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Benefits Briefing
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June 5, 2003 Issue #
4 |
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in this issue….
·
IRS Issues Guidance on Debit/Credit Cards
·
New Proposed COBRA Regulations
·
Child and Dependent Care Tax Credit Increases
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In the Next Issue
·
How To Contact Us
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Editor's Note
In an effort to keep you informed of regulation
issues and new developments, we will be sending quarterly issues of our
newsletter, Benefits Briefing. If there are HR contacts at your company
who would benefit from this, please give us their names and email
addresses, and we will add them to the distribution list.
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IRS Issues Guidance on Debit/Credit Card Usage for
FSA Administration |
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After releasing a draft on May 6, 2003, the IRS
published Internal Revenue Ruling 2003-21 in the Federal Register dated
May 27, 2003 issuing guidance on the use of Debit and Credit Cards in
the administration of Health Care Reimbursement Accounts and Health
Reimbursement Arrangements (HRAs) for expenses covered under Section 105
of the Internal Revenue Code. The Ruling did not address the use
of cards for administration of Dependent Care or Transportation Expense
Reimbursement Plans.
On May 28, 2003 Harry Becker, Chief of the Health
and Welfare Branch of the IRS, participated in a conference call with
members of the Employers Council on Flexible Compensation (ECFC). In
that call, Mr. Becker gave ECFC members his insights into the Ruling and
further informal, non-binding guidance on the Ruling. The ruling
describes 3 situations that are most commonly used by the major
marketers of Debit/Credit Card services for FSA Administration.
Following are the highlights of the Ruling:
- The use of Cards is acceptable where the
participant certifies upon enrollment that the Card will only be used
for eligible medical expenses that have not been reimbursed and
reimbursement will not be sought under any other plan. This is a
change from proposed regulations where is not reimbursable under
any other health plan coverage was used. Mr. Becker indicated he
felt that there should be language on the back of each card indicating
that the use of the card also certifies the same.
- The use of Cards should be limited to only
health and medical care providers identified by the Card System with
specific merchant codes.
- Every claim paid with the Card must be
substantiated. Three types of transactions may be considered
automatically substantiated. All others require further manual
substantiation. The three types of transactions approved for Automatic
Substantiation include:
- Co-payments equal to specific dollar amounts
in the plan the employee is enrolled in. Here, Mr. Becker indicated
whole dollar amounts divisible by co-payment amounts would not
qualify – only specific amounts equal to co-pays in the specific
plan an employee had elected. If an employer offered multiple
medical plan options, the amount must be specific to the plan he
participates in.
- Recurring Transactions matching a previously
approved and substantiated claim.
- Real-Time Transactions where the merchant or
independent third party (e.g. a pharmacy benefits manager) provides
information to verify the charge at the point of sale. This
transaction would most commonly be for drug plan co-pays where the
Card vendor has interfaces with the PBM to verify eligible claims.
For all other transactions where the Card
is used, the employee must file substantiation of the claim similar to
current manual processes. This is sometimes referred to as “Pay and
Chase” because the employer or administrator must follow-up on these
claims. The Ruling provides that reviewing these claims by statistical
sampling is not acceptable, but requested comments on sampling
techniques.
- The employer must establish meaningful recovery
procedures for non-qualified reimbursements or reimbursements where
the employee fails to file proper substantiation. Steps for recovery
must include:
- Requiring repayment of the improper amount by
cash or check.
- Wage withholding where not prohibited by state
law.
- Claim offset against future properly
substantiated claims.
The employer must also take actions to
ensure future violations do not occur including denying access to the
Card. As a last result, the employer must treat the debt as it would any
other business debt under its practices. This may result in including
the improper amount as taxable income to the employee, but only after
other options are exhausted.
- Payments made to medical service providers in
excess of $600 must be reported on Form 1099-MISC under IRS Code
Section 6041. Pharmacies and tax-exempt hospitals are exempt from this
requirement. This requirement may be particularly problematic because
Card vendors are not currently collecting taxpayer identification
numbers for providers. Mr. Becker indicated that the IRS had no
intention of relaxing this requirement at this time.
What does it all mean?
Card vendors argue that issuing cards increases
both the number of participants and the average employee contribution to
accounts and therefore increased employer FICA savings. Their marketing
statistics suggest that 60% of claims fall under the categories where
automatic substantiation applies, while our statistics indicate less
than 40% of the numbers of claims and less than 25% of the claims
dollars fall under these categories. There are also additional cost of
between $1.25 and $1.75 per card per month.
At Tri-Star, our concerns include:
- The cost of following up on unsubstantiated
claims will more than off set the cost savings from automatically
substantiated claims.
- Employee Communication of the substantiation
process may be difficult and confusing.
- Employee appreciation of the cash flow
convenience may be off set by substantiation follow up (pay and chase)
and recovery for improper claims.
