Flexible Spending Account Rules & Regulations

Flexible Spending Rules

Flexible Spending Account Rules

Flexible Spending Account rules are established by the IRS.  You, your employer, and the adminstrator are jointly responsible for knowing and applying these rules. The most important rules pertaining to growing families are:

  • Use it or lose it - growing families often have predictable expenses
  • Changing elections  - you must have a qualifying event
  • Qualifying life events - birth of a child is a qualifying event; a key factor in pre term delivery

Growing families have needs to fit FSA rules and regulations like a glove.  Often they have lots of predictable medical expenses they are sure will be spent.  And when surprised with unexpected hospital bills from a stay in Neonatal Intensive Care (NICU) they can change elections to help save money on these expenses.

FSA Eligible ExpensesFSA Eligible ExpensesPredictable medical expenses are most suitable for use in an FSA due to the use it or lose it rule. Only contribute what you are sure you will spend in the next 12 months. Growing families often have plenty of predictable expenses for infertility, prenatal care, baby delivery, well baby care, and much more. Explore the many ways you can save money.

Flex Spending Rules - Use it or Lose it

When you contribute pretax dollars to a Flexible Spending Account, you lower your taxable income; therefore, you generate tax savings and increase your spendable income.   Any reduction in your taxable pay may also lead to a reduction in your Social Security benefits; however, for most employees, the reduction in Social Security benefits is insignificant compared to the value of tax savings today. 

If you contribute dollars to a Flexible Spending Account and do not use all of the monies you deposit, you will lose any remaining balance in the account at the end of the plan year.  A very important thing to remember...the rule exists because the IRS has established strict guidelines on plans with tax savings.  So estimate carefully the amount you want to contribute to the FSA, and only contribute dollars you're confident will be used before the end of the plan year.

FSA Rules - Qualifying Life Event

A Qualifying Life Event falls into one of the categories below, and allows you to make changes to your annual elections: 

  • Change in legal marital status
  • Change in number of dependents for example birth of a child
  • Change in employment status
  • Dependent satisfies (or ceases to satisfy) eligibility requirements
  • Change of residence
The birth of your newborn baby is a qualifying event.  Why does this matter?  12% of pregnancies deliver pre-term and many premature infants spend unplanned time in a NICU.  Many families will be left with large unpaid hospital bills.  Many insurance plans have hospital deductibles, and other extra amounts that subscribers must pay out of pocket during these situations.  

Parents should not contribute funds to an FSA just in case this happens.  However if your child does need to be confined, FSA rules allow you to increase your contribution.  Moving quickly allows parents to save 1/3 or more on these crippling expenses.

Baby Delivery CostsBaby Delivery CostsCut NICU Hospital bills from uncovered medical costs such as extra hospital deductible, extra hospital co pay, co-insurance, out-of-network charges, amounts over usual customary & reasonable, maximum out of pocket, and policy limits

Flexible Spending Account Rules - Changing Elections

The latest set of cafeteria plan regulations develops a process for determining if a participant is allowed to make a change in election during the plan year.  The two step process is:

  1. A change in status must have occured.
  2. The participant's election change must be consistent with the status change event
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