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H.S.A.
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HRA
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FSB
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Program Sponsor
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Individuals & Employers
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Employer Program Only
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Employer Program Only
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Health Plan Requirements
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IRS qualified HDHP required
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None required by IRS
Typically sold with a higher deductible health plan
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None
Can be sold with any health plan(s)
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Account Type
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Employee trust or custodial
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Employer notational account
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Employer notational account
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Contributions
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Employers and / or individuals, up to IRS limits. Contributions & investment earnings
are tax-free
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Employer contributions only.
Tax deductible by employer.
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Employers and / or employees may contribute.
Tax deductible by employer, pre-tax to employees.
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Distributions
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Tax exempt for QMEs. Taxable + 10% penalty for all other withdrawals.
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Tax exempt for QMEs.
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Tax exempt for QMEs.
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Rollover
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Yes
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Yes
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No
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Portability
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Yes
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No
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No
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Validate Expenses
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Individual’s responsibility
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TPA
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TPA
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Administration
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Provided by a qualified financial institution
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Provided by employer or Third-party administrator
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Provided by employer or Third-party administrator
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Small Employers
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Yes
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Yes
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Yes
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Large Employers
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Yes
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Yes
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Yes
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C-Corp Owners
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Yes
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Yes
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Yes
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Self-Employed
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Yes
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No
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No
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Plan Document
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No
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Yes
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Yes
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Summary Plan Description
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Yes
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Yes
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Yes
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Special Health Insurance Policy Required
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Yes
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No
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No
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Employer Contributions
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Optional
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Required
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Optional
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Employee Contributions
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Optional
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No
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Optional
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Employee Tax Savings
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Contributions are tax-free
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Claims reimbursements are tax-free
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Contributions are tax-free
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Employer Tax Savings
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Business expense. 7.65% of employee contribution
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Business Expense deduction for payments
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Business expense. 7.65% of employee contribution
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Account Prefunded by Employer
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No
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No
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Yes
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Roll Unused Dollars to Next Year
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Yes
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Yes
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No
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Reimburse IRC Section 213(d) medical expences not covered by any other plan
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Yes
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Yes
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Yes
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Claims substantiation
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Yes, upon audit
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Yes
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Yes
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Debit Card
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Yes
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Yes
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Yes
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Insurance Premiums paid for from account
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Yes*, special rules apply
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Yes
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No
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Long-term care premiums paid from account
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Yes
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Yes
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No
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Banking
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IRA-type account
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Employer Assets
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Employer Assets
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Convert account to taxable income
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Yes*, special rules apply
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No
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No
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Annual IRS DOL Form 5500 (no tax due)
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No
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Yes**, if over 100 participants, Welfare Benefit Rules Apply
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Yes**, if over 100 participants, Welfare Benefit Rules Apply
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COBRA applies
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No
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Yes
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Yes*, special rules apply
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HIPAA certification rules apply
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No
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Yes
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No*, special rules apply
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HIPAA privacy and security rules apply
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Yes, if claims adjudicated
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Yes
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Yes
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Account retained by employee upon termination of employment
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Yes
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No, but terminated employees may be covered by plan
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No
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