The Ultimate Guide to Getting Your Product on the FSA Eligible List

To understand how to get a product FSA eligible, you need a step-by-step approach. Here are the main steps to guide you:

1. Register with SIGIS: This involves completing a Merchant Certification.
2. Implement an IIAS: Use a SIGIS-certified Third-Party Servicer (TPS)/POS Vendor.
3. Submit Your Products: Ensure they are added to the SIGIS Eligible Product List.

Navigating Flexible Spending Accounts (FSAs) can feel like an overwhelming task. With the IRS setting strict guidelines on what counts as eligible medical expenses, getting your product approved can open up a significant market opportunity.

FSAs allow consumers to use pre-tax dollars for medical expenses, offering a substantial savings advantage. However, only certain products qualify, and understanding the intricacies can save both time and frustration.

I’m Les Perlson, co-authoring this guide with the team at NPA Benefits. With decades of experience in the health insurance industry, I’ve seen the importance of making your product FSA-friendly. Here’s everything you need to know to make your product eligible and capitalize on this financial opportunity.

Understanding FSA Eligibility

Navigating Flexible Spending Accounts (FSAs) can feel like an overwhelming task. With the IRS setting strict guidelines on what counts as eligible medical expenses, getting your product approved can open up a significant market opportunity.

FSAs allow consumers to use pre-tax dollars for medical expenses, offering a substantial savings advantage. However, only certain products qualify, and understanding the intricacies can save both time and frustration.

I’m Les Perlson, co-authoring this guide with the team at NPA Benefits. With decades of experience in the health insurance industry, I’ve seen the importance of making your product FSA-friendly. Here’s everything you need to know to make your product eligible and capitalize on this financial opportunity.

What is an FSA?

A Flexible Spending Account (FSA) is a special account that lets employees save pre-tax money to pay for eligible healthcare expenses. This means that the money set aside in an FSA isn’t subject to payroll taxes, effectively increasing the value of every dollar saved.

FSAs are generally offered by employers as part of a benefits package. Employees decide how much money to contribute at the start of the year, and these funds can be used for a wide range of medical expenses, from co-pays to prescription medications.

Who Decides What is FSA Eligible?

The IRS, benefit plan administrators, and plan documents all play roles in determining what qualifies as an FSA-eligible expense. Below are the key factors:

IRS Criteria

The IRS provides the foundational guidelines for what counts as an eligible medical expense. According to the IRS, expenses must be primarily for the alleviation or prevention of a physical or mental defect or illness. This includes costs for:

• Doctor visits
• Prescription medications
• Medical devices
• Dental and vision care

Medical Necessity and LOMN

Some items not on the standard qualifying list can still be eligible if deemed medically necessary. This is where a Letter of Medical Necessity (LOMN) comes into play. A doctor can write a LOMN to recommend a product or service as necessary for a patient’s treatment. The LOMN is then reviewed by FSA administrators for approval.

Note: Even if an FSA administrator approves the LOMN, it may still be subject to IRS review during an audit.

Plan Administrators and Benefit Plan Documents

Once the IRS sets the guidelines, plan administrators and benefit plan documents further refine what is eligible. Each FSA plan may have its own set of rules and covered items, so it’s crucial to verify with the specific FSA plan administrator.

For example, some plans may cover over-the-counter medications only if they come with a prescription, while others may not.

Understanding these layers of criteria is crucial for getting your product on the FSA eligible list. By adhering to IRS guidelines and ensuring you have the necessary documentation, you can make your product accessible to a broader audience.

Next, let’s dive into the specifics of how to get a product FSA eligible, including the steps to register with SIGIS and submit your product for approval.

How to Get a Product FSA Eligible

Registering with SIGIS

The first step to getting your product FSA eligible is to register with the Special Interest Group for IIAS Standards (SIGIS). SIGIS is a non-profit organization that maintains the standards for determining which products qualify for FSA and HSA spending.

Membership and Fees

To become a SIGIS member, you need to complete an application on their website and pay an annual fee of approximately $200. This membership grants you access to the SIGIS portal, where you can submit your products for review.

Eligible Product List (EPL)

SIGIS maintains the Eligible Product List (EPL), which includes items that meet the criteria for FSA and HSA spending. Your goal is to get your product added to this list.

