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Fridays (with Benefits) - Communication can make-or-break your open enrollment

Yes it's still the middle of July, but we in the benefits industry run on a different calendar, and this time of year we're in the thick of open enrollment planning. For FSA users, this is a critical time to calculate your yearly contribution and make any necessary changes to your account before re-enrolling. FSA users tend to be benefits pros, but what about everyone else? The key ingredient to a successful open enrollment is communication - early and often!

Employee engagement: Why it matters for workers enrolling in benefits - Evelina Nedlund, Employee Benefit News

This week, we're taking a closer look at an Employee Benefit News interview with Rebecca Ray, executive vice president of human capital at The Conference Board, a non-profit business membership and research group organization, on the subject of open enrollment engagement. She had 3 interesting takeaways that every HR rep should stand up and take notice of:

Employees DO care about their benefits

While blank stares are common during most open enrollment presentations, research shows that employee benefits are massively important to workers. Benefits are part and parcel why your employees consider a place a great place to work, and they need to know how they can navigate them to get the maximum return from their hard work. It's not just another event on the calendar - it's pivotal for the entire employee base.

Employers need to take a larger role

Benefits administrators are key in communicating how benefits fit into a worker's overall financial picture, but employers have to do their part to open up these discussions to a larger audience. In addition to traditional benefits presentations, open forums where employees from all backgrounds can ask questions that go beyond the standard "what will my co-pay be?" shows that the company cares not only about work-life balance, but helping them achieve goals that extend outside of the office.

Student debt is a major issue to consider

Millennials make up the largest segment of today's workforce, but many are far more concerned with paying off their student loans than contributing to a retirement account. This is a wholly unique new trend for employers and benefit administrators to tackle, and one that will only become more relevant each year.

Financial wellness programs have become a common trend to help millennials better plan their finances and make the right choices for the future, but it shouldn't stop at one group. Workers at various life stages have all manner of important financial decisions to make, so offering these programs to multiple generations can give workers the tools and know-how they need to make smart financial decisions as they relate to their benefits choices.


Fridays (with Benefits) is a weekly roundup of the latest headlines about employee benefits -- from FSAs to fitness programs and everything workplace wellness. It appears every Friday, exclusively on the Learning Center. And for the latest info about your health and financial wellness, be sure to follow us on Facebook, Instagram and Twitter.

Sun Care Center

What is broad spectrum protection?

Sunscreen is one of the most vital FSA-eligible products available to American families for its role in preventing skin cancer, which 1 in 5 Americans will experience some time in their lifetime (AAD).

But what many people aren't aware of is what makes a sun care product eligible for flexible spending account dollars. Luckily, the main requirement is that it keeps the key feature that makes all sunscreens effective: broad spectrum protection.

We've all seen broad spectrum on sunscreen bottles, but what does it really mean? According to Johns Hopkins Medicine, ultraviolet rays are the key causes of sunburn and skin damage, which take the form of UVA, UVB and UVC rays. UVC rays are absorbed in the atmosphere, but the rest of this infrared light trickles down to us. But UVA/UVB rays damage skin in differing ways (University of Iowa):

UVA rays

These rays are the primary contributors to photoaging, or wrinkling of the skin that are most often associated with aging. They do this because they penetrate to deeper skin layers than UVB rays. UVA rays are the toughest to block, and traditional sunscreens are typically more effective in blocking UVB rays.

UVB rays

These are the sun's rays that affect your uppermost skin layers, and are the primary contributors to sunburn. These rays play the most active role in contributing to the formation of skin cancers, which can sometimes arise in dark-colored spots on the skin that can be the early signs of melanoma.

UV forecasts and sunscreen use

No sunscreen will be able to block 100% of UV rays, but broad spectrum sunscreens are the most effective in reducing the chance of sunburn and skin damage from prolonged sun exposure. Always use sunscreen when heading outdoors, but another tip to reduce your UV exposure year-round is to check on the UV Index in your area.

According to the U.S. Department of Environmental Protection (EPA), the UV Index is a calculation conducted by the National Weather Service for most ZIP codes across the U.S. to forecast the expected risk of excessive UV radiation.

Typically these are only reported on TV weather forecasts in events of extreme UV sun exposure, but if you want to be proactive about your sun care regimen, the EPA offers a free, downloadable UV Index app so you can be mindful of your risk wherever you're heading.

