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Cafeteria plan changes offer more options for employees, employers

Employers 09.08.2020 6 MIN READ


The impact of the COVID-19 pandemic reached into many corners of life and forced individuals to grapple with unprecedented concerns about matters such as healthcare and child care. In response, the Internal Revenue Service (IRS) gave employees enrolled in Section 125 cafeteria plans some relief by granting their employers the option to provide workers with more plan flexibility.

While most of these changes are only valid for this year, they still can be welcome news for employees struggling to adjust to the effects of the pandemic. However, these provisions also present challenges for employers in terms of administrative responsibilities and costs.

Either way, both employers and employees have decisions to make regarding these new options.

Cafeteria plan overview

To quickly review, a cafeteria plan is an employer-sponsored fringe benefit plan that provides employees with the opportunity to choose from at least one cash benefit and one qualified benefit.

Qualified benefits are offered on a pre-tax basis, and include the following:

  • Health insurance
  • Group term-life insurance
  • Disability insurance
  • Adoption assistance
  • Health savings account (HSA)
  • Health flexible spending account (FSA)
  • Dependent care assistance plan (DCAP)

What’s changed with cafeteria plans

The IRS provisions impacted several aspects of cafeteria plans. However, these changes aren’t mandatory for employers, and companies can place restrictions on changes they choose to accept. So, as an employee participating in a plan, check with your organization to see if any of the changes described below were adopted by your company, or may be implemented later.

Qualified life event

Normally, you must make any elections for qualified benefits before the plan year starts. But you’re also typically allowed—if your employer agrees to it—to make a mid-year change when you experience a “qualifying life event” which is defined as a loss of health coverage, change in marital status or change in dependent status. If you don’t experience any of these life events, you need to wait until the next open enrollment window to alter your plan.

However, for the calendar year 2020, the IRS is temporarily waiving the qualifying life event requirement allowing you to modify elections to your health plan or FSA for any reason.

Health plan coverage

You may have the ability to join a plan that you initially declined, modify your current election or drop your plan coverage at any point this year.

Health FSA and DCAP

You may now temporarily increase, decrease or revoke any existing elections to FSAs and DCAPs, or even make a new election.

Additionally, most health FSAs and DCAPs follow a “use-it-or-lose-it” rule. But cafeteria plans sometimes feature either a carryover or grace period option.

A carryover enables you to take advantage of any unused health FSA funds from the previous year (up to a specified amount) in the following plan year. Meanwhile, a grace period allows you to apply unused health FSA or DCAP funds to pay expenses incurred in the first two months and 15 days following the end of a plan year.

The new rule extends the grace period until December 31, 2020. You may use the money to pay for any medical or dependent care expenses.[K1]

The IRS also implemented a permanent change to health FSA carryovers. Beginning in plan year 2021, the carryover amount will be indexed each year at 20% of the maximum health FSA pre-tax contribution. For 2021, the carryover increases from $500 to $550.

Other considerations for employees

Some of the rule changes came with caveats. For instance, let’s say you have a general-purpose healthcare FSA with a grace period and had a balance in your account at the end of the year. You decide to move to a high-deductible plan during 2020. If your organization has extended the grace period until December 31, 2020 under the new rules, you can’t make any HSA contributions this year.

Also, if you switch your coverage, it may mean you’ll need to start over with your deductible. In other words, any amount you’ve applied towards your deductible on your previous plan might not be applied to your new coverage.

Do you have vision or dental coverage? At the moment, it’s not clear if the rule changes apply to these benefits. Consult with your organization as the year progresses for any updates.

Any modifications adopted by your organization must be made by December 31, 2021. But, the changes will be retroactive to January 1, 2020 no matter when they’re implemented.

Considerations for employers

As an employer, you can decide whether to adopt any of the changes made by the IRS, and you also may place restrictions on those you implement—as long as they comply with the Section 125 non-discrimination rules. Before making any changes, it’s advisable to conduct a careful review of your employee population to determine their current needs.

While incorporating changes may create additional administration responsibilities and costs, doing so can demonstrate good stewardship as an employer. You’ll be giving employees some needed flexibility during a time of uncertainty, especially with FSA accounts that may now be under- or over-funded because of the pandemic fallout.

However, providing employees with more freedom might lead to unanticipated consequences. For example, it could result in adverse selection, with healthier workers opting out or reducing their coverage while less-healthy ones maximize their coverage. To avoid this, you might restrict the types and number of changes permitted—such as only allowing a switch from single to family coverage, or from a low-deductible to a high-deductible plan.

Don’t forget to communicate any potential changes to your plan providers, too. As an example, consult with your insurance or stop-loss carriers to see if they’ll object to or place limits on any modifications an employee may make to their plan.

Other possible tips or suggestions you should consider:

  • Refer to “indexing” instead of using a specific dollar amount going forward with any documents about health FSA carryovers.
  • Make sure employees don’t try to revoke or reduce their health FSA contributions if the amount elected has already been spent (to avoid this situation, you could only allow employees to increase their contributions).
  • Check with your third-party administrator to ensure an employee taking advantage of the extended grace period hasn’t already forfeited those funds.
  • Review any required notices that must be distributed to your employees regarding these changes to see if they contain your desired messaging. In addition, providing educational material can help employees reach well-informed decisions.

Getting support

No matter if you’re an employee or employer, the rule changes give you plenty to think about.

As an employee, are you curious how these changes affect your financial plan? Contact your Ayco advisor for help maximizing the financial opportunities from your compensation and benefits. If you’re unsure whether your company offers Ayco Financial Counseling, please talk to your human resources representative.

Employers who work with Ayco have regular access to our thought leadership from specialists in benefits, compensation and other areas. Contact us to see how Ayco can help your team.



For disclosures relating to this article, please click here.