Flexible Spending Account (FSA)

A Flexible Spending Account (FSA) is a type of savings account that provides employees with specific tax advantages. The account allows employees to contribute a portion of their regular earnings to pay for qualified expenses, such as medical or dependent care costs. The funds in an FSA are contributed pre-tax, therefore reducing the amount of income tax you have to pay.

Last updated: July 23, 2023 9 min read

What Is Flexible Spending Account (FSA)?

A Flexible Spending Account (FSA) is a special account you put money into that allows you to pay for certain out-of-pocket health care costs. This money is deducted from your paycheck before taxes are applied, which allows for some tax advantage. However, funds must often be used within the designated benefit year.

What Is the History of Flexible Spending Account (FSA)?

The Flexible Spending Account (FSA) was first introduced in the United States in the 1970s as part of the Employee Retirement Income Security Act (ERISA). This act enabled employers to create cafeteria plans, allowing employees to use pre-tax dollars to pay for eligible health care expenses. Over the years, the rules and regulations concerning the usage of FSA funds have undergone several changes according to different tax law amendments, including the Affordable Care Act.

How Do You Calculate Flexible Spending Account (FSA)?

The amount you contribute to a Flexible Spending Account (FSA) is decided by you, within the limits set by the IRS. As of 2022, the maximum amount you can contribute to an FSA is $2,850 per year.

To calculate your FSA, you should estimate your expected out-of-pocket medical expenses for the upcoming year. This includes deductibles, copayments for medical visits and prescription drugs, over-the-counter medications, medical equipment, supplies, and other health care expenses not covered by your health insurance. Consider your previous year's expenses as a starting point, and adjust for any expected changes.

Once you've estimated the total amount, this is the amount you can set aside in your FSA, up to the IRS limit. It will be deducted from your paycheck in equal parts throughout the year before taxes.

Remember, FSAs typically operate on a use-it-or-lose-it basis, which means funds not used by the end of the plan year (or grace period if your employer offers one) are forfeited.

Please note that each person's circumstances are different, and it can be beneficial to seek advice from a tax or financial professional when determining your FSA contributions.

What Are Some Examples of Flexible Spending Account (FSA)?

There are primarily two types of Flexible Spending Accounts (FSAs):

  1. Healthcare FSA: This account is used for out-of-pocket healthcare costs. These can include expenses such as copayments, deductibles, prescription drugs, over-the-counter medications, glasses, contact lenses, and more.

  2. Dependent Care FSA: This account is used to pay for certain types of dependent care. This can include daycare costs for children under 13, adult daycare for dependent senior citizens, and care for any dependent incapable of self-care.

The list of eligible expenses for both types of FSAs can also be found in the IRS Publication 502. It is always recommended to check this list because some expenses require a doctor's prescription to be considered eligible.

What's the Difference Between Flexible Spending Account (FSA) and Health Savings Account (HSA)?

Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs) both provide pre-tax dollars to pay for eligible health care expenses, but they have distinctive features:

  1. Ownership and Eligibility: HSAs are owned by the individual and require a qualifying high-deductible health plan (HDHP). FSAs are owned by the employer and do not require an HDHP.

  2. Rollover: HSAs allow you to roll over all unspent money for future years. FSAs typically allow up to $500 to roll over to the next year, or offer a grace period into the following plan year to use the funds, depending on the employer's plan.

  3. Portability: HSAs are portable and remain with you if you change jobs. FSAs are not portable; if you leave or lose your job, you lose your FSA unless you are eligible and choose to continue coverage under COBRA.

  4. Contribution limits: For 2022, the maximum limit for HSA contributions is $3,650 for self-only and $7,300 for family coverage. For FSAs, the contribution limit for 2022 is $2,850.

  5. Change in contribution amount: With an HSA, you can change the contribution at any point during the year. For FSAs, you cannot change the contribution amount mid-year unless there is a qualifying event such as marriage, birth of a child, or job change.

  6. Investment: HSA funds can be invested and the earnings grow tax-free. FSA contributions cannot be invested.

Always consult with a tax or health care professional for personal advice based on your specific circumstances. This information may vary and rules might have changed based on new guidelines or regulations.

What's the Difference Between Flexible Spending Account (FSA) and Health Reimbursement Account (HRA)?

