HRAs

[Official Guidance] Text of IRS Rev. Rul. 2010-23: Making Obsolete the Existing Revenue Ruling on Reimbursement of Drug Expenses by FSAs, HRAs, HSAs, MSAs (PDF)
1 page. Excerpt:"Because the definition of medical expenses has been changed, the Internal Revenue Service has concluded that the ruling position stated in Rev. Rul. 2003-102 is no longer determinative. Accordingly, Rev. Rul. 2003-102 is declared obsolete as of the effective date of section 9003 of the Affordable Care Act."(Internal Revenue Service)

[Official Guidance] Text of IRS Notice 2010-59: Most Non-Prescription Drugs Purchased After 2010 Cannot Be Reimbursed from FSAs, HRAs (PDF)
6 pages. Excerpt:"The Affordable Care Act, enacted in March, established a new uniform standard that, effective Jan. 1, 2011, applies to FSAs and health reimbursement arrangements (HRAs). Under the new standard, the cost of an over-the-counter medicine or drug cannot be reimbursed from the account unless a prescription is obtained. The change does not affect insulin, even if purchased without a prescription, or other health care expenses such as medical devices, eye glasses, contact lenses, co-pays and deductibles."(Internal Revenue Service)

New IRS Guidance on Health Care Reimbursement
Excerpt:"The IRS said that Notice 2010-59 provides guidance on new section 106(f) of the Internal Revenue Code, added by section 9003 of the Affordable Care Act. That section sets forth a new standard, effective January 1, 2011, for reimbursement of expenses for over-the-counter drugs from all workplace health plans . . . ."(PLANSPONSOR.com)

[Opinion] Comments to HHS by Employers Council on Flexible Compensation, on Application of Patient Protection and Affordable Care Act to Health Reimbursement Arrangements (PDF)
4 pages. Excerpt:"Given that HRAs are not set up with a bright line annual limit and that they are most often used in conjunction with primary overage as a supplemental benefit, ECFC urges the agencies to exempt all HRAs from the prohibition on annual limits. The exemption should apply regardless of whether or not primary coverage is offered through the individual's employer or is obtained through another avenue, such as a spouse's employer."(Employers Council on Flexible Compensation)

[Opinion] Comments to HHS by Employers Council on Flexible Compensation, on Application of Patient?Protection?and?Affordable?Care?Act?to Health Reimbursement Arrangements (PDF) (PDF)
4 pages. Excerpt:"Given that HRAs are not set up with a bright line annual limit and that they are most often used in conjunction with primary overage as a supplemental benefit, ECFC urges the agencies to exempt all HRAs from the prohibition on annual limits. The exemption should apply regardless of whether or not primary coverage is offered through the individual's employer or is obtained through another avenue, such as a spouse's employer."(Employers Council on Flexible Compensation)

[Opinion] Comments to HHS by Employers Council on Flexible Compensation, on Application of Healthcare Reform to Healthcare Reimbursement Arrangements (PDF)
4 pages. Excerpt:"Given that HRAs are not set up with a bright line annual limit and that they are most often used in conjunction with primary overage as a supplemental benefit, ECFC urges the agencies to exempt all HRAs from the prohibition on annual limits. The exemption should apply regardless of whether or not primary coverage is offered through the individual's employer or is obtained through another avenue, such as a spouse's employer."(Employers Council on Flexible Compensation)

[Opinion] Comments to HHS by Employers Council on Flexible Compensation, on Application of PPA to Health Reimbursement Arrangements (PDF)
4 pages. Excerpt:"Given?that?HRAs?are?not?set?up?with?a?bright?line?annual?limit?and?that?they?are?most?often?used?in?conjunction?with?primary?overage?as?a?supplemental?benefit,?ECFC?urges?the?agencies?to?exempt?all?HRAs?from?the?prohibition?on?annual?limits.??The?exemption?should?apply?regardless?of?whether?or?not?primary?coverage?is?offered?through?the?individual's?employer?or?is?obtained?through?another?avenue,?such?as?a?spouse's?employer."(Employers Council on Flexible Compensation)