Submitting Your Product

Once you are a SIGIS member, the next step is to submit your product for inclusion in the EPL. Here’s how to do it:

1. Complete the Product Form

In the SIGIS member portal, you’ll find a form to submit your product. You’ll need to provide detailed information, including:

• 14-digit GTIN or UPC code: This is crucial as it uniquely identifies your product.
• Product name: Ensure it’s clear and descriptive.
• Rationale for addition: Explain why your product qualifies as a medical expense. This is the most critical part of your submission.
• Product URL: A link to your product page.
• Fine line code: A category code that best describes your product. SIGIS provides a reference document to help you identify the correct code.

2. Category Selection

Categorizing your product correctly is essential. It helps the review committee understand its use and relevance. Look at similar products already on the EPL to guide your category selection.

3. Comparison Items

Including comparison items in your submission can strengthen your case. Show how your product is similar to items already on the EPL. This can be particularly helpful if your product is unique or falls into a gray area.

Fast-Tracking Your Product

After submitting your product, it typically takes about a month for SIGIS to review and update the EPL. However, if you want to speed up the process, here are some tips:

1. Seller Support Case

For platforms like Amazon, you can create a seller support case to fast-track the addition of the HSA/FSA badge to your product listings. Mention that your product is on the SIGIS list and include the UPC code. This helps route your request to the correct team.

2. Amazon HSA/FSA Badge

Once your product is on the EPL, you can request Amazon to add the HSA/FSA badge to your product listings. This badge can significantly increase visibility and sales, as it signals to customers that they can use their FSA or HSA funds to purchase your product.

3. Ensure UPC Code Submission

Make sure your product’s UPC code is correctly submitted and matches the one on the SIGIS list. Amazon uses UPC codes to verify eligibility, so accuracy is crucial.

By following these steps, you can efficiently steer the process of getting your product FSA eligible, opening up a significant market opportunity. Next, we’ll explore common FSA eligible items to give you a better understanding of what qualifies.

Common FSA Eligible Items

When it comes to managing healthcare costs, knowing which items are FSA eligible can save you a lot of money. Flexible Spending Accounts (FSAs) cover a wide range of medical expenses, from everyday healthcare needs to more specialized treatments. Let’s explore some common categories and examples of FSA eligible items.

Examples of FSA Eligible Items

Medical Expenses

Medical expenses are a broad category that includes costs for treatments, services, and medications aimed at preventing or alleviating physical or mental conditions. Here are some examples:

• Doctor Visits: Co-pays and deductibles for appointments.
• Lab Fees: Costs for blood tests, X-rays, and other diagnostic services.
• Prescription Medications: Any medication prescribed by a doctor, including antibiotics and chronic condition management drugs.

Dental and Vision Expenses

Taking care of your teeth and eyes is essential, and many dental and vision expenses are FSA eligible:

• Dental Care: Routine cleanings, fillings, and even orthodontic treatments like braces.
• Vision Care: Eye exams, prescription glasses, and contact lenses. You can even use FSA funds for prescription sunglasses.

Over-the-Counter Medications

Thanks to the CARES Act, many over-the-counter medications are now FSA eligible without a prescription:

• Pain Relievers: Medications like ibuprofen and acetaminophen.
• Allergy Medications: Antihistamines for seasonal allergies.
• Cold and Flu Products: Cough syrups, throat lozenges, and nasal sprays.

Medical Devices

Medical devices that help monitor and manage health conditions are also covered:

• Blood Pressure Monitors: Essential for those managing cardiovascular health.
• Diabetic Supplies: Blood sugar test kits, lancets, and glucose monitors.
• Orthopedic Supports: Items like ankle braces or back supports.

First Aid Supplies

First aid supplies are another common category of FSA eligible items:

• Bandages and Wraps: From adhesive bandages to elastic wraps.
• Thermometers: Essential for monitoring fevers.
• Burn Creams and Ointments: Useful for treating minor burns and cuts.

Where to Buy FSA Eligible Items

You have multiple options for purchasing FSA eligible items, both in-store and online.

FSA Store

The FSA Store offers a comprehensive selection of FSA eligible products. They have a detailed list of eligible items and a search feature to make it easy to find what you need.

Amazon FSA Store

Amazon also has an FSA Store, where you can find a wide range of eligible items. Look for the “FSA or HSA eligible” badge on product listings to ensure they qualify.

Drug Stores and Grocery Stores

Many drug stores and grocery stores carry FSA eligible items. Popular chains often have sections dedicated to these products, making it easy to shop for essentials like medications, first aid supplies, and medical devices.

Online Retailers

In addition to Amazon, other online retailers offer FSA eligible products. Just make sure the items are clearly marked as eligible, and keep your receipts for reimbursement.

