose FSA

Transit / Parking FSA

HRA

HSA

Do you use your own or your broker's online BenAdmin system to collect Admin America, Inc elections?

This excludes the Admin America, Inc consumer portal online enrollment option.

Yes

Do you use your own or your broker's online BenAdmin system for enrollments not sent through EDI?

Yes

Do you want to allow your participants to elect their Admin America FSA benefit(s) through their Admin America Participant Portal?

This option is available for current participants only.

Yes

What is your estimated enrollment submission date to Admin America, Inc?

How will you submit enrollments to Admin America, Inc?

If you are submitting a census, you do not need to submit forms.

I will enter the enrollments through the Admin America, Inc Employer Portal

I will submit a completed Admin America, Inc census template

I will submit completed Admin America, Inc enrollment forms

Download the Employer Portal Guide by clicking on the link below.

Instructions on how to add a new participant and enroll them in a plan can be found on pages 27-31.

Instructions on how to search for a participant already in the system can be found on page 32.

Instructions on how to enroll a participant already in the system into a plan can be found from the last bullet point on page 28-31.

Employer Portal Training Guide

How will you submit enrollments to Admin America, Inc that do not come over EDI?

If you are submitting a census, you do not need to submit forms.

I will enter the enrollments through the Admin America, Inc Employer Portal

I will submit a completed Admin America, Inc census template

I will submit completed Admin America, Inc enrollment forms

Download the Employer Portal Guide by clicking on the link below.

Instructions on how to add a new participant and enroll them in a plan can be found on pages 27-31.

Instructions on how to search for a participant already in the system can be found on page 32.

Instructions on how to enroll a participant already in the system into a plan can be found from the last bullet point on page 28-31.

Employer Portal Training Guide

Submission Summary

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Renewal: Confirmation

Your Email

Enter your name below to acknowledge that you are renewing with Admin America, Inc and the information you have submitted is accurate. Inaccurate information submitted to Admin America, Inc. that results in an audit will incur an audit fee of $150.00 per audit hour.

Submission Date