GAO Report on Consumer-Directed Health Plans: Health Status, Spending, and Utilization of Enrollees in Plans Based on Health Reimbursement Arrangements
Excerpt:"On average, enrollees in the HRA groups [that] GAO reviewed spent less and generally used fewer health care services before they switched into the HRA in 2003 than those who remained in the PPO, suggesting that the HRA groups were healthier. Average annual spending per enrollee for the . . . HRA group was $1,505 lower than the PPO group . . . ."(U.S. Government Accountability Office)

GAO Study Finds CDHP Enrollees Healthier Than Those in Other Health Plans
Excerpt:"A new Government Accountability Office . . . study of two large employers, one public and one private, finds that enrollees in consumer-driven health plans . . . with a health reimbursement arrangement (HRA) are healthier than employees who remain in traditional health plans."(PLANSPONSOR.com)

What Do We Really Know About Consumer-Driven Health Plans?
Excerpt:"Surveys show that employers offering a CDHP increased from less than 5 percent in 2005 to between 12?15 percent by 2009. Growth in offer rates can be seen across all firm sizes."(Employee Benefit Research Institute (EBRI))

[Guidance Overview] Centers for Medicare and Medicaid Services Updates HRA Coverage Reporting
Excerpt:"Among the issues addressed in the updated guide are references to changes in reporting for Health Reimbursement Arrangements (HRAs). CMS has removed all references from the updated guide that previously referred to reporting only for'free-standing'HRAs."(Fisher&Phillips LLP)

[Guidance Overview] Cafeteria Plans, HRAs and Health Care Reform
Excerpt:"This article will explain which PPACA requirements impact HRA and/or Cafeteria plans. In the chart . . ., we summarize the main requirements that apply to HRA and/or Cafeteria plans and provide the effective dates of the requirements. Rules that apply differently to grandfathered plans are noted under the effective date . . . ."(CCH INCORPORATED)

[Guidance Overview] What Will Health Reform Mean for HRAs, HSAs, and FSAs?
Some changes to those account-based plans will be effective January 1, 2011. (PLANSPONSOR.com)

Changes Under Health Care Reform to the Cver-the-Counter Medicine Rules
Excerpt:"One provision that is effective fairly quickly is the change to the over-the-counter drugs/medicines rules in Flexible Spending Accounts (FSA), Health Reimbursement Arrangements (HRA) and Health Savings Accounts (HSA)."(TRI-AD)

[Guidance Overview] CMS Issues Alert on MSP Mandatory Reporting Requirements for HRA Coverage
Excerpt:"EBIA Comment: Although the alert states that it'provides updated information'about HRA reporting and reflects certain'refinements,'we note that that it does not make any substantive changes to the requirements since the issuance of the January 2010 CMS User Guide."(Employee Benefits Institute of America)

Health Savings Accounts and Health Reimbursement Arrangements: Assets, Account Balances, and Rollovers, 2006?2009 (PDF)
32 pages. Excerpt:"ASSET LEVELS GROWING: In 2009, there was $7.1 billion in consumer-driven health plans (CDHPs), which include health savings accounts (or HSAs) and health reimbursement arrangements (or HRAs), spread across 5 million accounts. This is up from 2006, when there were 1.2 million accounts with $835.4 million in assets, and 2008, when 4.2 million accounts held $5.7 billion in assets."(Employee Benefit Research Institute)

[Guidance Overview] IRS Clarifies Rules Regarding Adult Dependents
Excerpt:"[I]f an adult child turns 27 in any month of 2010, a Health FSA/HRA cannot reimburse any 2010 expenses for that adult child. However, expenses for adult children who are 26 or younger as of the end of the calendar year may be reimbursed if incurred on or after March 30, 2010. . . . [P]articipants who add an adult child dependent can increase their current year Health FSA election."(Infinisource)

[Guidance Overview] Health Care Reform Reshapes Tax Code; Several Employee Benefit Provisions Affected
Excerpt:"[A]mounts paid for over-the-counter medications will no longer be reimbursable from health savings accounts (HSAs), Archer medical savings accounts (MSAs), health FSAs, or health reimbursement arrangements. . . This provision is effective for amounts paid or expenses incurred after Dec. 31, 2010."(Journal of Accountancy)

