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Third-Party Administration (TPA)

HSA – FSA – HRA Administration

Benefit accounts – also known as Consumer-Directed Healthcare (CDH) accounts – allow pre-tax money to be set aside for eligible expenses that might not be fully covered under traditional health plans. Avail offers fully managed tax-advantaged benefit accounts, including Health Saving Accounts (HSAs), Flexible Spending Account (FSAs) and Health Reimbursement Accounts (HRAs) that add value to your benefits program and reduce your payroll tax obligations. 

What is an FSA?

Flexible Spending Accounts (FSA) are part of the IRS Section 125, also known as cafeteria plan. FSAs are an employer sponsored benefit that allows employees to set aside money on a pre-tax basis for qualified medical and/or child care expenses.

The IRS regulates what services or purchases are eligible under Section 125. Each benefit under Section 125 has maximum contribution limits and guidelines for when elections can change. Current IRS limits which can be found at our Resources page.

Medical FSA:

  • Insurance deductible
  • Co-payments and coinsurance
  • Prescriptions
  • Dental or vision expenses

Dependent Care:

FSAs can also be established to pay for certain expenses to care for dependents while the legal guardian is at work. While this most commonly means child care, for children under the age of 13, it can also be used for children of any age who are physically or mentally incapable of self-care

Unlike a medical FSA, dependent care is a pay as you go account. Learn more from our Dependent Care guide.

Premium Only Plan (POP):

POP Plans allow employees to pay for their employer’s sponsored health plan premiums before taxes. Regulations require a legal plan document to offer this benefit.

Limited Purpose FSA:

Limited Purpose FSAs were designed to work in-conjunction with Health Savings Accounts (HSA). Participants who elect a Limited Purpose FSA can pay for dental and vision expenses with pre-tax funds. This plan helps employees save money while retaining their HSA eligibility.


Health Savings Accounts  

A Health Savings Account (HSA) is a type of personal savings account available to employees covered by qualified high-deductible health plans (HDHPs). The account is designed to help them save money for many out-of-pocket medical expenses like doctor visits, vision and dental care, and prescriptions.


Health Reimbursement Arrangements

With Avail, employers create a plan that’s best for their organization, with three plan options to fit types of expenses covered. Plus, our unique funding arrangement allows claim payment to employees before full plan funding has been received.

What is an HRA?

Health Reimbursement Arrangements (HRA) are a versatile benefit sponsored by employers. Plans can vary dramatically to meet the unique needs of each employer.

An HRA is the right choice for employers who want to provide maximum employee healthcare benefits in conjunction with a high-deductible health plan. Employers allocate a set dollar amount for employee medical expenses, and employees pay for healthcare expenses with tax-free, employer-provided funds. It’s a win-win!

Medical HRA:

  • Paid for solely by the employer and not provided pursuant to salary reduction election or otherwise under a Section 125 cafeteria plan
  • Co-payments and coinsurance
  • Prescriptions
  • Dental or vision expenses

QSEHRA (Qualified Small Employer)

  • An employer with less than 50 full time employees and does not offer a group health plan to any employees
  • The Small Employer HRA must be provided on the same terms to all eligible employees. However, the Cures Act allows benefits under the HRA to vary based on family size to help with varying health insurance plan costs
  • The maximum contributions for 2018 are $5,050 for individuals and $10,250 for families


COBRA Administration

The Consolidated Omnibus Budget Reconciliation Act (COBRA) requires employers to extend group health benefits to employees (and their families) who lose health benefits due to specific qualifying events.
When you choose Avail to manage your COBRA compliance via our comprehensive and efficient administration service you enjoy considerable cost savings over administering COBRA in-house. Our website offers convenient access and control for everything related to your Plan.

  • Access comprehensive real-time reports
  • Access easy-to-understand account reports
  • Access reports, forms, and online submissions

Online Portal

Allows you to view real-time information about COBRA participants, including:

  • Name, address, SSN, and DOB
  • Qualifying Event date and type
  • Latest date Qualified Beneficiaries may elect COBRA coverage
  • COBRA participant elections
  • Dependent details
  • Complete COBRA premium payment history
  • Any letter or other communication sent to the COBRA participant
  • A complete timeline of activity for each COBRA participant

Participant Service

Dedicated Service

We answer your participants’ questions and concerns, so you don’t have to get involved saving you time.
Web self-service:

  • 24/7 web access allows participants to manage their own accounts:
  • Online enrollment and review coverage
  • Pay online, verify payment receipts and research account status
  • Download copies of notices, communications, and coupons
  • Request recurring ACH for premium payments

Retiree Billing

After their years of service, your retirees deserve proper management of their ongoing benefits. Unfortunately, doing that in-house takes time and adds stress to your company’s team. With our retiree billing service and benefits administration, your retirees will work directly with our team to handle their payments and answer questions.

This employee benefits administration service ensures accuracy and timeliness while reducing demands on your Human Resources staff. Plus, it improves your bottom line.

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