: Allison Schoening receives a periodic statement from the FSA in VS .NET

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Example: Allison Schoening receives a periodic statement from the FSA
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plan administrator, informing her that she still has $250 of funds left in her cafeteria plan account with one month to go before the plan year-end Accordingly, she accelerates the purchase of several prescriptions at the local pharmacy on the last day of the plan year, even though she will not need the medication for some time to come Because this action is acceptable under the cafeteria plan rules, reimbursement of the late purchases from the fund are approved and she does not lose any funds from her FSA account
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Another problem for employees is that contributions into an FSA plan are treated as separate pools of funds if they are intended for medical expense reimbursements or for dependent care reimbursements Cash from these two types of funds cannot be mixed For example, if an employee contributes too much money
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152 / Accounting for Payroll
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into a dependent care account and cannot use it all by the end of the plan year, these funds cannot be shifted to other uses, such as the reimbursement of medical expenses A problem for employers offering an FSA cafeteria plan is that employees may legally make claims against the fund that exceed the amount they have thus far contributed to the plan, and then quit the company if so, the business cannot seek recompense from the individual for the difference between the amount contributed into the fund and the amount paid out A company cannot alleviate this potential problem by forcing employees to accelerate the amount of their contributions beyond the preset amount
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Example: Mr Adolph Armsbrucker contributes $100 per month into the company s FSA fund, which will result in a total contribution of $1,200 at the end of the year However, he submits expenses to the plan administrator of $550 in February, for which he is reimbursed He has only contributed $200 into the fund at this point, so the company is essentially supporting the fund for the difference between $550 in expenses and $200 in funding, or $350 Mr Armsbrucker leaves the company at the end of February, leaving the company with this liability
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The favorable tax treatment accorded to participants in a cafeteria plan is only available if the plan passes several nondiscrimination tests First, a plan must have the same eligibility requirements for all employees; this involves avoidance of giving plan participation solely to highly compensated employees and having a standard term of employment prior to participation in the plan (not to exceed three years) Second, all plan participants must have equal access to the same nontaxable benefits offered under the plan Finally, no more than one-quarter of all nontaxable benefits provided under the plan can be given to key employees
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This can include medical, dental, vision, and life insurance Deductions are usually taken from every paycheck to help defray the cost of the insurance, either in part or in total A company may contribute to this cost by paying for some portion or all of the insurance itself Even if employees pay the entire amount of the insurance, it is still usually less expensive than if they had obtained it themselves, since insurance companies generally quote lower prices to businesses employing a number of people The contribution made by the company to defray the cost of medical insurance is not considered income to employees Furthermore, if the company has a medical expense reimbursement plan under which employees can be reimbursed for any out-of-pocket medical expenses that they incur, these additional payments are also not considered income to employees
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Company announces at the company business party that all co-payments and deductibles on its medical insurance plan for the upcoming year will be paid by the company These reimbursements are not taxable income to the employees
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The most common ways to provide medical insurance are through the Health Maintenance organization (HMO), Preferred Provider Organization (PPO), and Point of Service (POS) plan The HMO arrangement requires employees to go to designated doctors who have signed up to participate in the plan The PPO option allows employees to consult with doctors outside of the group of designated doctors, but at a higher cost in terms of co-payments and deductibles The POS plan requires employees to choose a primary care doctor from within the HMO network of doctors, but they can then see doctors outside the HMO s network, as long as the primary care doctor is still the primary point of contact Given the high cost of medical insurance provided by third parties, some organizations are turning to self-insurance plans Under this approach, employee medical claims are submitted directly to the company or a third-party administrator, with the claims in either case being paid by the company Once total claims reach a certain point, a stop-loss insurance policy takes over and pays all remaining claims This stop-loss coverage prevents the company from incurring inordinate losses by providing umbrella coverage for major insurance claims This approach eliminates the profit that would otherwise be charged by a third-party medical provider, while also allowing the company to exert more control over employee claims A key drawback to this arrangement is that, if the plan s benefits are skewed in favor of highly compensated employees, the excess medical payments made on behalf of this group will be considered income to them for tax reporting purposes Excess payments are considered to be those payments paid that exceed the level of payments made to other employees in the plan In order not to be considered discriminatory, a self-insured plan should include at least 70 percent of all employees
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