[Guidance Overview] Health Accounts'Limits for Over-the-Counter Medicines Under Health Reform
Excerpt:"[R]eimbursements for over-the-counter medicines through a health FSA, HRA, or other employer-provided accident or health plan may not be excluded from the employee's gross income. Also, distributions from an HSA or Archer MSA to pay for over-the-counter medicines may not be excluded from the employee's gross income and will be subject to additional penalty."(Wolters Kluwer)

[Guidance Overview] Limitation of Distributions from Health Accounts for Over-the-Counter Medicines
Excerpt:"The definition of qualified medical expenses, for purposes of reimbursements from health flexible spending arrangements (health FSAs) or health reimbursement arrangements (HRAs), and distributions from health savings accounts (HSAs) or Archer medical savings accounts (Archer MSAs), has been modified to include amounts paid for medicine or a drug only if such medicine or drug is a prescribed drug (determined without regard to whether such drug is available without a prescription) or is insulin."(Wolters Kluwer)

Health Care Reform Bill Passes Without HRA Tax Parity Provision
Excerpt:"The health care reform bill recently passed by the House and Senate (H.R. 3590) does not include provisions to extend tax-free employer-paid coverage to nonspouse or nondependent beneficiaries. This would have provided tax parity to non-spouse/non-dependent individuals who qualify for and receive employer-provided health plan benefits."(ICMA-RC)

Health Reform Provisions that Could Impact Consumer-Driven Health Plans (PDF)
3 pages. Excerpt:"The health care reform legislation approved by the 111th Congress (H.R.3590, now Public Law 111-148, as amended by the budget reconciliation bill, H.R.4872) will likely have a modest impact on consumer-driven health plans and their associated health care accounts (i.e., FSAs, HRAs, and HSAs). Earlier proposals that would have eliminated some of these options (particularly FSAs and HRAs) did not survive the legislative process. [The target page] is a description of the provisions that were included in the final legislation."(The Council for Affordable Health Insurance)

Demystifying High-Deductible Health Plans
Excerpt:"[A]t least half of large employers offer a high-deductible plan. The figure in 2009 was 54 percent, according to the Health Care Cost Survey by Towers Perrin (now Towers Watson). The survey focused on Fortune 1,000 companies."(Workforce Management)

[Guidance Overview] Alzheimer's Expenses are Qualified Medical Expenses
Excerpt:"A recent information letter by the IRS addressed whether the monthly fee that is paid to an Alzheimer's medical facility is considered a qualified medical expense and in turn tax deductible."(Infinisource)

Which Consumer-Driven Health Care Option Should You Choose: HSAs, FSAs, HRAs? (PDF)
4 pages. Excerpt:"As the satisfaction of consumer driven health plans hasincreased over the years, the interest has grown significantly. Unfortunately, many consumers and employers are confused about the differences between the various consumer driven plans and which optionwould be best for them. The Council for Affordable Health Insurance (CAHI) first prepared this analysis in 2002 and has updated it annually in an effort to help people make informed choices about consumer driven health plans."(Council for Affordable Health Insurance)

[Guidance Overview] IRS 2010 Versions of Forms 1099-SA and 5498-SA for HSA, Archer MSA, and Medicare Advantage MSA Trustees and Custodians
Excerpt:"EBIA Comment: Remember that trustees and custodians should not use these 2010 forms until 2011, when reporting for the 2010 tax year is due. The 5498-SA and 1099-SA information returns -- together with account-related information provided by employers on Forms W-2 -- provide useful information to account holders, who have reporting obligations of their own."(Employee Benefits Institute of America)

[Guidance Overview] Updated Mandatory Reporting User Guide Clarifies and Eases HRA Reporting Requirements, Among Other Changes
Excerpt:"EBIA Comment: RREs and service providers involved with HRAs will welcome the partial exemption, no retroactive reporting, and clarifications about what constitutes an HRA for reporting purposes. Some questions still remain, such as those relating to concepts of free-standing and linked coverage and the meaning of HRA effective dates. Note: Other technical, non-HRA changes were made in the Guide that will be of interest to individuals on the front line of MSP reporting."(Employee Benefits Institute of America)