Flexible Spending Accounts (FSAs) and Health Reimbursement Accounts (HRAs) are both tools used for managing healthcare costs, but they have several important differences:

  1. Ownership: FSAs are owned by the employee, while HRAs are entirely owned by the employer.

  2. Contributions: In an FSA, employee contributions are made pre-tax via payroll deductions. An HRA, on the other hand, is entirely funded by the employer.

  3. Rollover of funds: In an FSA, the employee may lose unused funds at the end of the year, depending on the specifics of the employer's plan (up to $500 may be carried over, or a grace period may be granted). For HRAs, policies on rollovers vary, but in most cases, remaining funds can be rolled over to the next year.

  4. Portability: FSAs are not typically portable—if you leave your job, you lose access to your FSA funds unless you choose to continue coverage under COBRA. HRAs are not portable at all—when you leave a job, you can't take remaining HRA funds with you.

  5. Eligible expenses: Both FSAs and HRAs can be used for out-of-pocket health expenses, but the specific list of eligible expenses may differ between plans.

  6. Availability: Most employees, regardless of their health plan, can use an FSA, but an HRA is typically paired with certain types of health insurance plans and is less common than FSAs or HSAs.

Please, consult with your human resources department or a tax professional for information tailored to your specific circumstances. This information might vary, and the regulation can change.

What Are Some Examples of Health Reimbursement Account (HRA)?

Health Reimbursement Accounts (HRAs) come in several forms, depending on the specific arrangements agreed upon by an employer and their employees. Here are a few common examples:

  1. Integrated HRA: This type of HRA is paired with a high-deductible health plan. Once the employee meets their deductible, the HRA can be used to pay for qualified medical expenses until the account is depleted.

  2. Retiree HRA: Some companies offer HRAs for their retired employees to pay for eligible healthcare expenses, including Medicare premiums.

  3. Limited Purpose HRA: This type of HRA is designed to complement an HSA and is usually restricted to dental and vision care expenses.

  4. Qualified Small Employer HRA (QSEHRA): Small businesses that do not provide group health insurance to their employees can offer a QSEHRA. This allows employers to provide a set amount of money each month for employees to purchase individual health insurance or use for qualified health care expenses.

  5. Individual Coverage HRA (ICHRA): This acronym represents a type of HRA that can be offered by employers of any size, and it allows employees to be reimbursed for individual health insurance coverage and other medical expenses.

  6. Excepted Benefit HRA (EBHRA): This HRA type is designed to complement traditional group health insurance, and can pay for copayments, deductibles, or other expenses not covered by the primary plan, or for other types of coverage like dental, vision, or short-term plans.

The specifics of each HRA can vary depending on the employer's stipulations and plan details. As such, employees are advised to thoroughly understand their specific HRA plan and its benefits.

What Factors Influence the Usage of a Flexible Spending Account (FSA)?

Several factors can influence the usage of a Flexible Spending Account (FSA):

  1. Financial Situation: The individual's or family's financial situation can influence the decision to use an FSA. Those who have a stable income might be more inclined to take advantage of the tax benefits.

  2. Healthcare Needs: Expected medical expenses significantly influence FSA usage. Those with predictable, recurring medical costs (for example, regular prescriptions or ongoing treatments) or anticipated health expenses (like planned surgeries or maternity care) may be more likely to take full advantage of an FSA.

  3. Tax Benefits: FSA contributions are pre-tax deductions, which can lower taxable income. People might use an FSA to reduce their tax burden.

  4. Risk Tolerance: Since many FSAs operate on a use-it-or-lose-it principle, individuals who are comfortable with this risk and can accurately forecast their healthcare expenditures may be more likely to use an FSA.

  5. Understanding of FSA: Knowledge about how an FSA works, its benefits and limitations, positively influences its usage. Misunderstanding or lack of awareness can lead to underutilization.

  6. Employer communication and education: Effective communication and education about the benefits and usage of FSAs by employers can encourage their uptake and utilization.

  7. Size of the benefit: The dollar amount of the benefit can impact utilization. A larger benefit can encourage more usage.

  8. Family size: Larger families or those with dependents who have health care needs might utilize FSAs more due to higher health-related expenses.

