Common Participant Questions Related to COVID-19

To our participants:

Update 7/30/20: As a result of the disruption caused by the COVID-19 virus, the regulatory agencies have provided relief for certain FSA, HRA, and COBRA deadlines discussed below. The relief applies during an “Outbreak Period” defined as March 1, 2020 until 60 days after (a) a yet-to-be announced end of the COVID-19 national emergency, or (b) an end date announced by the agencies, which is not to extend beyond March 1, 2021. The Outbreak Period is disregarded when determining certain standard deadlines. Any mention below of Outbreak Period refers to this definition. We will share the exact end date of the Outbreak Period as soon as we have that information. Additionally, due to the COVID-19 national emergency, the IRS has provided relief for certain FSA plans during 2020. We have updated our frequently asked questions list below to include information about the COVID-19 relief provided by the agencies.

Update 3/31/20: The CARES Act, passed by Congress on Friday afternoon in response to the COVID-19 crisis, includes a provision that allows reimbursement of OTC drugs and medicines without a prescription. You can read more about this in our blog post, and we’ve added some questions and answers below regarding this important change.

3/27/20: While many things have changed due to the COVID-19 health crisis, the rules regarding the plans we administer for you largely remain the same at this point.  We continue to monitor any changes to applicable rules and regulations and will update you if and when guidance is released.  We have compiled a list of answers to some questions we have been asked frequently by participants since the beginning of this crisis, and will continue to update this list as we encounter new common questions or changed regulations. If you don’t see your question answered below, or if you need more information, please do not hesitate to contact us – we’re here to help!

 

Q: Are face masks and medical gloves Health FSA-eligible?

A: We have recently received many questions about the eligibility of face masks and gloves. Like many FSA questions, IRS rules have not specifically altered the eligibility of these items under the pandemic. However, based on the IRS rules for these items, we recommend following the CDC guidelines recommending the use of masks for the prevention of spreading illness during the pandemic. As such, masks will be eligible without a Letter of Medical Necessity (LMN) during the pandemic. A receipt or documentation is, of course, required for any expense that does not automatically approve; and “stockpiling” is still not allowed. Latex gloves are not part of the CDC’s recommendations – currently, handwashing is the protocol. Gloves would still need a Letter of Medical Necessity in order to be eligible. For more detail on this question, see our FAQ on the topic.

CARES Act – Over-the-Counter Drugs and Medicines Questions

Q: What changed regarding reimbursement of over-the-counter drugs and medicines due to the CARES Act?

A: The CARES Act, a landmark stimulus bill passed by Congress on 3/27/20, includes a provision repealing an ACA rule from 2010 that required a prescription for reimbursement of over-the-counter (OTC) drugs and medicines from Health FSAs, HSAs, and certain HRA plans that include all IRS-allowed out-of-pocket medical/dental/vision expenses. This is retroactive to the beginning of the year, so any OTC drugs and medicines (such as pain relievers, cold and allergy medicines, acne treatments, and many others) purchased since 1/1/20 and within your current plan year are now reimbursable without a prescription. Also, the CARES Act added menstrual care items to the eligible items list.

Q: When will I be able to use my ProBenefits debit card to purchase OTC drugs and medicines?

A: The master eligible items list used by most merchants around the country is expected to be updated with over 20,000 newly-eligible OTC drugs and medicines and menstrual care items by April 15th, 2020. At that point, each merchant will be responsible for updating their internal systems with the new information. Additional items will continue to be reviewed and added to the master list in the coming months. Due to the rather massive nature of this change, it is likely that your experience using your card for these items will be inconsistent in the near future; however, we expect that it will improve quickly. And in the meantime, you may purchase these items out-of-pocket and submit a Health FSA or HRA (if applicable) reimbursement claim or HSA distribution request on our web portal or mobile app.

Q: What about claims that have been denied for OTC drugs and medicines already this year, because I didn’t have a prescription?

A: If you have previously-denied claims for OTC drugs and medicines purchased since 1/1/20 and during your current plan year, please re-submit them and we will happily process them for you under the new rules.

Q: What about vitamins and supplements, and OTC non-drug items like bandages?

A: Vitamins and supplements require a Letter of Medical Necessity for reimbursement, not a prescription; this requirement has not changed. Non-drug OTC medical supplies and equipment such as bandages and thermometers did not previously require a prescription or Letter of Medical Necessity (unless the item was dual-purpose), and this has not changed either.

Health and Dependent Care FSA Questions

Q: What relief has been provided for Health FSA participants to submit claims and use remaining funds that may have been earmarked for a service or procedure that was cancelled or delayed?