2009 Versions of HSA Reporting Form 8889 and Publication 969
Excerpt:"EBIA Comment: The absence of significant changes in these 2009 releases is what we expected, given that the rules governing HSAs, HRAs, and health FSAs have remained relatively stable this year. It will be interesting to see what changes may emerge in 2010 as part of any health care reform proposals that may be enacted, and to see whether the final cafeteria plan regulations will be issued."(Employee Benefits Institute of America)

House Passes Legislation on Health Reimbursement Arrangements
Excerpt:"Legislation that will provide tax parity to non-spouse/non-dependent individuals who qualify for and receive employer-provided health plan benefits passed in the House [in November]."(ICMA-RC)

[Guidance Overview] Decrease of 7.5 Cents in 2010 Mileage Rate for Transportation to Obtain Medical Care or as Part of Deductible Moving Expenses
Excerpt:"EBIA Comment: Transportation expenses that are deductible medical expenses under Code Section 213 generally form the basis for tax-free transportation benefits under a health FSA, HRA, or HSA. To simplify administration, some employers'health FSAs or HRAs exclude medical transportation expenses from the list of reimbursable items; if not excluded, such expenses may be reimbursed by health FSAs or HRAs at the 16.5 cents per mile rate for 2010. HSA account holders can also choose to use the standard mileage rate to calculate the tax-free distribution that they can take for medical transportation expenses that meet the Code Section 213 definition of medical care. But remember, the new rate doesn't apply until 2010."(Employee Benefits Institute of America)

[Guidance Overview] IRS's 2009 Version of Pub. 502 on Medical and Dental Expenses
Excerpt:"EBIA Comment: Pub. 502 provides valuable guidance on what qualifies as a medical expense under Code Section 213(d), and thus, certain information about which expenses can be reimbursed or paid by health FSAs, HSAs, or HRAs. However, using Pub. 502 to determine what expenses are reimbursable under these tax-favored vehicles must be done with caution, because Pub. 502 addresses only what expenses are deductible -- -it doesn't describe the different rules for reimbursing medical expenses under health FSAs, HSAs, or HRAs."(Employee Benefits Institute of America)

What Do We Know About Enrollment in Consumer-Driven Health Plans?
Excerpt:"This article summarizes the literature on CDHP offer rates and enrollment. The percentage of employers offering CDHPs has gone from virtually none in 2000 to 12 percent in 2009. Based on the various sources of data on enrollment in health reimbursement arrangements (HRAs) and HSA-eligible plans, it appears that 15?19 million people were enrolled in these plans in 2009, representing 9?11 percent of the privately insured market."(Employee Benefit Research Institute (EBRI))

Mercer Says'Cadillac Tax'Would Force Employers To Trim Health Insurance Costs
Excerpt:"Two-thirds of employers would raise deductibles, change insurers or scale back coverage to avoid the so-called Cadillac tax on high-cost benefits proposed in the Senate Democrats'health care bill, a survey to be released Thursday by consulting firm Mercer says. Among things employers might change or drop: flexible spending accounts, which are used to cover unreimbursed medical expenses, and dental or vision policies."(Kaiser Health News)

Employers Prefer HSAs in CDHP Offerings, According to Survey
Excerpt:"Among employers who offer a consumer-driven health plan (CDHP), health savings accounts (HSAs) continue to be the preferred funding choice, according to a survey by Aon Consulting and the International Society of Certified Employee Benefit Specialists. Of the 370 survey respondents, 44% of employers currently offer a CDHP to employees - similar to last year, according to a press release. Of those offering CDHPs this year, 56% are now using the HSA model, 35% are using the Health Reimbursement Arrangements (HRA) model, and 9% use both. Over the last three years, the gap has widened between HSAs and HRAs, as the number of employers offering HSAs has gone from 48% to 56%, and the number offering HRAs has dropped from 43% to 35%."(PLANSPONSOR.com; free registration required)

Employers Drop, Shift Contributions to Consumer-Directed Health Plans
Excerpt:"[E]mployees with family coverage in a CDHP saw their employer contributions rise this year. The percentage of workers with CDHP family coverage receiving an employer contribution of at least $1,000 stood at 79% in 2009, up from 59% in 2008. The share of the adult population enrolled in account-based health plans remains small and growing slowly, the survey confirmed. In 2009, 4% of adults with health insurance were enrolled in an HRA or had a high-deductible plan with an HSA . . . ."(Employee Benefit Adviser; free registration required)

