frequently asked questions
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Employees are eligible to join the plan based upon the terms in the Plan Document and Summary Plan Description. Typically, employees may join the plan at the same time they become eligible for your group medical plan. If eligibility is triggered due to a status change event (birth, marriage, divorce, etc.) then employees have 30 days to join after they become eligible. Please see the Change in Status form provided with the administrative binder.
Enrollment information can be submitted in one of the following ways:
- Email: firstname.lastname@example.org
- Enter elections online
No, participants need to keep their current debit cards. Those participants who are currently utilizing the debit card option will not receive new cards, but rather their new election amount will be loaded to their existing card. The Card expires every five years, at which time participants who elect it will automatically receive a new Card in the mail.
Claims run-out is a period of time after the plan year has ended for the participant to submit claims for reimbursement. The Grace Period is an additional 2 ½ months after the plan year end date that permits participants to incur expenses against the balance in the plan year that recently ended. If the previous plan year balance doesn’t cover the amount of the claim, any residual amount would then be applied to the current plan year. Grace Period expenses must be submitted manually and by the end of the claims run-out period.
Yes, participants can make changes to their elections mid-year if they have experienced a status change event. The requested election change must be consistent with the status change event. Please click here to get a list of eligible status changes.
It is important to discuss LOA options with the employee before they go on leave. First, determine whether the employee wants to continue coverage during leave. If so, determine how they will fund the benefit. If coverage continues, expenses incurred during leave are eligible.
There are three funding options: 1) accelerate contributions out of the last paycheck before leave begins; 2) pay-as-they-go by sending contributions to the employer each pay period (similar to COBRA); and 3) catch-up payments upon return. The employer would not record a LOA date with Navia and expenses incurred during leave would be eligible.
If the employee revokes FSA coverage, expenses incurred during the LOA are not eligible for reimbursement. Upon return from leave, the employee may resume their original per paycheck deduction (thereby decreasing their annual election by the amount of the missed contributions) or they may increase their per paycheck deduction to meet their annual election. Remember that they revoked coverage during leave so regardless of their payment options upon return any expenses incurred during leave are not eligible. You must record an LOA start and end date with Navia to ensure ineligible expenses are not reimbursed.
Employers may differ in their application of these rules. Check your Plan Document or employee handbook for more information.
Upon termination or retirement of employment, the participant can stop participation in the Plan or continue to participate through accelerated contributions or with monthly post tax contributions.
IRS regulations require that all Section 125 Plans undergo NDT each plan year. The NDT is included in your plan.
You can generate a Year-to-Date (“YTD”) report on the Employer Portal. This report can be generated for a specific date range and will list the contributions, disbursements, and annual amounts for your participants.
In general, an employee cannot change their elections after the beginning of the Plan Year. However, if they have experienced a “change in status” they may be able to change their election. Keep in mind that their election change request must be consistent with the change in status they or their spouse and/or dependent experienced. The following is a list of some change in status events:
- Divorce, legal separation, or annulment
- Death of a spouse or Dependent
- Birth, Adoption, or placement for adoption
- A dependent ages off the plan
- Change in employment status that affects eligibility for benefits such as;
termination, commencement of employment, a strike or lockout, return from an unpaid leave of absence