A: Generally, participants can only be reimbursed for expenses incurred during the applicable plan year (or grace period) and submitted prior to the end of the 90-day runout period at the end of the plan year or following termination of participation. In response to the COVID-19 national emergency, the regulatory agencies have provided relief extending the deadline to submit claims during the Outbreak Period for all Health or Limited Dental/Vision FSA plans ending in 2020 and for any Health or Limited Dental/Vision FSA plans ending 10/31/19 through 12/31/19 with the grace period feature. Because we do not currently know the end date for the outbreak period, we have extended the deadline to at least 8/31/20 in our system, and will continue to adjust as needed until we know the final date.

Additionally, if adopted by your plan, relief has been provided extending the deadline to incur expenses to 12/31/20 for Health or Limited Dental/Vision FSA plans ending in 2020 and for any Health or Limited Dental/Vision FSA plans ending 10/31/19 through 12/31/19 with the grace period feature. If the deadline to incur expenses has been extended to 12/31/20 for your plan, then the deadline to submit claims will be at least 12/31/20 as well, and may be longer depending on the duration of the Outbreak Period. Note that your plan must adopt an amendment to allow the extension of the deadline to incur expenses. If your plan did not adopt the claims incurred deadline extension, or if your plan ended 12/31/2019 and did not have the grace period feature, you may continue to submit claims during the Outbreak Period, although all dates of service must be within the standard plan year.

To see the Final Filing Date and Final Service Date for your plan, hover your mouse over the question mark next to the benefit in the Accounts section of your home page on the web portal, or tap on the benefit name in the My Accounts section on the mobile app.

These extensions will help you avoid forfeiting contributions that remain unused from the affected plan years. This is temporary relief. Future plan years and other deadlines that extend beyond 12/31/20 currently remain unchanged. Please keep this extension in mind when making new elections.

As always, we encourage you to go ahead and submit reimbursement claims for any other expenses you have already incurred during the plan year. Even if your provider’s office is currently closed, you may be able to access EOBs or prescription purchase logs online and submit those for reimbursement. You may also consider purchasing eligible items from the FSA Store or other merchants to use up some of your funds. And your plan may offer a grace period or carryover to allow you to use some funds from this plan year during the next plan year.

Q: Can I change my Health FSA election mid-year without a qualifying event?

A: Because of the disruption caused by the COVID-19 virus, your plan may adopt an amendment to allow you to increase or decrease your Health or Limited Dental/Vision FSA election during the 2020 calendar year even if you do not experience a qualifying life event. Any change must be prospective, and you cannot decrease your election below the amount you have already contributed or the amount you have already been reimbursed for expenses, whichever is higher. This is temporary relief for the 2020 calendar year only. After 2020, you will not be permitted to make election changes without a qualifying event. If your plan did not adopt this amendment, the standard election change rules apply.

Q: Is deadline relief available to Dependent Care FSA participants?

A: Due to the COVID-19 pandemic, your plan may adopt an amendment to extend the deadlines to submit claims until 12/31/20 for any Dependent Care FSA plan ending in 2020. This also effectively extends the claims runout period for Dependent Care FSA plans to 12/31/2020. This extension will help you avoid forfeiting contributions that remain unused from the plan year ending in 2020. This is temporary relief. Future plan years and other deadlines that extend beyond 12/31/20 currently remain unchanged. Please keep this extension in mind when making new elections. As always, we encourage you to go ahead and submit reimbursement claims for any other expenses you have already incurred during the plan year.

Q: If my dependent care needs have changed, can I change my election mid-year?

A: There are qualifying events that will allow you to change your dependent care election during the plan year. These include:

  • Change in employment status or change in employment location (e.g., move from full-time to part-time or move to working remotely)
  • Loss of eligibility (e.g., reduction of hours)
  • Commencement of FMLA and return to work following FMLA
  • Daycare provider is closed/opens

In addition, because of the disruption caused by the COVID-19 virus, your plan may adopt an amendment to allow you to increase or decrease your Dependent Care FSA election during the 2020 calendar year even if you do not experience a qualifying event. Any change must be prospective, and you cannot decrease your election below the amount you have already contributed or the amount you have already been reimbursed for expenses, whichever is higher. This is temporary relief for the 2020 calendar year only. After 2020, you will not be permitted to make election changes without a qualifying event. If your plan did not adopt this amendment, the standard election change rules apply

Before you decide to make a change to your election, be sure to calculate the expenses you’ve incurred so far during the plan year. If you’ve already incurred expenses equal to the amount of your election for the plan year, you can submit those claims and continue to be paid out as your contributions are made.

