Guidance on question of the week administration and compliance — practical resources for employers, brokers, and benefits teams navigating real operational questions.
A former employee who elected COBRA continuation coverage is requesting a refund of the premiums she paid over the past six months because she did not need to use her medical insurance. Are we required to refund her premiums?
An employee says they use sunscreen daily and wants to be reimbursed for the cost from their Health FSA. Is this allowed?
Do we have to give an employee time off to attend their child's school conference?
Can I use my Health Care FSA to reimburse medical expenses even if I have not contributed enough money to cover the expense?
Why was an employee’s FSA debit card declined if the expense is eligible?
What happens if a COBRA participant waits until the end of the grace period to pay the monthly premium and has a medical claim in the meantime?
Can a Health FSA reimburse an expense that insurance doesn't cover?
What does a grace period mean for COBRA payments?
Can I use my Dependent Care FSA to pay a babysitter while I attend Back-to-School Night?
Can I use my Dependent Care FSA to pay for private school tuition?
How can we use amounts participants did not spend from their FSAs?
I know the cost of a dental retainer is an eligible FSA expense, but can I also be reimbursed for the cost of an ultrasonic machine to clean the retainer?
Why isn't my credit card receipt enough to be reimbursed from my Health FSA?
Can my Dependent Care FSA really be used to pay for summer camp?
Can an employee stop contributing to a Dependent Care FSA if a family member begins providing child care?
A health FSA cannot reimburse an employee for a spouse's expenses paid before the marriage — dependent status is determined when the expense was incurred, not when it's submitted.
COBRA participants generally must continue the same coverage as before their qualifying event but may make changes available to active employees.
A health FSA carryover feature lets employees carry over unused balances, but employers need not allow carryovers indefinitely if participation stops.
Health FSA funds may generally be used to reimburse eligible medical expenses for a spouse or qualifying dependents even if they are not enrolled in the employer's health plan.
When a covered employee becomes entitled to Medicare before retiring, a covered spouse may receive up to 36 months of COBRA continuation from the date of Medicare entitlement.
When a covered employee becomes entitled to Medicare before retirement, the spouse may be eligible for up to 36 months of COBRA continuation coverage.
Q.- Is the cost of sunscreen really eligible for reimbursement from my health FSA?
Q.- What happens if we forget to send a COBRA qualifying event letter to a terminated employee?
- Can the cost of an Apple Watch be reimbursed from a health FSA? - In certain circumstances and with the proper documentation, Yes.
Q.- An employee waived coverage under our dependent care FSA but he now wants to enroll to put away money to be used to send his daughter to day camp. Should we let him enroll now?
Q.- Is it true a former employee can elect COBRA but not pay for it with the election?
Whose expenses can be reimbursed from an employee’s Health FSA? A Health FSA may reimburse eligible expenses incurred by the employee, the employee’s...
Q: When is the deadline to submit claims for the prior plan year under an FSA and how does that work with the grace period?
Are allergy medications eligible for FSA reimbursement? Yes. Most allergy medications, including over-the-counter antihistamines and prescription allergy...
How long does an individual have to elect COBRA coverage? Individuals generally have 60 days to elect COBRA coverage, measured from the later of the date...
Q: I heard the government released an updated model HIPAA Notice of Privacy Practices. What is the HIPAA Notice of Privacy Practices and when do employees receive it?
When does COBRA continuation coverage begin after a qualifying event? COBRA coverage begins on the date that group health coverage would otherwise end due...
Q: What documentation is required to substantiate an over-the-counter (OTC) item under a Health FSA?
Q. Can an employee change their Health FSA election during the year if they realize they elected the wrong amount?
Q.- We offer an HSA as part of our medical plan. An employee asked for a copy of her HSA tax form. What is she referencing?
Q.- Our payroll company completed our W-2 Forms and sent them to our employees. An employee asked me what the number in Box 12 was. What should I tell him?