Availability, Contributions, Account Balances, and Rollovers in Account-Based Health Plans, 2006?2009
Excerpt:"The share of the adult population with private health insurance enrolled in account-based health plans (so-called'consumer-driven'health plans, or CDHPs) remains small but continues to grow. In 2009, 4 percent of the adult population with private health insurance was enrolled in an health reimbursement arrangement (HRA) or had a high-deductible plan with an health savings account (HSA), up 1 percentage point from the previous year."(Employee Benefit Research Institute (EBRI))

[Guidance Overview] New IRS Considerations Regarding Over-the-Counter Items as Medical Care Expenses
Excerpt:"While the IRS guidance adds some certainty, it also reminds us that for many over-the-counter items, reimbursement cannot be automatic. If you decide to cover the expenses of dual-purpose items as part of your FSA or HRA benefit program, you must ask questions necessary to verify that those expenses are reimbursable medical expenses."(Warner Norcross&Judd LLP)

[Guidance Overview] Michelle's Law Amendments: HRA Plans and Cafeteria Plans with Health Care Reimbursement Accounts
Excerpt:"Tax/COBRA Treatment[:] Because Michelle's Law did not amend Code section 152, reimbursements for eligible expenses of dependents covered under Michelle's law that do not meet the definition of dependent under Code section 152 may be subject to tax. In addition, it is unclear whether COBRA coverage for'Michelle's Law'dependents is measured from the loss of student status or the loss of extended coverage provided by Michelle's law."(Fort William LLC)

[Guidance Overview] Requirement that Employees Complete Health Risk Assessments in Order to Receive HRA Reimbursements Violates the ADA
Excerpt:"The broadened scope of the definition of'disability'under recent amendments to the ADA . . . may cause more inquiries in health risk assessments to be viewed as disability-related and thus subject to scrutiny under the ADA. Formal guidance from the EEOC on the ADA's application to wellness programs is sorely needed. It also bears repeating that in addition to the ADA, wellness programs must also meet applicable HIPAA requirements and comply with GINA."(Employee Benefits Institute of America)

Making Sense of High-Deductible Health Plans
Excerpt:"If you and I are spending more of our own money on health care, then we are likely to ask doctors and hospitals many more questions upfront and be more careful about which tests and procedures we receive. After all, until we exhaust that high annual deductible, it's our money on the line. Employers are pushing these plans because they can save the company as much as 20 percent, compared with traditional insurance."(New York Times; free registration required)

[Guidance Overview] Summary of and Suggested Action Steps to Address the GINA Interim Final Regulations
10 pages. Excerpt:"Employers whose plans include wellness, health risk assessments and/or disease management will be most affected by the new rules. Detailed action steps will depend on the specifics of the employer's health care program, but some general action steps will apply to many group health plans: . . ."(Gallagher Benefit Services)

[Guidance Overview] GINA Impacts Employer Health Plans and Use of HRAs (PDF)
Excerpt:"While consideration may be given to eliminating requests for genetic information from any HRAs entirely, employers may alternatively consider bifurcating the HRA so as to eliminate requests for genetic information where premium rewards or rebates are offered, while offering a separate voluntary HRA that would request genetic information (without any rewards, and after open enrollment). While we understand that any design changes at this time of year may be disruptive to employers'health plan administration as well as the open enrollment process, these changes may nonetheless be necessary when such a significant regulation impacting wellness programs is issued so late in the year."(Aon Consulting)

[Guidance Overview] Red Flags Rule: Application to Health Flexible Spending Accounts, Health Reimbursement Arrangements, Dependent Care Assistant Programs and Transportation Plans
Excerpt:"Under the Red Flags Rule, certain businesses and organizations must establish and implement a written Identity Theft Prevention Program (ITPP). To comply with the Red Flags Rules, a written ITPP must have four basic elements . . . ."(Groom Law Group)