By knowing what items are FSA eligible and where to buy them, you can make the most of your FSA funds and save on healthcare expenses. Next, we’ll answer some frequently asked questions about FSA eligibility to clear up any remaining doubts you might have.

Frequently Asked Questions about FSA Eligibility

How does a product become FSA eligible?

To get a product on the FSA eligible list, it must meet specific IRS guidelines. The IRS defines FSA eligible items as those used primarily to alleviate or prevent a physical or mental disability or illness. This includes a wide range of medical expenses, from doctor visits to prescription medications.

However, for items that aren’t automatically considered eligible, you can use a Letter of Medical Necessity (LOMN). A doctor writes this letter to confirm that a specific product or service is medically necessary for a patient. This letter is then reviewed by FSA administrators, who decide if it meets IRS criteria.

That even with a LOMN, there’s no guarantee the IRS will accept the expense if audited. Always check with your FSA administrator first.

How do I apply for FSA eligibility?

To get your product FSA eligible, you need to follow these steps:

1. Register with SIGIS: The Special Interest Group for IIAS Standards (SIGIS) oversees the eligibility of products for FSA spending. You’ll need to complete a Merchant Certification with SIGIS.

2. Submit Your Product: Once registered, you can submit your product to the SIGIS Eligible Product List (EPL). You’ll need to provide detailed information about your product, including a 14-digit GTIN, a UPC code, and a rationale for its medical necessity.

3. Implement an IIAS: Use an Inventory Information Approval System (IIAS) to verify that your product is eligible for FSA spending. This system helps ensure that only approved items are purchased with FSA funds.

How to determine if something is FSA eligible?

Determining if a product or service is FSA eligible involves understanding Qualified Medical Expenses as defined by the IRS. Qualified medical expenses are costs incurred for the diagnosis, cure, mitigation, treatment, or prevention of disease, and for treatments affecting any part or function of the body.

To check if an item is FSA eligible:

1. Refer to IRS Guidelines: The IRS provides a comprehensive list of eligible expenses in Publication 502. This document is updated regularly and is a reliable resource.

2. Consult Your FSA Administrator: Each FSA plan may have specific rules. Always confirm with your plan administrator to ensure an item is covered.

3. Use Online Resources: Websites like the FSA Store offer detailed lists of eligible items and search features to simplify the process.

By following these steps and understanding the guidelines, you can effectively steer the process of getting a product FSA eligible and make the most of your FSA funds.

Next, let’s explore some common FSA eligible items to give you a clearer picture of what you can purchase with your FSA funds.

Conclusion

At NPA Benefits, we are committed to helping you steer the complexities of Flexible Spending Accounts (FSAs) and maximize your pre-tax healthcare dollars. Our expertise in providing flexible, cost-saving health insurance options ensures that you have the control you need over your healthcare expenses.

Flexible Health Insurance Options

We understand that every individual and business has unique healthcare needs. That’s why we offer a variety of self-funded health insurance plans that can be custom to meet your specific requirements. Our goal is to provide you with the flexibility to choose the best options for you and your family, ensuring comprehensive coverage without unnecessary expenses.

Cost-Saving Solutions

One of the biggest advantages of using an FSA is the potential for significant tax savings. By contributing pre-tax dollars to your FSA, you reduce your taxable income, which can lead to substantial savings over time. Our plans are designed to help you make the most of these benefits, whether it’s through covering routine medical expenses or planning for unexpected healthcare costs.

Control for Individuals and Businesses

We prioritize giving you control over your healthcare spending. With our self-funded plans, both individuals and businesses can manage their healthcare funds more effectively. This control allows you to allocate resources where they are needed most, ensuring that you and your employees are covered for a wide range of medical expenses.

Your Partner in Health

At NPA Benefits, we are more than just a health insurance provider. We are your partner in navigating FSAs and health savings. Our comprehensive Eligibility List and expert guidance make it easy for you to determine which expenses are covered, so you never miss an opportunity to use your pre-tax dollars effectively.

By understanding and leveraging the benefits of FSAs, you can take charge of your healthcare expenses and achieve greater financial wellness. Let NPA Benefits assist you in planning contributions, understanding eligibility, and maximizing your tax savings through your FSA.

For more information on how we can help you get your product FSA eligible, visit our FSA Eligible Products page.

By partnering with NPA Benefits, you gain access to flexible, cost-saving health insurance solutions that put you in control. Make the smart choice for your healthcare and financial well-being today.