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Health Insurance Claims Assessment (HICA) Act
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The only service provided by a licensed Third Party Administrator (TPA) in Michigan is health care and dependent care flex benefit administration for a client. The TPA receives the employees' payroll deductions for health and dependent care and makes reimbursements to these employees when they submit the required documentation showing out of pocket payments for co-pays etc. and dependent care costs. Are the payments made by this TPA subject to the assessment?
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Answer:
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No. Pursuant to Section 2(s)(viii) of the Health Insurance Claims Assessment (HICA) Act, reimbursements made to individuals under a flexible spending arrangement are specifically excluded from the definition of "paid claims" subject to the assessment, provided that the flexible spending arrangement in question meets the definition of that term under Section 106(c)(2) of the Internal Revenue Code.
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