[Guidance Overview] DOL Staff Members Provide Informal Views on SPDs/SMMs and Issues Under the Davis-Bacon and Service Contract Acts
Excerpt:"The Joint Committee on Employee Benefits (JCEB) of the American Bar Association has reported on its May 7, 2009 Q&A session with DOL staff members. Highlights include unofficial, nonbinding remarks about these welfare plan topics: (1) SPD requirements when there is a change in federal law, and (2) treatment of FSAs, HRAs, and HSAs under the Davis-Bacon Act and the Service Contract Act."(Employee Benefits Institute of America)

[Guidance Overview] IRS Discussion on Whether Various Over-the-Counter Items Are Medical Care Expenses
Excerpt:"EBIA Comment: This information letter is noteworthy for its detail and provides insights into a number of difficult expenses, many of which have not previously been addressed by the IRS. Those who work with health FSAs and HRAs will want to familiarize themselves with the letter and the analysis it contains. [See http://www.ebia.com/files/PDFs/OTCltr.pdf.]"(Employee Benefits Institute of America)

[Guidance Overview] FTC Delay of Enforcement of Red Flags Rule Until November and FAQs Addressing Employee Benefit Plans
Excerpt:"EBIA Comment: The enforcement delay is welcome news and the FAQs provide some helpful clarification for health FSAs and 401(k) plans. Unfortunately, some issues for employee benefit plans remain unanswered. For example, for those offering health FSA debit cards, it is unclear who is responsible for implementing the Rule -- the plan sponsor, the TPA, or another entity involved in the card program. Further clarification would also be helpful about the Rule's application to other benefits, such as DCAPs, HRAs, and HSAs."(Employee Benefits Institute of America)

Say Goodbye to Reimbursement of Over-the-Counter Medications Through FSAs, HRAs, MSAs
Excerpt:"The House Ways and Means Committee's amendment to the America's Affordable Health Choices Act (H.R. 3200) would prohibit employees from using health FSA dollars to pay for over-the-counter medications. The proposal is estimated to raise $8.2 billion over 10 years. The proposal also would extend to health savings accounts (HSAs), health reimbursement arrangements (HRAs) and Archer Medical Savings Accounts (Archer MSAs)."(Wolters Kluwer)

[Guidance Overview] CMS Update on Mandatory Insurer Reporting User Guide and Other Guidance
Excerpt:"This Capital Checkup summarizes key issues addressed in the updated guidance: New registration deadline for entities reporting only on Health Reimbursement Arrangements (HRAs), What it means for a person to be'known to be entitled to Medicare'), and CMS's recommended process for collecting Medicare Health Insurance Claim Numbers (HICNs) or Social Security Numbers (SSNs)."(The Segal Group, Inc.)

Text of Comments by Employers Council on Flexible Compensation Concerning Proposed Tax Law Changes for FSAs, HRAs and Employer-Provided Health Coverage in General
5 pages, submitted to the Senate Finance Committee May 26, 2009. (Employers Council on Flexible Compensation)

[Guidance Overview] EEOC Opinion Letter: ERISA Plan HRA Requirement in Order to Obtain Health Coverage Violates ADA
Excerpt:"The U.S. Equal Employment Opportunity Commission (EEOC) issued an opinion letter in March which recently became public regarding the use of health risk assessments (HRA) and the Americans with Disability Act (ADA). While opinion letters from the EEOC are not official opinions, this letter does provide guidance for employers to clarify the use of HRAs."(Aiken&Aiken, LLC)

EEOC States HRA Requirement for Health Insurance Eligibility Violates ADA
Excerpt:"The U.S. Equal Employment Opportunity Commission (EEOC) issued an opinion letter indicating that a health risk assessment (HRA) requirement for health insurance eligibility would violate the Americans with Disability Act (ADA). The ADA requires disability-related questions or medical examinations to be job-related and consistent with necessity or, part of a voluntary wellness program. In this instance, the HRA is neither job-related nor consistent with necessity. As part of a wellness plan, refusing to participate in an HRA would penalize an employee, violating ADA. The letter is an informal discussion and does not constitute an official opinion of the EEOC."(International Foundation of Employee Benefit Plans)