Q: I can’t get the requested documentation for my debit card purchase because my provider’s office is currently closed. Can I have more time?

A: Yes, please contact us and we will happily extend the deadline for you to submit documentation.

Q: What happens if my Health FSA participation terminates?

A: Generally, participants can only be reimbursed for expenses incurred prior to termination of participation and submitted prior to the end of the 90-day runout period following termination of participation. However, in response to the COVID-19 national emergency, the Outbreak Period will be disregarded when determining the end of the 90-day runout deadline.

The practical result of this extension is any Health or Limited Dental/Vision FSA participant whose participation terminates after 12/1/19 can, at present, continue to submit claims incurred prior to termination and can continue to do so throughout the Outbreak Period. If you are unable to enter your claim online or on the mobile app, please contact us for assistance. As always, we encourage you to go ahead and submit reimbursement claims as soon as possible. There is no runout extension for terminated Dependent Care FSA participants.

HRA Questions

Q: Have any HRA deadlines been extended?

A: Yes. Because of the disruption caused by the COVID-19 virus, the deadline to submit claims for certain plans has been extended. Participants of any HRA with a plan year or end of year runout that extended beyond 3/1/20 may continue to submit claims during the Outbreak Period for expenses incurred during the plan year even though the standard 90 or 180-day end of year runout may have expired.

HSA Questions

Q: Can I change my HSA contributions for the current plan year? Can I still make contributions for the 2019 tax year?

A: HSA contributions can be changed on a prospective monthly basis.  No change event is required.  Contributions may be made to your HSA for a particular year, at any time during the year or by the due date for filing your return for that year.  Because the IRS granted relief extending the deadline to file Federal income tax returns to July 15, 2020, under this relief, you may make contributions to your 2019 HSA at any time up to July 15, 2020.

COBRA Questions

Q: I am on COBRA. Have my premium payment deadlines changed?

A: Yes. Standard deadlines for COBRA premium payments due during the Outbreak Period are suspended. Although you will receive a termination of coverage notice if you do not make payments within the standard deadlines, your coverage will be retroactively reinstated if you subsequently make payment within the extended deadlines provided by the COVID-19 relief. See the example below for illustration.

The extended due dates for premium payment will be either 45 or 30 days after the end of the Outbreak Period depending on whether you are making an initial or subsequent monthly payment respectively. If possible, we encourage you to make payments on the normal monthly schedule to prevent any delay in claims processing by the insurance carrier or any potential hardship for you if multiple payments become due at one time in the future. If you receive a termination of coverage notice and have questions about the amount of premium due or reinstatement of your COBRA coverage, please contact our team.

Example: You are an active COBRA participant with monthly premium payments due by the first of the month. The premium payment for April 2020 is timely submitted, but you are unable to make your monthly premium payments for May, June, and July. You receive a termination of coverage notice due to non-payment after missing the May payment. After the end of the Outbreak Period, you will have 30 days to make premium payments for the months of May, June, and July. If you timely make payment, you will have COBRA coverage reinstated for these months.

Please note that COBRA coverage must be continuous. You cannot selectively choose which months you have coverage. For example, if you do not make payments for May, June, and July, and you then incur a large claim in August, you will be required to pay all outstanding months before coverage will be effective for August. Also, if you wait to make any payments until the end of the Outbreak Period, you will have a large amount due in order to ensure coverage of current and prior claims and expenses.

Q: My health coverage terminated, and I was offered COBRA. Has my deadline to elect COBRA changed?

A: Yes. Normally, you must elect COBRA within 60 days after the Election Notice is mailed to you. The Outbreak Period will be disregarded when determining your deadline to elect COBRA. If you experience a qualifying event March 1, 2020 or later, the new deadline to elect COBRA is 60 days after the end of the Outbreak Period. Once elected, all monthly premiums due must be paid in full in order to reactivate COBRA coverage. To prevent delay and ensure coverage, we encourage you to provide timely notice if possible.

Q: Have any other COBRA deadlines changed?

A: Yes. Normally, you must notify the plan within 60 days of certain COBRA qualifying events, second qualifying events (divorce or legal separation, a dependent child ceasing to be a dependent, death or Medicare entitlement), or if you are deemed disabled by the Social Security Administration and potentially eligible for a disability extension. The 60-day limit will not be enforced for any required notification that would normally be due during the Outbreak Period. To prevent delay and ensure coverage, we encourage you to provide timely notice if possible.

Transportation Plan Questions

Q: I have a transportation reimbursement plan, but now I’m working at home and don’t have transit or parking expenses. Can I change my election?

A: Yes, you can change transit and parking deductions on a prospective monthly basis.  No qualifying event is required.