Q.- An employee is asking if day care expenses for her intellectually disabled 16 year old child are eligible for reimbursement from her Dependent Care FSA. What information do we
Q.- Do we have to reimburse an employee for the full amount of their annual Health FSA election if they have only made one payroll contribution so far?
Q.- I know we have to offer medical coverage to our full-time employees. We define full-time as an employee who works 37.5 or more hours a week. Will we comply with the Affordable
Q.- Why should employers who provide a cash payment to employees who decline medical coverage get proof that the employee has coverage elsewhere?
Do we have to provide our employees disability coverage? Disability coverage is not a federally mandated benefit but some states do require mandatory...
Q: What are some end of year suggestions for employees who still have funds in their health FSA?
Do we have to provide our employees disability coverage? Disability coverage is not a federally mandated benefit but some states do require mandatory...
Q: Open enrollment for the 2026 plan year has closed, and an employee wants to change his election before the new year starts. Can we allow the change?
Q.- We are allowing employees to elect up to the new IRS maximum for their dependent day care FSA. We want to provide a reminder about whose expenses are eligible for
: Can employees change their FSA election mid-year? : Not without a qualified life event.
Q.- An employee terminated in August. She elected COBRA but took her full 60 days to do so. She wants her payments to be applied starting in November since she hadn’t elected
Q: An employee said they want to save money in December to buy holiday presents. They don’t anticipate needing to use our health coverage. Can we let them stop paying their
Q.- We are going to offer a health flexible spending account plan to our employees starting 1/1/2026. We know there is a risk of loss if an employee gets the full reimbursement
Q: Our Dependent Care FSA runs on a July 1-June 30 plan year. We have an employee who started participating in July 2025. She wants to make the full $5,000 annual contribution in
Q.- An employee resigned and still has a balance in her parking reimbursement account. Can she continue to use the account? What if she has a claim she incurred before terminating
Q: An employee is going to drop her spouse from coverage at open enrollment. We know they are in the process of getting a divorce. The spouse contacted us and demands to be kept
Can an employee who was not enrolled in our health coverage elect COBRA? No. COBRA continuation coverage is only available to individuals who were actively...
Can I use my Dependent Care FSA to pay for my child's after-school program? Yes, if the after-school program provides care that allows you (and your spouse,...
Q.- We are requiring all employees to return to office work. Will this mandate allow dependent care FSA participants to change their election amounts?
Q.- Can we structure our health FSA so employees can only get reimbursed up to the amount they have contributed through payroll deductions at the time of the reimbursement request?
Q.- We received a report identifying the amounts that employees did not use in their FSAs from last plan year. What can we do with the forfeited amounts?
Q. An employee is terminating. Can we hold his last paycheck until he either waives COBRA continuation coverage, elects and pays for coverage, or allows the election period to
- Do we have to file a Form 5500 for our cafeteria plan? - There is no Form 5500 filing requirement for a cafeteria plan itself.
What is the difference between a self-funded and an insured health plan? Who Pays Claims Self-Funded Plan: The employer pays claims out of its own funds...
Q: Can a former employee get more than 18 months of COBRA coverage? A: In certain cases, COBRA continuation coverage can be extended beyond the standard 18-month period.
Q.- We set up a short FSA plan year, 1/1/25 – 6/30/25, and then on 7/1/2025 we began a full plan year. Our plan has a carryover feature. Do employees get the full amount to
Q.- Our health plan runs on a 7/1 to 6/30 plan year. An employee enrolled in the plan starting July 1 and then terminated employment July 2. Do we have to offer COBRA? He was only
Q.- Can employees be reimbursed from their health FSAs for the cost of sunscreen?
Q: What happens if we forget to send a COBRA qualifying event letter and the employee doesn’t receive their COBRA election notice on time?
