Claims after a change in coverage due to a qualifying event

[Guest twd]

A participant in a HCFSA & DCFSA has experienced a qualifying event and stopped contributing to the plans. Can this participant be reimbursed for expenses incurred after the date she stopped contributing?

[Mary C]

What does the plan SPD say? We specifically state that only expenses incurred while a plan participant are reimbursable. If cotnributions are stopped, they are no longer a plan participant and the expenses are not reimbursable.

[GBurns]

You say that she stopped contributing, but did she leave an unused balance in her account? Is this what she is seeking reimbursement from?

[JanetM]

If SPD says only claims incurred while a participant they are out of luck on claims after date of change. If the have unpaid claims incurred while a participant they need to get those filed before the run out period ends. This would also be in the SPD.

[Guest twd]

The SPD is silent on the issue (this will be changed in future SPDs). The participant did have funds remaining from the period in which she was contributing, but the service dates of her claims are after the date she stopped contributing.