Sun Care Center

What you should know about sun care for your lips

No matter what time of year it may be, there are certain parts of your body that will get sunburned before others if you're outdoors for an extended period of time. Your nose and the tops of your shoulders are the usual culprits, but one area we may overlook are our lips! If you've ever had a lip sunburn, you know how painful it can be, but leaving your lips unprotected from the sun's rays can pop up again in bothersome, unexpected ways.

Pay attention to chapped lips

Did you know that one of the biggest contributors to chapped, dry lips is excessive sun exposure? Chapped lips are caused by a lack of moisture in the upper skin layers of the lips, which can result in painful cracks in the skin that can be difficult to heal. According to Healthline, sun exposure can worsen chapped lips, even more if you're sunburned and dehydrated.

To stave off chapped lips and protect your lips from the sun, look for a lip balm that has moisturizing ingredients, as well as an SPF of 15 or above (AAD). Lips are also susceptible to skin cancer, more than any other area of the body. The Skin Cancer Foundation reports that the lower lip is approximately 12 times more likely to be affected by skin cancer than other parts of the body, owing to its greater exposure to sunlight. So proper lip sun care isn't just about warding off a sunburn, it is a smart choice for your long-term health.

Handling a lip sunburn

If your lip care lapses on a sunny day and you end up with a lip sunburn, it's going to be a pain in a sensitive place for about 3-5 days! But luckily, most traditional sunburn remedies can help you bounce back quickly. From Healthline:

  • Cold compresses: Cold packs are surefire treatments for all forms of body inflammation and your lips are no different. If your lips are especially sensitive, wrap the compress in a towel to avoid numbing the skin.
  • Moisturizers: As tempting as it may be to use lidocaine products and other cooling sunburn treatments, the risk of ingesting them after treating your lips is too high to risk. Moisturizers are the best choice, namely those with natural ingredients like vitamin E, coconut oil, or almond oil that can jumpstart the healing process.
  • Anti-inflammatories: In addition to good old-fashioned cold therapy, a smart way to fight inflammation is to take a pain relief like acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) that is a pain reliever AND an anti-inflammatory to bring down swelling.
  • Aloe vera: If you have an aloe vera plant in your home, break a branch open! The cooling gel in these plants is a natural cure for skin burns and rashes, and can provide a measure of relief for bad sunburns.

Last but not least, what to avoid:

As we mentioned above, skip the lidocaine products that you could ingest with a lip sunburn, as well as any oily products that can trap heat instead of allowing the area to heal.

But the best defense against a lip sunburn is to use lip balm with an SPF of 15 or above, and there are plenty of options to be had with your FSA funds.

Sun Care Center

What is mineral sunscreen?

For some, sustainability is not just a practice, it's a lifestyle they embrace with everything they do, and a key deciding factor in the brands they support and the products they use. So when it comes to sun care, these individuals aren't just applying any old chemical sunscreen, they care deeply about its effect on the environment.

In recent years, mineral sunscreen has emerged as one of the top eco-friendly sun care products on the market. But how does it differ from traditional medical sunscreen and is it just as effective? Let's dive in and find out.

Mineral sunscreens vs. traditional sunscreens

To get the latter question out of the way, yes, both of these sunscreen types will help protect you from sunburn and more advanced skin damage if used as directed. Both will absorb ultraviolet (UV) rays to prevent sunburn, but where they really differ is in their ingredients:

Chemical sunscreens

This type of sunscreen has long been the most widely used sunscreen type and is formulated with chemical ingredients that aren't found in nature. The most common active ingredients in chemical, also known as "synthetic" sunscreens include oxybenzone, octinoxate and octocrylene.

Here's where things get interesting: for these sunscreen to work, the active ingredients have to be absorbed into the skin, which may be an issue with those with allergies or sensitive skin, says Consumer Reports.

While these products have proven to be an effective means of preventing sunburn and skin damage, sustainability issues have arisen in recent years about active ingredients like oxybenzone/octinoxate playing an active role in eliminating coral reef populations through bleaching.

Hawaii even took a major step forward to ban sunscreens with these ingredients in mid-2018 (CNN). While other states have not yet followed suit, it is a trend that bears watching and may induce other consumers to make the switch to natural alternatives.