Q.- An employee elected a health FSA effective 1/1 and now during their annual open enrollment for a 7/1 plan, they are considering enrolling in a High-Deductible HSA plan. What
Q.- One of our employees who had family coverage just found out he was not legally married. We will terminate the “wife” from coverage, but do we have to offer her COBRA? If
Q.- A terminated employee wants to elect COBRA. He said he doesn’t have a checking account anymore and told us we have to allow him to pay using his credit card. Is this true? Do
Q.- We have an employee who is currently on long-term disability. Company policy is to discontinue an employee’s medical benefits if they are on leave longer than 6 months. Next
Q.- Are we required to send COBRA qualifying event notices by certified mail to make sure they are received?
Q.- An employee enrolled in our health plan wants to drop coverage. Can we let employees cancel coverage whenever they want?
Q.- Do we have to provide a COBRA qualifying event election letter in a non-English language if we know the recipient does not speak English?
Q.- An employee said he is really strapped for cash and wants to cancel his health FSA contributions. Can we let him stop participating?
Q.- We are going out of business. What do we do about our employees’ benefits? Our business is part of a controlled group but our employees don’t have anything to do with the
Q.: What happens if a former employee on our health plan through COBRA makes a late payment?
Q.: An employee terminated employment. He did not have a health FSA election for the plan year, but he did have a carryover balance from prior years. Should he be given a COBRA
Q. - What type of documentation is needed for a Prescription to be reimbursed from a Health FSA?
Q.- An employee is retiring in July. He elected a $3,300 FSA contribution. Can he be reimbursed for the full election even though the total amount will not have been deducted from
Q.- An employee is terminating employment, and we know he is moving far away. Do we have to offer him COBRA if we know he will be outside our plan’s coverage area?
Q.- A former employee continued coverage under COBRA. She terminated COBRA effective 12/31/2024 and enrolled in a Marketplace plan starting 1/1/2025. She doesn’t like the plan and
Q.- What do employees do with the Form 1095-C we send to them? Do they have to file the forms with their taxes?
Q: A former employee did not have to use coverage during the month she left employment. She wants to start COBRA at the beginning of the second month. We would be fine with this.
Q.- An employee terminated employment and is receiving a COBRA election. She was on our buy-up plan but says she wants to have our standard plan under COBRA. Do we have to offer
Q.- Can Long Term Care premiums be reimbursed from a health flexible spending account?
Q.- If a group’s health flexible spending account plan year is 11/1/24 – 10/31/2025, can participants elect to contribute up to $3,300 or are they limited to $3,200?
Q. May we structure our Health FSA to restrict participation to only those who are covered under our medical plan?
Q.- An employee enrolled in health coverage effective 1/1. He changed his mind and wants to drop coverage. Can we let him drop coverage and return the premiums he's already paid?
Q.- We have an employee who is age 66 and is enrolled in Medicare. Can she also participate in our HDHP with an HSA?
Q: Is an employer required to offer health plan coverage to an employee’s domestic partner?
Q.- We are replacing our standard group health plan with ICHRA coverage. Do we have to offer COBRA to individuals who lose ICHRA coverage for a COBRA qualifying event?
Q.- We are offering a High Deductible Health Plan with an HSA. What are the requirements for an employee to participate in the HSA?
Q.- Do we have to mail our COBRA Initial Rights Notice to employees or can we distribute it as part of our benefits enrollment package?
Q.- A terminated employee declined our COBRA coverage because he quit for another job. He worked that new job for a week and then quit. He did not have health coverage at the new
Q.- We just completed a dependent audit and found several dependents who were wrongly enrolled in our health coverage. When we remove the dependents, do we have to offer them
Q.- Our FSA plan documents include the IRS mid-year change rules. An employee had a baby and now wants to cancel his health FSA contributions. Do we allow this?
Q.- Our health plans are not changing this year. Do we have to offer an open enrollment?
Q.- What is the maximum time period an HRA can allow for submitting expenses for reimbursement?
Q.- Can an HRA allow the reimbursement of an expense incurred in a prior year to be reimbursed from the present plan year’s account?