Company Leverages HRAs to Help Employers and Their Workers Split the Savings from Medical Tourism
Excerpt:"A startup company is banking on its small network of elite overseas hospitals plus a unique employer health reimbursement arrangement (HRA)-linked health benefit to carve a niche for itself in the outbound medical tourism business. Satori World Medical, based in San Diego, recently launched its Health&Shared Wealth program, a patent-pending approach that enables employers to offer a 100% overseas medical travel benefit to their employees. Leveraging the significant savings Satori says it is offering for a range of traditional medical procedures performed at its network hospitals, employers can share with their employees a fixed dollar amount or a percentage of the savings realized by using the benefit. The predetermined savings amount is deposited in the employee's HRA account. The employer can then're-invest'what it calculates to be the rest of the savings."(AISHealth.com)

Benefits Card Increases Appeal of Tax-Favored Accounts
Excerpt:"Health care consumers report the availability of benefits cards positively influenced their decision to sign up for tax-favored accounts including Flexible Spending Accounts (FSAs), Health Savings Accounts (HSAs), or Health Reimbursement Arrangements (HRAs), according to the results of the Evolution Benefits Consumer Experience Survey."(PLANSPONSOR.com; free registration required)

[Guidance Overview] IRS Explaination on Why Standard Mileage Rate for Medical Expenses Is Substantially Less Than Rate for Business Expenses
Excerpt:"Transportation expenses that are deductible medical expenses under Code Section 213 generally can be paid or reimbursed on a tax-free basis by a health FSA, HRA, or HSA. (Some employers'health FSAs or HRAs exclude medical transportation expenses from the list of reimbursable items to simplify plan administration.) The explanation in the information letter can help health FSA and HRA administrators, who may be asked why the medical and business rates differ so much."(Employee Benefits Institute of America)

[Guidance Overview] IRS Discussion of Deductibility of Nursing Home Care for Individual With Alzheimer's Disease
Excerpt:"EBIA Comment: The most important thing for employers and administrators to remember about this guidance is what it does not say. Specifically, although qualified long-term care services can be deductible on a tax return, health FSAs cannot reimburse them on a tax-free basis. Similarly, most HRAs may not reimburse expenses for qualified long-term care services. (This is because most HRAs are health FSAs -- meaning that the maximum amount of reimbursement they offer is not more than 500% of the employer's contributions.) In contrast, HSAs can reimburse long-term care services tax-free."(Employee Benefits Institute of America)

When Is $100 Worth $155? If You're in 28 Percent Tax Bracket, That's the Value of Paying for Personal Expenses with Pre-Tax Dollars
Excerpt:"Any time you take advantage of a tax savings opportunity, less of your hard-earned money goes to taxes and, therefore, more ends up in your pocket. So, let's . . . review some of the tax breaks available to you these days."(The Boston Globe)

[Guidance Overview] 2009 Reporting Forms and Instructions for HSA, Archer MSA, and Medicare Advantage MSA Trustees and Custodians
Excerpt:"EBIA Comment: Remember that these 2009 forms aren't to be used by trustees and custodians until 2010, when reporting for the 2009 tax year is due. We note that the mention of economic stimulus payments in the Form 1099-SA instructions for 2009 presumably relates to IRS guidance allowing individual account holders to withdraw without penalty payments made by direct deposit under the Economic Stimulus Act of 2008 . . . ."(Employee Benefits Institute of America)

[Guidance Overview] Milliman's Monthly Benefits News and Developments. Jan. 2009 Edition (PDF)
2 page list of principal employee benefits news and developments in December, 2008. (Milliman)

[Guidance Overview] IRS's 2008 Version of Publication 969 on HSAs, HRAs, Health FSAs,and MSAs
Excerpt:"EBIA Comment: Publication 969 is a handy tool for comparing the basic features of various consumer-driven health care vehicles without getting too bogged down in the details. The updated version of Publication 969 is also a reminder of the considerable amount of pertinent guidance that the IRS issued in 2008, particularly on HSAs."(Employee Benefits Institute of America)

Healthcare Providers Enjoy Year-End Rush as Health Plan Participants Beat Deductibles Deadline
Excerpt:"It's the Year-End Mini-Boom, a new phenomenon brought on by health insurance plans with deductibles. . . . Early in the year, patients are more likely to hold off getting care because they are paying out of pocket. Later in the year, some have paid enough to reach their deductible and insurance kicks in. At that point, insurance covers most medical services [including many that are elective] . . . ."(StarTribune.com)