Common Participant Questions Related to COVID-19

To our participants:

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 a previous ruling 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: 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

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: I was saving my Health FSA funds for a procedure or service that has been delayed or cancelled. What do I do?

A: Unfortunately, the IRS has not granted relief yet where employees have set aside FSA dollars for elective surgeries that have been cancelled due to the Coronavirus.  We hope this relief will be addressed.  In the meantime, 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: If my employment is terminated, what happens to my FSA?

A: For both Health and Dependent Care FSA, there is a terminated employee claims run-out period, generally 90 days, to submit claims with dates of service between the beginning of the plan year and the termination date.  For the Dependent Care FSA, participants terminating with positive Dependent Care account balances can continue to submit claims during the terminated employee claim run-out period for expenses incurred during the plan year or during the terminated employee claim run-out period.

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: No official guidance has been issued at this time extending the COBRA premium payment deadlines.  We do not have authority to extend the payment deadline.  If there is a hardship, you may file an appeal.

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.