Q.- We have a fully insured health plan. Do we still need to distribute a Medicare Part D Notice of Creditable Coverage?
Q.- An employee said she put too much money into her dependent day care FSA and wants to be reimbursed from that account for some medical expenses she paid for her child. Is that
Q.- If a company is new, is it subject to COBRA this year? They would have had 0 employees for 50% of 2023.
- Can I get reimbursed from my health FSA for a massage? If the massage is for a medical reason, it is eligible for reimbursement from your health FSA.
- Are we allowed to require some employees to work on Labor Day? - Yes, there are no federal rules requiring Labor Day to be provided as a non-work day.
Q.- An employee dropped her husband from health coverage at our open enrollment. Now the husband is asking to continue his coverage under COBRA. Should we have sent him a COBRA
Q.- We are a small employer with 22 employees. We offered our employees a health insurance plan last year but it is costly for us and we don’t want to offer it next year. Is that
Are we required to give paid time off to an employee who has a baby? Under the Family and Medical Leave Act (FMLA), eligible employees are entitled to take...
Q.- We give employees a choice of paying for medical coverage with after-tax money during an FMLA leave or reimbursing us for premiums when they return from leave. An employee
Q.- We are changing COBRA vendors September 1 and we just offered a former employee COBRA coverage. Do we have to give the full election period since we are changing vendors? We
Q.- We just discovered that two employees were enrolled in our health coverage effective 1/1/2024 but they did not elect to be covered. Our HR admin sent their information to our
Q.- Our company is based in the United Kingdom. We have a small U.S. workforce of 8 employees. Do we need to offer someone COBRA when they terminate employment since fewer than 20
Q.- Does a COBRA disability extension apply to dental and vision coverage, or is it for medical/Rx only?
Q.- We have an employee assistance plan (EAP) for our employees. Do we have to offer employees the right to continue participating in the EAP under COBRA?
Q.- We conducted a dependent eligibility audit and found about 30 people who were enrolled in our health plan as a dependent but didn’t meet the plan’s eligibility requirements.
How long does a former employee have to pay for COBRA coverage? An individual who is eligible for COBRA has 60 days to elect COBRA and 45 days from the date...
Q.- A person is enrolled in a group health plan with Company A for many years and then gets a second job with Company B and enrolls in their group health plan as well (having dual
Q.- A COBRA continuant wants to extend her 18 months of COBRA due to divorce, but she didn’t tell us about the divorce until her 18 months of COBRA is finishing. Do we have to let
Q.- We are revising our health plan eligibility requirements and will no longer cover domestic partners. Do we have to offer a COBRA election to the covered domestic partners who
Q:- If a member exhausts COBRA, how long do they have to enroll onto their new employer’s medical plan (assuming the waiting period was satisfied)?
Q.- Can we increase the premiums we charge employees for health coverage throughout the year?
Q.- We are struggling with how we are to know when dependents turn 26 and lose coverage under our health plan. Are we required to track dependent ages and provide COBRA notices to
Q.- We transmitted our Forms 1095 to the IRS timely, but our vendor just told us the submission was “Accepted with Errors.” What does that mean?
Q.- We didn’t realize we had to file our ACA forms electronically and our paper forms were not accepted by the IRS. Are there penalties for filing late?
Q.- Do we need to send a COBRA notice to an employee’s child who turns age 26 and ages out of our plan? The employee clearly knows our plan’s eligibility requirements and knows
Can an employee enroll in our health plan in the middle of a year? That depends. If you allow premiums to be paid on a pre-tax basis through a cafeteria...
Q.- Can I get reimbursed from my health flexible spending account plan for over-the-counter allergy nasal spray?
- Are third parties allowed to pay for someone’s COBRA coverage? - There are no restrictions on who can pay the premium for COBRA coverage.
Q.- Do employees who contribute to an HSA have to request reimbursement within a specific time period?
