BVoss

Glad to hear this is being resolved to everyone's satisfaction. I understand that the account owner was pushing for the disbursement, but would like to point out that for the ex to get her share of the funds from an account belonging to her husband, the normal process calls for her lawyer to get a QDRO submitted in a timely manner. Failure on the part of the lawyer to do that (timely) may be malpractice. (I am not suggesting it is here, but sharing as an FYI.) There was a case out of NY where the lawyer for the spouse dallied on getting the QDRO done correctly (he had tried once and was told his document did not satisfy the Plan's standards for a QDRO). Meanwhile, a few years went by, and the economy tanked; the husband's retirement account lost just under 40% of its value from the date on the Court order. The wife's attorney had a successful malpractice claim brought against him for failure to act diligently and secure the funds with a QDRO in a timely manner. Attorneys in every jurisdiction in the US have a duty under their respective Rules of Professional Conduct to be diligent, and waiting around when the economy (or other factors, including a spouse who actually intends to abscond with the funds) can negatively impact the value of the awarded property, is a failure of the standard of care he/she owes the client.

Self-funded plans are not required to cover essential health benefits (EHBs), but if they do, they cannot place dollar limits on them. However, the air ambulance can be capped, because it is not clear that it is considered an EHB (unlike normal ambulance transport coverage). There is mention of Air Ambulance services in the ACA, but not relative to benefits - only in regard to payments/allowable rates for those services. My colleagues and I interpret this to mean a self-funded plan could place limits on the benefit with a maximum per trip amount. Of course, even if this was an EHB, I would look at the state benchmark plans to see if any of them have limitations on air ambulance services. If one does, a self-funded plan is allowed to follow the benchmark of any state, as long as their benefits are consistent with that state, they remain in compliance. Some commenters requested clarification as to whether air ambulance transport and other emergency transportation is within the scope of the term “emergency services.” The Departments decline to provide a rule addressing this issue. These final regulations continue to provide that the terms emergency medical condition, emergency services, and stabilize have the meaning given to those terms under EMTALA, section 1867 of the Social Security Act.[88] - https://www.federalregister.gov/documents/2015/11/18/2015-29294/final-rules-for-grandfathered-plans-preexisting-condition-exclusions-lifetime-and-annual-limits

I am looking for information that either expressly allows or prohibits the carryover of HRA funds into a limited purpose FSA. (An employer group is adopting a HDHP, along with an HSA and a limited purpose FSA). All the guidance we are uncovering relates to HSA conversions. -- If the HRA is amended to allow for qualified distributions to the newly established limited purpose FSA, is this permissible? Our two member team here is divided and we could use some ideas/pointers. Team "yes" is thinking that because a LPFSA can be funded both by employer and employee contributions, this would be allowed. Team "no" is erring on the side of caution -- until we find something saying it can be done, it cannot be done.