Mineral sunscreens

In addition to having different active ingredients to absorb UV rays, mineral sunscreen has a unique texture that is different from chemical sunscreens that feel more like a moisturizing lotion. Mineral sunscreens utilize active ingredients like zinc oxide and titanium oxide, and as such have a different texture and feel a bit lighter on the skin than chemical variants.

However, the key difference with mineral sunscreen is that while chemical versions are absorbed into the skin, mineral sunscreen sits on top of the skin layers and absorbs UV rays in that fashion. So they may be safer choices for those with sensitive skin, as well as small children. Lastly, because mineral sunscreen uses active ingredients that are derived from natural materials, it is eco-friendly and safe to wear everywhere.

Wrapping up...

So which is the right choice? According to the Mayo Clinic, you should always practice year-round sun care with the right sunscreen for your needs, but don't let that lull you into a false sense of security! Even with the best product on the market, a combination of shade, sunscreen, clothing coverage and common sense can keep you and your loved ones protected year-round from the sun's rays.


Flex-Ed: Think before you "double dip" with your FSA!

Whether you're new to flexible spending accounts (FSAs) or consider yourself to be a tax-free wizard, you've probably been warned about "double dipping." And if you've read the fine print on any claim you've submitted, you may have already stated you won't double dip.

Basically, double dipping is being reimbursed for the same expense twice, which can happen a lot of ways when managing your FSA. While it's not technically illegal, it's highly unethical and could get you in serious trouble with your employer.

Why? Because by claiming FSA reimbursement you're unable to seek payment for things already paid for pre-tax, or things you intend to pay with another tax-free health account. This can happen without even knowing it.

It's up to your employer to hire an administrator to make sure plans are compliant with the IRS. The IRS says employers (or administrators) have to ask for a written guarantee by the participant that they will not double dip.

If double dipping goes by unnoticed by the administrator, the whole plan could be considered non-compliant and everyone in your company could lose the benefit.

Even worse, if the FSA plan was found to be out of compliance, all those tax-free benefits could instantly become taxable to employees. And we wouldn't want to be the person responsible for that mistake. So, let's explore the most common ways double dipping can happen and how you can avoid it.

Double expensing

One of the most common forms of double dipping is by paying for an FSA-eligible expense with your FSA card, and then submitting the same expense for reimbursement. Most benefits administrators can catch these mistakes pretty quickly. But if a claim does go through and you get reimbursed twice for the same expense, you'll have to pay it back to your administrator if they become aware of the issue.

Doubling expensing on separate accounts

Let's say you and your spouse each have FSAs through your respective employers. If you pay for a copayment or FSA-eligible product and submit a claim for that expense under both accounts, this is another clear example of double dipping.

To avoid this, make sure to keep your FSA claims separate for each account to avoid confusion.

Wellness plan double dipping

Employee wellness plans have become popular in the last few years. But this has created new ways to commit some financial foul play. According to Business Management Daily, the IRS identified wellness plan double dipping as something to watch for.

Basically, employees are paying for wellness program premiums with tax-free funds, and then getting these premiums reimbursed. Technically, wellness programs are "employer contributions," and can't be reimbursed through plans like FSAs or HSAs.

Double dipping can be an honest mistake, but if you make a real effort to double your reimbursements for qualifying healthcare expenses, you're probably not going to get away with it. And I can't imagine anyone wants to deal with the IRS (or an angry HR department) any more than they already do.

Stick to the honest path: Use your FSA card whenever possible, and keep your receipts organized to avoid any issues down the line.


New to FSAs? Need a refresher course in all things flex spending? Our Flex-Ed column gives you a dose of FSA Living 101, offering tips for making the most of your tax-free funds. Look for it every Thursday, exclusively on the Learning Center.

Living Well

Flex-Ed: 5 little-known health facts about U.S. Presidents

As the nation settles in for a day full of barbecues, fireworks and outdoor fun, we thought July 4 would be a good time to think back to some of the people that led this nation over the last 250 years. Because, as it turns out our leaders were (and are) just as human as us all. Many suffered from the same illnesses, while others rose above to develop positive health habits.

As we look back on the lives of our notable leaders, let's take a peek at their health situations to shed light on their lives (not to mention the eras in which they lived).

Thomas Jefferson's romantic wrist wrangling

In the summer of 1785, Thomas Jefferson served as the U.S. minister to France. But the importance of this office didn't stop Jefferson from leaping over a fence to impress a French woman. This rom-com maneuver ended badly for him, however, when he landed wrong and ended up breaking his wrist.