- The steps required for recovery of
unsubstantiated or improper claims will create an unreasonable burden
on employer’s staff.
- Systems are not currently able to meet the
1099-MISC reporting requirements.
We will continue to evaluate Card vendor
capabilities and the appropriateness of the use of Debit/Credit Cards
for the Plans we administer. If you would like to discuss the use of
Cards for you Plan(s) please contact Ken Dixon at 314/985-0284 or
800/727-0182 x 110.
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New Proposed COBRA Regulations
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In the May 28, 2003 Federal Register, the
Department of Labor released proposed regulations regarding COBRA
notices and disclosures. The new regulations are scheduled to become
effective for plan years beginning in 2004. They include safe harbor
model forms for the initial GENERAL NOTICE OF COBRA CONTINUATION
COVERAGE RIGHTS and COBRA CONTINUATION COVERAGE ELECTION NOTICE
(Qualifying Event Notice).
Also included is guidance on what should be
incorporated into Employer notifications to plan administrators of
Qualifying Events and rules regarding what kinds of notices employees
and qualified beneficiaries may have to provide plan administrators.
They include notice of qualifying events (divorce, legal separation,
dependent child no longer being covered by the plan.), second qualifying
events for extensions up to 36 months, and disability extensions.
Two new notices are specified in the regulations.
If an employee or qualified beneficiary notifies the plan administrator
of changes beyond the time limit specified by the plan, a “notice of
unavailability of continuation coverage” will need to be sent to the
individual who is not eligible to continue coverage. They also require
plans to provide written notice to qualified beneficiaries receiving
COBRA coverage of any early termination of coverage prior to the end of
the applicable maximum coverage period (i.e. for non payment of
premiums). Most administrators, including Tri-Star, currently issue
these notices.
The proposed rules stipulate that COBRA election
notices must be “written in a manner calculated to be understood by the
average plan participant” and include 15 specified provisions. Those
provisions include disclosure of the consequences of failing to elect or
exhaust COBRA coverage under HIPAA’s portability, guaranteed access and
special enrollment rules.
At Tri-Star, we are reviewing the current notices
and procedures for each employer we administer COBRA for, and will be
submitting our recommendations for changes to our contacts. The entire
text of these new regulations is available at:
http://www.dol.gov/ebsa/regs/fedreg/proposed/2003013057.pdf.
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Child and Dependent Care Tax Credit Increases in
2003 |
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In 2003 the amount of Dependent Care expenses
eligible for the tax credit calculation increases from $2,400 to $3,000
for one dependent and from $4,800 to $6,000 on two or more dependents.
The tax credit percentage also increases from 30% to 35% for taxpayers
with earned income of $15,000 or less. The credit percentage decreases
1% for each additional $2,000 of earned income up to $43,000 ($28,000 in
2002 and prior years) where it remains at 20%. The maximum contribution
to the Dependent Care Reimbursement Account (DCRA) remains $5,000 in
2003. Please click on this
website link for worksheet to compare.
In many cases, using the DCRA saves employees more
than taking the Tax Credit. Assuming state income taxes of 6% and FICA
tax of 7.65%, if the combined earned income of a couple filing jointly
or the earned income of a single taxpayer exceeds $39,000, using the
DCRA is more beneficial than taking the tax credit. Additionally, if the
taxpayer has only one dependent and eligible expenses exceed $3,000 the
DCRA savings are available on up to $5,000 of expenses. The attached
worksheet can help estimate advantages of the DCRA over taking the tax
credit.
Helpful Hints:
If you participate in the DCRA at an amount less
than the tax credit limits you can still take a tax credit on the
difference. For example, if you contribute $5,000 to the DCRA and have
two eligible dependents in day care with $6,000 or more in expenses,
you can take the tax credit on $1,000 ($6,000 tax credit maximum -
$5,000 DCRA contribution).
To take either the tax credit or use the DCRA you
must report the name, address, and tax payer identification number of
the care provider on IRS Form 2441 and include it with you federal tax
return.
If you are married and both spouses are eligible to
participate in a Dependent Care Reimbursement Account and one spouse
earns more than the FICA limit ($87,000 in 2003) you would want to
consider having the spouse making less than the FICA limit participate
in the DCRA.
IRS Publication 503 gives guidance on Child and
Dependent Care Expenses and includes a sample Form 2441. At this
writing, the IRS has not updated it for the 2003 credit
increases. The Worksheet on the website link has been updated for
the credit increases.
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In the Next Issue...... |
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·
HIPAA Privacy-Business Associates Agreement
·
Debit Card Updates
·
Employee Internet Access for FSA Claims Account
Information
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Contact Us |
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for free: Email
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TO CONTACT US:
Stephanie Latina
Tri-Star Systems
stephanie.latina@tri-starsystems.com
14323 South Outer 40 Road, Suite 400 North
Chesterfield, MO 63017-5734
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(314)985-0264 or (800) 727-0182 Ext. 116
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