IRS gives double tax benefits of health FSAs a boost

As we inch closer to 2014, many clients are gearing up for a potential reduction in covered health benefits as employer-sponsored health plans are modified and insurers have begun cancelling coverage in anticipation of the Patient Protection and Affordable Care Act (PPACA) effective date. Planning for these costs is heating up, and the IRS has placed the significance of the health flexible spending account (FSA) as a tax-free funding tool in the spotlight. While reducing taxable income in light of higher tax rates is a priority for many clients, the potential for increased out-of-pocket medical expenses under PPACA may provide an even stronger motivation in 2014. As a result, the double tax benefits offered by FSAs have become more valuable than ever, and the IRS has recently taken steps to ease the restrictions that may have previously dissuaded clients from taking advantage of these vehicles.


Flexible Spending Accounts: The basics

A client whose employer offers the health FSA option is permitted to contribute up to $2,500 annually in pre-tax dollars to these accounts which, in turn, are used to pay for qualified medical expenses that are not covered under the client’s health insurance plan. Because many clients are anticipating higher out-of-pocket health expenses in 2014, FSAs are likely to become more popular than ever because they provide a tax-preferred method of paying for higher co-pays and other health expenses that may be considered “non-essential” under the new law.

Despite this, many clients — especially younger and healthier clients — may have been wary of committing funds to a health FSA in the past because of the so-called “use-it-or-lose-it” rule that required clients to exhaust FSA balances each year to avoid forfeiting those funds. While employers are permitted to include a two and a half month grace period if a client fails to incur enough medical expenses to drain his FSA account during the year, all remaining funds are still forfeited at the end of that period.

In order to encourage their use, the IRS has issued rules designed to make FSAs more flexible by allowing employers to provide that up to $500 of a remaining FSA balance may be carried over into the next tax year. However, it should be noted that employers are not required to offer the $500 rollover option, and they are prohibited from offering both the two and a half month grace period and the rollover option in the same year.

See also: IRS eases FSA use-it-or-lose-it rule

Further, the $500 rollover option is not available for dependent care FSAs, which are similar to health FSAs but instead offer a tax-preferred method to reimburse clients for qualified dependent care expenses.

Tax implications for 2014

While contributing to an FSA reduces the client’s taxable income, it is important to note that, unlike 401(k) or IRA contributions, funds contributed to the FSA are never taxed if they are used to pay for qualified medical expenses (a term that is broad enough to include items such as eyeglasses, hearing aids, and dental expenses).

Because tax rates on income, along with those applicable to capital gains and other investment-type income, have been increased for the foreseeable future, permanently removing funds from a client’s taxable income has become a priority for many clients.

As a refresher, clients whose income exceeds $406,750 in 2014 ($457,600 for joint returns) are subject to the new top tax rate of 39.6 percent, as well as the new 20 percent tax on capital gains. The value of itemized deductions and the personal exemption begins to phase out for single taxpayers with income in excess of $254,200 ($305,050 for joint returns). Also, the additional 3.8 percent tax on investment income applies once a client’s income reaches a certain threshold level.


Reducing taxable income may always be a priority for clients, but forces have combined in 2014 to make planning for increased health-related costs equally important for many. Therefore, employer-sponsored accounts such as health FSAs are likely to attract more attention this year, as clients seek to permanently reduce taxable income while simultaneously paying for health care costs on a tax-free basis.

For previous coverage of using tax-preferred accounts to plan for ACA-related changes in Advisor’s Journal, see The Affordable Care Act Raises the Stakes for HSAs.

For in-depth analysis of planning with tax-preferred health FSAs, see Advisor’s Main Library: HRAs and Cafeteria Plans.

Your questions and comments are always welcome. Please contact the Panel of Experts.

About the Author
Robert Bloink

Robert Bloink

Robert Bloink worked to put in force in excess of $2B of death benefit for the insurance industry’s producers in the past five years. His insurance practice incorporates sophisticated wealth transfer techniques, as well as counseling institutions in the context of their insurance portfolios and other mortality based exposures. Robert Bloink is a professor of tax for the Graduate Program of International Tax and Financial Services, Thomas Jefferson School of Law.

Previously, Robert Bloink served as Senior Attorney in the IRS Office of Chief Counsel, Large and Mid-Sized Business Division, where he litigated many cases in the U.S. Tax Court, served as Liaison Counsel for the Offshore Compliance Technical Assistance Program, coordinated examination programs audit teams on the development of issues for large corporate taxpayers, and taught continuing education seminars to Senior Revenue Agents involved in Large Case Exams. In his governmental capacity, Mr. Bloink became recognized as an expert in the taxation of financial structured products and was responsible for the IRS’ first FSA addressing variable forward contracts. Mr. Bloink’s core competencies led to his involvement in prosecuting some of the biggest corporate tax shelters in the history or our country. He can be reached at

About the Author
William H. Byrnes

William H. Byrnes

William Byrnes is the leader of Summit Business Media's Financial Advisory Publications, having been appointed July 1, 2010. He has been an author and editor of ten books and treatises and seventeen chapters for Lexis-Nexis, Wolters Kluwer, Thomson-Reuters, Oxford University Press, Edward Elgar, and Wilmington, as well as numerous commissioned, peer-reviewed, and law review articles. He was a Senior Manager, then Associate Director of international tax for Coopers and Lybrand, which subsequently amalgamated into PricewaterhouseCoopers, practicing in Africa, Europe, Asia, and the Caribbean.

He has been commissioned and consulted by a number of governments on their tax and fiscal policy from policy formation to regime impact. He has served as an operational board member for companies in several industries including fashion, durable medical equipment, office furniture, and technology. Since 1994, he has been a professional trainer for professional association conferences, government workshops, and financial service institutions in-house meetings.

Before Associate Dean Byrnes joined the administration of Thomas Jefferson School of Law, he was a tenured law faculty member at St. Thomas School of Law. He serves on the Academic Committee of the American Academy of Financial Management. He created the first online graduate program offered to wealth managers and life insurance producers without any legal background—see (Graduate Program of International Tax and Financial Services, Thomas Jefferson School of Law).


Originally published on National Underwriter Advanced Markets. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.


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