Jefferson described the incident in a letter to American artist John Trumbull: "It was by one of those follies from which good cannot come, but ill may." Unfortunately, 18th century doctors didn't have access to advanced wrist support items, so his broken bones were improperly set by French doctors, and his wrist remained deformed and painful for the rest of his life.

William Henry Harrison's near-instant pneumonia

William Henry Harrison holds the unfortunate distinction for the shortest time in office at just 32 days in 1841. Harrison gave a two-hour inaugural speech on a cold, rainy March day and soon developed a cold that progressed into pneumonia.

While a lot has happened in medicine since that dreary day in 1841, we now know Harrison might have benefited from some modern cold, flu and allergy products to break up his congestion before it got infected. Sadly, he passed from complications, just nine days later.

Calvin Coolidge's surefire sleep habits

The 30th President put a notable emphasis on his sleep cycle and was known to sleep 11 hours each day. Coolidge was known to retire to bed at 10 p.m., wake up between 7 and 9 a.m. and always made time for an afternoon nap lasting 2 to 4 hours.

Could you imagine a modern-day president having the time to have this sleep schedule? Chances are our current leaders are lacking quality sleep, and probably need a little help from FSA-eligible sleep aids to get rest in order to tackle the world's problems with the right clarity and focus.

John F. Kennedy's silent, but severe back issues

John F. Kennedy's back issues were never revealed to the public until after his death, but they were a constant source of difficulty starting from a young age. Throughout his Presidency, JFK wore a back brace and took medication to manage the pain from his condition.

It turns out one of the most public-facing presidents was actually hiding a life-threatening disease. The notoriously camera-friendly Kennedy chose to hide his diagnosis of Addison's disease — an incurable disorder of the adrenal glands.

Barack Obama toppled his tobacco addiction

Shortly before entering the White House, the 44th President made a vow to his wife, Michelle, that he would quit smoking cigarettes before entering the 2008 race. Though he had smoked tobacco since high school, Obama managed to quit thanks to the use of smoking cessation products like nicotine gum.

It appears Obama has continued to fight the addiction, which may still stand as one of his greatest accomplishments -- even after a noteworthy two terms in office.

Yes, it turns out the forefathers of our country, shared quite a bit with current leaders … and had more than a few similarities to the rest of us. We've probably missed a ton of great stories about other presidents, so please let us know who we should add on our social media pages.


New to FSAs? Need a refresher course in all things flex spending? Our weekly Flex-Ed column gives you a weekly dose of FSA Living 101, offering tips for making the most of your tax-free funds. Look for it every Thursday, exclusively on the Learning Center. And for the latest info about your health and financial wellness, be sure to follow us on Facebook, Instagram and Twitter.


FSA Friday - 12/7/18 - Change is on the horizon for benefits in 2019

If you go back into the FSA Friday archives, there's one word that seems to appear in headlines more than most -- change. And why wouldn't it? After all, tax-free healthcare accounts changed consumer health. Plus, FSAs certainly change the way people approach their budgeting and planning.

And on a larger scale, the employee benefit landscape always seems to be looking forward, hoping for challenges to become accomplishments, and positive trends to become realities. This week's headlines cover some more trends and predictions for the coming year.

Part-timers are gaining ground in employee benefits - Valerie Bolden-Barrett, HRDive

According to the article, employers are shifting toward extending benefits to part-time workers. The Flexible Work Arrangements: 2017 Survey Report found that 78% of organizations employ part-time workers, and 90% of those organizations define part-time work as fewer than 30 hours a week.

Of the benefits discussed, the most favorable were (unsurprisingly) healthcare coverage (54%), prescription drug coverage (53%), dental and vision care (52%), flexible spending accounts (47%) and health savings accounts (33%).

Plus, paid leave benefits offered to part-time employees included holidays, bereavement leave, sick pay, short-term disability, maternity leave, parental/family leave and personal leave.

This is a growing trend in this burgeoning "gig economy" -- and we don't see that changing anytime soon.

Top 10 HR challenges of 2019 - Nick Otto, Employee Benefit News

This time of year always brings out the "prediction" and "reflection" articles -- culling wisdom from the year that was, and applying it to the year to come. These pieces might be speculation, but they offer some good insights into the state of different industries. Especially when it comes to attracting and retaining quality workers.

