Claims Procedures for FSAs

[Guest kredlin]

Are health FSAs considered group health plans for the purposes of the new claims procedures?

[Guest BenefitsLawyer]

Yes, unless the health FSA is subject to one of the exemptions in ERISA section 4(B) (e.g., government plan, church plan, etc.). The claims and appeals regs do not contain any exemption for health FSAs.

[Guest kredlin]

In that case, the new claims procedures are not effective for FSA's until the first plan year after 1/1/2002, correct?

[Guest MSMA]

This thread has caught my eye....can you please give me an overview of what the new changes are ?

Thanks in advance

[Guest kredlin]

New claims procedures were passed a couple years ago. They became effective for all plans other than group health plans on 1/1/2002. The changes are pretty significant for health and disability plans, but very minor for other plans. The changes are too extensive to explain here.

[Guest MSMA]

My only real concern is with FSA's...

if you can't summarize, can you provide me with a reference specific to this area of concern?

(Or, should I be asking this on the Cafeteria Plans board?)

Thanks again for your assistance!

[Guest kredlin]

It's my understanding that FSA's would be covered under the group health plan provisions. Check the regs under ERISA section 503.

[Guest BenefitsLawyer]

For health plans, the new regs apply to claims filed on or after the first day of the first plan year beginning on or after July 1, 2002, but not later than January 1, 2003.

[papogi]

MSMA, try these (especially the digested version from AON):

http://www.fei.org/gr/download/DOL_Revises..._Procedures.pdf

http://www.dol.gov/pwba/pubs/claimsfs.htm

[Guest MSMA]

Excellent! Thanks...and have a good weekend