  9. Availability of other benefits: Access to other types of accounts like Health Savings Accounts (HSAs) or Health Reimbursement Accounts (HRAs) might impact the decision on whether to use an FSA.

What Are the Benefits of Flexible Spending Account (FSA)?

Flexible Spending Accounts (FSAs) provide multiple benefits:

  1. Pre-tax Contributions: Contributions to your FSA are deducted from your pay before your income taxes are calculated, which decreases your taxable income and could potentially put you in a lower tax bracket.

  2. Tax-Free Withdrawals: Withdrawals used to pay for eligible health care expenses are not taxed.

  3. Covers a Wide Range of Expenses: You can use your FSA to pay for a variety of out-of-pocket medical expenses, including copayments, deductibles, prescription medications, and even some over-the-counter medications and medical equipment.

  4. Immediate Availability of Funds: Unlike HSAs and HRAs, the total amount you elect to contribute to your healthcare FSA for the year is available from the beginning of the plan year, regardless of the amount you've contributed to date.

  5. Employer Contributions: Depending on your individual employer's plan, your employer can also contribute to your FSA, increasing the amount of money you have to spend on eligible medical expenses.

  6. Potential for Carryover or Grace Period: Depending on your plan, you might be able to carry over up to $500 of unused funds into the following year, or you might have a grace period (usually 2.5 months) to use the unused funds in the next plan year.

Remember, the specifics of each FSA benefits package can vary depending on the employer's stipulations and plan details. Always consult with your human resources department or a financial advisor for information tailored to your specific circumstances.

What Are the Potential Disadvantages of Utilizing a Flexible Spending Account (FSA)?

While Flexible Spending Accounts (FSAs) offer numerous benefits, they also come with some potential disadvantages:

  1. Use-it-or-lose-it Rule: If you don't use all the money in your FSA by the end of the year, or by the end of the grace period if your employer's plan offers one, you lose any funds left unused. There is the potential to waste money if you overestimate your healthcare expenses.

  2. Dependent on Employment: FSAs are employer-sponsored, meaning if you leave or lose your job, you lose access to the funds in your FSA unless you can continue coverage under COBRA.

  3. Limited Time to Use Funds: Funds must often be used within the plan year. While some employers may offer a carryover option or grace period, not all do.

  4. No Portability: Unlike an HSA, FSA funds do not roll over year after year, and the funds do not travel with you if you change jobs.

  5. Predicting Healthcare Costs: It can be difficult to accurately estimate your healthcare costs for the upcoming year when deciding on your FSA contribution amount. Overestimating could lead to wasted funds due to the use-it-or-lose-it rule, while underestimating may leave you with more out-of-pocket healthcare costs than expected.

  6. Funds are Not Investable: Unlike HSAs, the money in FSAs cannot be invested to potentially grow over time.

  7. Potential for Misuse: If you use an FSA incorrectly, for example by spending funds on non-qualified expenses, you could be subject to penalties.

Remember to review carefully the specifics of your FSA plan and consult with a financial advisor or your HR department, so you understand these potential disadvantages.

Which Employers Are Likely to Be Affected by Flexible Spending Account (FSA)?

Flexible Spending Accounts (FSAs) are employer-established benefit plans, and typically companies in the following categories are most affected:

  1. Large Corporations: Large corporations, where the cost-savings associated with tax advantages can be significant due to the larger number of employees, often offer FSAs as part of their comprehensive employee benefits package.

  2. Mid-sized Businesses: Mid-sized businesses also often provide FSAs to attract and retain talent, offering a robust benefits package to compete with larger corporations.

  3. Health-conscious Companies: Companies that emphasize health and wellness often offer FSAs to encourage employees to manage their health proactively.

  4. Companies with Highly-paid Employees: Since contributions to FSAs lower taxable income, companies with highly-paid employees are likely to offer FSAs because of their potential to reduce employees' annual tax burdens.

  5. Organizations Seeking to Minimize Employee Absenteeism: Companies that aim to reduce employee sick days and promote overall wellbeing might offer FSAs as part of their strategy to encourage employees to address medical issues promptly.

Remember, offering an FSA not only benefits the employees but also employers. Contributions made by employees to an FSA are not subject to payroll taxes, potentially saving employers money.

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