According to this article, this challenge is going to persist into 2019, and will continue to be difficult to administer as employers enforce compliance with laws like the ACA, ERISA, COBRA, HIPAA and GINA. As benefit managers reevaluate benefit strategies, the report also suggests benefits be tailored according to the needs and interest of multiple generations.

Staying on top of the news cycle is a great first step, but you should also be mindful of what to look for. News alerts are a great way to start, and EBN predicts action on joint employment, overtime exemptions, GINA and wellness benefits and of course, further action on the Affordable Care Act. Or you can just follow this column, we'll have you covered.

FSA Friday is a weekly roundup of the latest topics, tips and headlines to keep you updated on all things flex spending. It appears every Friday, exclusively on the Learning Center. And for the latest info about your health and financial wellness, be sure to follow us on Facebook, Instagram, YouTube and Twitter.


Asked and Answered: Why can’t I use my FSA to pay for insurance premiums?

In running the and Learning Centers, there are some questions that always seem to pop up. And the subject of using flexible spending accounts (FSAs) to cover health insurance premiums is one of the most-common questions we get.

So, since open enrollment is winding down, and we probably have a slew of new FSA owners checking out the site, let's revisit this topic, to see if we can clear the air a little better.

First, a quick overview of premiums

Premiums are amounts paid to an insurance company to cover the cost of coverage. Their value is heavily based on factors like:

  • Type of coverage
  • Likelihood of a claim being made
  • Where the policyholder lives or operates a business
  • Inherent risk of health problems or behavior
  • Competition with other insurance companies.

In short, premiums are an insurance company's way to cover any liabilities that come with the plans they underwrite. State insurance regulators work to make sure companies have enough reserves to cover any claims, to ensure that medical expenses are covered. Premiums can fluctuate after each policy period, based on a number of cost factors.

For policyholders to continue receiving coverage through their insurance plans, premiums must be paid according to the policy's payment plan schedule. It's left up to policyholders to decide where the funds should come from. And unfortunately, the IRS doesn't allow for those funds to come from your FSA.

But don't take our word for it - instead, listen to IRS code 213(d), which states the following about FSA spending:

"...medical care includes amounts paid for the diagnosis, cure, mitigation, treatment or prevention of disease, or for the purpose of affecting any structure or function of the body."

In other words, health insurance premiums fall outside of this definition, since they pay for coverage, but aren't directly connected to the actual care.

Are premiums ever covered by healthcare accounts?

FSA holders can't count insurance premiums as eligible expenses, but health reimbursement arrangements (HRAs) and health savings accounts (HSAs) offer slightly more options.

In a small number of exceptions an HSA can cover long term care, or premiums for spouses and qualified dependents when the account holder is receiving healthcare continuation benefits (COBRA) or federal/state unemployment compensation. But, for the most part, they won't cover premiums. HRA coverage of premiums is even more complex, so don't count on it.


If you have an FSA you can't use these tax-free funds on premiums. But don't let that give you buyer's remorse for signing up. Your FSA covers thousands of FSA-eligible items, alongside other vital out-of-pocket expenses like copayments, deductibles, over-the-counter items, and more.

From FSA basics to the most specific account details, in our weekly Asked and Answered column, our team gets to the bottom of your most-pressing flex spending questions. It appears every Wednesday, exclusively on the Learning Center. And for the latest info about your health and financial wellness, be sure to follow us on Facebook, Instagram and Twitter.


Flex-Ed: Shedding light on the letter of medical necessity

Every year, as we approach open enrollment (and it's we receive a lot of the same questions. And discussing the letter of medical necessity (LMN) is always at the top of the list. So, since this a column about the basics of flexible spending account use, we're happy to cover it again. Because it's important, and can impact how you shop for FSA-eligible products and services.

If you've spent some time looking through our Eligibility List, you probably noticed a classification of qualifying medical products and services as "requiring a letter of medical necessity."

In short, an LMN is like a doctor's note. Having an LMN can help any product or service that falls outside the IRS's definition of "medical care" (but can assist the treatment of a condition) get approved for FSA reimbursement.

Defining "medical care"

For a product or service to be FSA-eligible, it must treat, cure, diagnose or prevent a disease or illness. Or it has to affect a function of the body. So a product like a first-aid kit is a no-brainer, as it can be used in a huge variety of medical situations.