Q.- We offer a high deductible health plan with health savings account. We forward employee contributions to the HSA vendor but do not have any information about claims
Q.- We know if our Health FSA meets certain requirements and if a terminating employee has been reimbursed from his FSA more than the amount he has to contribute for the rest of
Q.- Do we have to send a COBRA notice to an employee’s son who turned 26 and can no longer be covered under our medical plan?
Q.- Is there a penalty if we don’t distribute Forms 1095-C to our full-time employees by the due date?
Q.- An employee enrolled in our Dependent Care FSA during open enrollment. He didn’t realize what the plan was and he doesn’t have any children. Can we cancel his election and
Q.- We started offering employees the ability to contribute to a health flexible spending account beginning 1/1/2024. An employee just submitted her first expense reimbursement
Q.- We contribute to an Individual Coverage Health Reimbursement Account for our employees to purchase their own health coverage. Do we have to offer COBRA for the benefit?
Q.- Can an employee be reimbursed for the parking lot charge at his doctor’s office?
Q.- We send about 55 Forms 1095-C to our employees. We have always mailed copies of the forms to the IRS with Form 1094-C. Someone mentioned that we might not be able to mail the
Q.- Do our teachers become part-time employees for Affordable Care Act purposes when they are out of school for winter break?
Q.- We just hired 4 employees this week and now we have 23 employees. Before this week we never had more than 19 employees. One employee also quit. Do we have to offer that
Q.- Our employee was offered medical, dental and vision coverage under COBRA. He elected only medical and vision. He is now eligible for Medicare. Is he now eligible for an 18
Do we have to hold an open enrollment each year? Cafeteria plan sponsors must give employees an annual election opportunity; large ACA employers must provide effective access to
Q.- We have an employee going on FMLA leave. Do we give her a COBRA notice when she takes her leave?
Q.- Our former employee and her child were offered COBRA coverage. The employee declined coverage but the child elected and became a qualified beneficiary. The child had 18 months
Q.- Do we have to provide a Summary of Material Modifications during Open Enrollment?
What is a self-funded health plan? A self-funded health plan, also known as a self-insured plan, is a healthcare benefit arrangement where an employer...
When does an employer have to give a COBRA Initial Rights Notice? Group health plans must give each employee and spouse a general notice describing COBRA...
Q.- When should we perform nondiscrimination testing for our flexible spending account plans?
Q.- An employee has a separation agreement with her spouse which says they must live apart for a year. She wants to drop her husband from coverage. The employee lives in
Q.- We heard that we need to tell COBRA participants of a rate change at least 30 days before the change goes into effect. Is that correct?
Q.- A terminated employee who is eligible for COBRA coverage told us he had COVID-19 on the last day of his election period. Does the government require us to give him more time
Q.- Can employees still use their health FSAs to get reimbursed for the cost of masks and hand sanitizer?
Q.- We have a COBRA participant who also has Medicare (he was enrolled in Medicare before his COBRA qualifying event). Does our plan pay primary benefits for him or does Medicare
Q.- We provided the wrong premium amount on our COBRA notice to a terminating employee. We don’t think he is going to elect COBRA anyway. Should we fix the error?
Q.- Last month we filed a Form 5500 for our retirement plan. The instructions mention “welfare plans.” Do we need to file a Form 5500 for our health plan?
Q.- I am sending my child to a private kindergarten starting in September. May I use my Dependent Care FSA to pay the tuition for the school?
Q.- We employ fewer than 50 employees and do not offer a medical or dental plan. Can we offer our employees a health FSA?
Missed COBRA Notice for Terminated Employee? Act Now to Avoid Penalties. Send Notice ASAP, Start 18-month Period from Sending Date. Learn More.
No need to file or pay the PCORI fee for fully-insured group health plans. The insurer takes care of it. Learn more here.
Applicable large employers must offer coverage to full-time employees, while small employers may have state-specific rules.
