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OPS-SOP-028 — FSA / HSA Administration (HealthEquity)

Document IDOPS-SOP-028 Version1.0 Effective Date[TBD — upon adoption] Next ReviewAnnually OwnerOperations / HR (Nuwell)
Prepared ByOperations

1. Purpose

This SOP governs the setup, administration, and ongoing management of Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) for participating employer groups under the Unity Care Member Plan Master Trust. HealthEquity is the designated FSA/HSA administrator. The Nuwell HR/Benefits Administrator is the primary employer-side contact for FSA/HSA setup and payroll instructions.

2. Scope

Applies to all participating employer groups offering FSA or HSA benefits. Covers account setup, employee enrollment, payroll deduction configuration, annual limit updates, mid-year changes, eligibility file feeds, and excess contribution correction procedures.

3. Roles & Responsibilities

Role Responsibility
HealthEquity HSA and FSA account administration; member portal; debit card issuance; eligibility file processing; compliance reporting.
HR / Benefits Administrator (Nuwell) Owns FSA/HSA setup for Nuwell employer group; manages payroll deduction instructions; coordinates employee enrollment and mid-year changes.
Operations Coordinates HealthEquity setup for new employer groups; monitors HealthEquity file feed accuracy; escalates eligibility discrepancies; ensures annual limit updates are implemented before January 1.
Employer HR (all groups) Configures payroll deductions in payroll system; submits enrollment data; processes mid-year changes upon qualifying life events.

4. HSA Eligibility Requirements

HSA Eligibility Rule: An employee may only contribute to a Health Savings Account if they are enrolled in a qualifying High Deductible Health Plan (HDHP). Under Unity Care's plan options, eligible plans include the HSA EPO and the DPC HDHP plan options. Employees enrolled in non-HDHP plans (including standard EPO or other lower-deductible plans) are not eligible to make or receive HSA contributions.

5. FSA Availability

Flexible Spending Accounts (FSA) are available to employees enrolled in any plan option offered under the Unity Care Member Plan Master Trust, including non-HDHP plans. Employees enrolled in an HDHP with an active HSA may only contribute to a Limited-Purpose FSA (dental and vision expenses only) to preserve HSA eligibility.

FSA vs. HSA Interaction: An employee cannot hold both a general-purpose FSA and an HSA simultaneously. If an employee is HSA-eligible and enrolled in an HDHP, they may only use a Limited-Purpose FSA. Operations confirms this at setup with HealthEquity.

6. New Employer Group Setup

Step 1 — HealthEquity Account Creation

Operations contacts HealthEquity to establish an employer account for the new employer group. Required information includes: employer legal name, EIN, plan effective date, plan options offered (to determine HSA vs. FSA eligibility), and employer HR contact details. HealthEquity confirms account activation in writing.

Step 2 — Payroll Deduction Instructions Configured

Employer HR configures payroll deduction codes in the payroll system for FSA and/or HSA contributions. Deduction amounts must match employee elections. Operations reviews the deduction configuration for accuracy before the first payroll cycle. Nuwell HR owns this step for the Nuwell employer group.

Step 3 — Employee Enrollment Submitted to HealthEquity

Employer HR submits employee election data (name, SSN, plan option, FSA/HSA election amount, payroll frequency) to HealthEquity via the enrollment file or HealthEquity's employer portal. Operations confirms HealthEquity receipt and account activation for each enrollee.

Step 4 — Eligibility File Feed Established

Operations ensures the HealthEquity eligibility file feed from Allied is active and accurate. Allied transmits enrollment data (including plan option) to HealthEquity on the standard feed schedule. Operations confirms the first feed transmission is received and processed correctly.

Step 5 — Employee Communication

Employer HR distributes HealthEquity welcome materials and debit card instructions to enrolled employees. Operations confirms distribution is complete before the plan effective date.

7. Annual Limit Updates

The IRS publishes annual FSA and HSA contribution limits each fall (typically October/November). Operations must ensure all payroll deductions and HealthEquity account limits are updated before January 1 of the new plan year.

Account Type Limit Source Update Deadline Owner
HSA (self-only and family) IRS Rev. Proc. (published fall) Payroll updated before January 1 Employer HR / Operations
FSA (health care) IRS Rev. Proc. (published fall) Open enrollment elections must comply with new limits Employer HR / Operations
FSA (dependent care) IRS (typically unchanged) Confirm limit annually; update if changed Employer HR
Process: Operations monitors IRS announcements each October/November. Upon publication, Operations notifies all employer HR contacts of new limits with instructions to update open enrollment materials and payroll configurations. HealthEquity account limits are updated by HealthEquity on their system; Operations confirms update is applied before the new plan year begins.

8. Mid-Year Changes

FSA and HSA election changes mid-year are only permitted upon a qualifying life event (QLE). QLEs include: marriage, divorce, birth or adoption of a child, death of a dependent, change in employment status (self or spouse), change in dependent care needs, and loss or gain of other coverage.

No changes outside QLEs: FSA/HSA elections are irrevocable except upon a qualifying life event. Employer HR may not process mid-year changes without QLE documentation on file. Operations escalates disputes to Legal Counsel.

9. Eligibility File Feed Monitoring

Operations monitors the HealthEquity file feed from Allied on a monthly basis to ensure eligibility accuracy:

Step 1 Operations reviews HealthEquity's eligibility file confirmation reports each month (following the standard Allied file feed transmission date).
Step 2 Operations compares HealthEquity's active account roster against Allied's enrollment data. Discrepancies (active HSA but enrolled in non-HDHP plan; terminated employee with active account; missing enrollee) are flagged.
Step 3 Discrepancies are corrected within 5 business days. Operations coordinates correction between HealthEquity and Allied. Employer HR is notified if payroll action is required.
Step 4 Operations maintains a monthly reconciliation log documenting discrepancies found, corrections made, and resolution dates.

10. Excess Contribution Correction

If an employee contributes more than the IRS annual limit to their HSA or FSA, the excess must be corrected to avoid tax penalties.

Account Type Consequence of Excess Correction Deadline Correction Method
HSA Excess contributions subject to income tax + 6% excise tax (IRC §4973) April 15 of the following tax year (or October 15 with extension) Withdraw excess + earnings from HealthEquity before tax filing deadline. HealthEquity issues corrected Form 5498-SA.
FSA Elections above IRS limit are non-compliant; employer must correct the plan document / election Before excess is received / first payroll of plan year Employer HR corrects the payroll deduction; HealthEquity notified; excess election reversed.
Process — HSA Over-Contribution

If Operations or employer HR identifies an HSA over-contribution: (1) Notify the employee in writing identifying the excess amount and applicable deadline. (2) Direct employee to request a withdrawal of excess contributions + attributable earnings from HealthEquity. (3) Employee reports on Form 8889 (filed with personal tax return). (4) Employer HR corrects payroll deduction to prevent future over-contributions. (5) Operations logs the corrective action.

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