However, there are many treatment methods and products available that fall outside IRS guidelines that could be made eligible with some additional documentation from your doctor.

Here's an example: If your doctor suggests massage therapy to treat an injury, it's not FSA-eligible on its own. However, if you get an LMN from your doctor that outlines how the treatment method is essential to your recovery, your benefits administrator may accept it as an FSA-eligible expense.

How to submit a letter of medical necessity

If you and your doctor have identified a medical product or service that can aid the treatment of an injury or medical condition and it falls outside FSA eligibility, here's what you need to do:

  • Check with your benefits administrator to see if there is an official form to fill out for the expense to be approved.
  • If your doctor is writing a letter on his/her own, the letter must outline: what medical condition is being treated, a description of the treatment (frequency, dosage), and how long the expense will be needed to treat the condition.
  • A receipt or invoice must be submitted with the LMN for the full price to be reimbursed.

In some cases, benefits administrators may ask for additional information from your doctor, most likely for products/services that also have non-medical uses.

Beyond its direct medical use, most expenses are non-reimbursable if the individual would have purchased it anyway. In other words, this product can't be something you would purchase even if you didn't have the condition. It needs to be directly related to this course of treatment, and the specific use needs to be confirmed by a doctor.

One example is yoga. If you're already paying for yoga classes unrelated to a medical condition, your payments are not FSA-eligible, and these costs won't be covered retroactively. But if a physician recommends yoga to help a specific condition, they might submit an LMN on your behalf, to allow you to use tax-free funds to cover the costs of classes for a set period of time, until the doctor determines your treatment is complete.

With any luck, you shouldn't have any difficulties getting reimbursed for your expense as long as you keep an open line of communication with your benefits administrator and ensure that your physician is as detailed as possible.


New to FSAs? Need a refresher course in all things flex spending? Our weekly Flex-Ed column gives you a weekly dose of FSA Living 101, offering tips for making the most of your tax-free funds. Look for it every Thursday, exclusively on the Learning Center.


Flex-Ed: Decoding common insurance terms

We're committed to helping readers understand their healthcare benefits and the potential of tax-free healthcare accounts. But, before you can do any of that you have to understand the “language" of healthcare. To simplify things, we've put together the top terms you'll need to know to make educated decisions with your healthcare benefits. Check them out!

Benefit/benefit level

These two terms are usually confused, but there's a clear difference. A benefit is the amount the insurance company pays on your behalf. A benefit level is how much the insurance company is willing to pay for a specific service.


Simply put, a "claim," as it relates to health insurance, is a request for insurance coverage. "Claims" for health insurance plans are typically submitted automatically to an insurance carrier when a qualified medical service has been performed. However, with an FSA or HSA, the claims process is not automatic.

Today, most FSA- and HSA-enabled plans utilize FSA/HSA cards that automatically approve purchases when you buy them. If you don't have one of these cards, FSA/HSA users who pay for qualifying expenses can submit a claim to their benefits administrator so they can be reimbursed for the cost of that expense with their funds.


Coinsurance is a cost-sharing arrangement in which the plan holder will pay a percentage of the costs of a medical service, often after a deductible has been met. As an example, if an individual's insurance plan offers a 70/30 split for medical expenses after the deductible is met, an expenditure of $100 would mean that the insurance company would pay $70, while the account holder pays $30. Depending on the structure of the healthcare plan, coinsurance percentages may also vary if a patient goes outside of their physician network.


Many health plans will offer a type of cost-sharing arrangement called a co-payment where the plan holder will pay a fixed portion of the overall cost of the healthcare service. In the case of copayments, these are flat amounts (not percentages like coinsurance) that are paid for a healthcare service.


An insurance plan's deductible is the amount that a plan holder must pay out-of-pocket before the insurance company will begin to pay its portion. For instance, if you are enrolled in a plan with a $1,500 deductible, you will have to pay for your medical expenses in full until you meet the $1,500 threshold. At that point the health insurance plan will begin its coverage.


A dependent is any person that you list on your health plan, including children, a spouse or an adult relative that is covered by the primary insured member's plan.

Explanation of benefits

An explanation of benefits is the fine print that dictates how a medical claim is paid. It's usually received by the plan member following a qualified medical service or expense and contains detailed information about the total cost of the service, what the health plan paid and what portion of the costs the plan holders are responsible for, including any remaining copay, coinsurance or deductible amounts.


Health insurance premiums are the regular amounts paid to an insurance company to be considered “covered" under a health insurance plan. These amounts can be paid out biweekly, monthly, quarterly or annually.

Out-of-network provider

Every insurance plan contracts with a network of doctors, hospitals, and other health care providers to provide medical services at discounted rate to its members. On the other hand, out-of-network providers are those medical providers that fall outside the insurance plan's network of preferred providers. So, their services will typically cost more than those in the plan network.

Out-of-pocket maximum

The out-of-pocket maximum is the most a person will pay toward their health insurance over the course of a year and is usually a combination of deductibles, copayments and coinsurance. Once you have spent your out-of-pocket maximum, the insurance company will pay 100% of all covered health expenses for the rest of the year.


A rider is a legal term that refers to an additional condition added to a contract. In the health insurance world, a rider usually refers to an additional level of coverage that is added to a health insurance plan and paid for with an additional premium. One example of this is a maternity rider, which provides additional pregnancy coverage that standard plans may not completely cover.

Of course, there's a lot of other terms to know. But these definitions should get the ball rolling for a bigger discussion with your insurance provider or FSA administrator.

New to FSAs? Need a refresher course in all things flex spending? Our weekly Flex-Ed column gives you a weekly dose of FSA Living 101, offering tips for making the most of your tax-free funds. Look for it every Thursday, exclusively on the Learning Center.

Laws and Legislation

Flex-Ed: $92 billion package of healthcare bills proposes more "flex" for FSA owners

Healthcare legislation typically moves at a snail's pace in Washington, but over the past week a series of bills are being discussed that could expand the reach of flexible spending accounts (FSAs) more than we've seen since their debut in 2003.

We're not big on hyperbole at FSA Store, but this series of new regulations, if they become law, would be huge for FSA owners.

This week, in a special Flex-Ed, we're breaking down this news to examine the most important regulations that could help make FSAs an even bigger factor in your monthly budgeting.

(And if you're interested in all the potential changes to health savings accounts (HSAs), be sure to check out our companion article on the HSA Store Learning Center.)

A quick overview of this legislation

The House Ways & Means Committee approved a $92 billion package of 11 bills that could impact the American healthcare system at large. While these bills have cleared the committee stage, there is no guarantee that they will become law, or even be voted on in this legislative session.

But these bills signify what both consumers and the industry have pushed for in recent years and could form the backbone of legislation in the future.

Expanding the meaning of "qualified medical expense"

If passed, these changes would allow FSAs, HSAs and health reimbursement arrangements (HRAs) to reimburse for a bunch of new products -- including a potentially huge win that many believe is long overdue.

Why it's important: This is music to our ears! While account holders can submit a prescription to purchase OTC meds like Advil or Benadryl, this is a major obstacle to overcome. With this restriction lifted, account holders would be able to buy their healthcare essentials without needing extra documentation.

Quite possibly the biggest news to come out of this slate of bills is the expansion of qualified medical expenses to include menstrual care products! According to the National Center for Health Research, U.S. women spend about $3 billion per year on these products, and this new freedom to use tax-free funds can help women finally cut the cost of these essentials.

These expansions include certain sports and fitness expenses

The bill places limits on the types of expenses would be considered qualified medical expenses and places dollar limits on the amount of those qualifying expenses. Sports and fitness expenses that qualify as medical expenses under the legislation would be limited to $500 per year for single tax return filers and $1,000 per year to joint return filers.

Why it's important: With all of the FSA-eligible products that help you bounce back from workout soreness and sports-related injuries, including hot/cold packs, elastic bandages, and athletic braces, it was always strange that the IRS didn't directly cover account holders' efforts to get in shape in the first place.

For the first time, these new bills would allow fitness and sports expenses like gym memberships to become eligible with yearly caps on these types of expenses. This would be a huge development that could further broaden the appeal of tax-free accounts -- and hopefully encourage more account holders to embrace healthier lifestyles along the way.

Of course, we're a long way from seeing these bills enacted into law, so we're not planning the party just yet. But every journey begins with an idea, and these proposed legislations could potentially change the face of tax-free healthcare.

New to FSAs? Need a refresher course in all things flex spending? Our weekly Flex-Ed column gives you a weekly dose of FSA Living 101, offering tips for making the most of your tax-free funds. Look for it every Thursday, exclusively on the Learning Center.