CARES Act of 2020 – FSA/HSA/HRA Expanded Eligible Expenses and Educational Assistance Provisions

NOTE: This article has been updated to reflect that the end date for employers to provide relief to employees by making student loan payments through the employer’s Educational Assistance Program has been extended by Congress to December 31, 2025.

On March 27, 2020, the President signed the Coronavirus Aid, Relief, and Economic Security Act of 2020 (“CARES Act”) to provide a broad economic stimulus and coronavirus (COVID-19) relief for Americans.  Below are the Act’s provisions impacting health flexible spending accounts, health savings accounts, health reimbursement arrangements and educational assistance programs.


Health Flexible Spending Accounts (HFSAs), Health Savings Accounts (HSAs) and Health Reimbursement Arrangements (HRAs) – New Eligible Expenses

The CARES Act expanded the list of eligible expenses for HFSAs, HSAs and HRAs retroactive to January 1, 2020.

  • Over-the-counter drugs/medicines – over-the-counter (OTC) drugs and medicines as eligible expenses for HFSAs and HSAs were eliminated by the Affordable Care Act of 2010. There have been several bills introduced over the past several years to reinstate OTC drugs and medicines as eligible expenses, to no avail, and the CARES Act reinstates these expenses as eligible for reimbursement.
  • Feminine products – the CARES Act also includes expenses for “menstrual care products.” The law specifies these items include tampons, pads, liners, cups, sponges, or similar products used by consumers with respect to menstruation.

HFSA Operational Changes

Service providers are working quickly to update the list of eligible expenses to include these items.  SIGIS (The Special Interest Group for IIAS Standards) is one organization that several pharmacies/retail stores use to manage their eligible expense lists.  According to SIGIS, their eligible expense list for OTC drugs and medicines will be updated by April 15, 2020.  SIGIS will update their eligible expense list for feminine products by May 15, 2020.  Once SIGIS or other similar entities update their lists, pharmacies/retail stores that carry these OTC and feminine products must update their software systems to include these items as HFSA eligible expenses.  Stores vary on how often they update their eligible expense items, some monthly, quarterly or annually.  Until the stores have updated their eligible expense lists, benefits debit cards will not approve these types of expenses. However, HFSA participants can submit manual claims with appropriate receipts dated January 1, 2020 and prospectively.  The receipts should clearly specify the items that were purchased for the expense to be eligible for reimbursement.

HFSA Annual Election Changes

One question employers are asking is whether employees can increase their HFSA annual elections due to the law change.  The CARES Act did not include language to this affect.  Reviewing the current status change events, it appears that the closest change event that might apply in this situation is where there is an addition or improvement of a health benefit package option.  However, this event applies where the employer is making the change, not the government.  Under this event however, HFSA annual elections cannot be changed.  The IRS is very strict on allowing changes to HFSA annual elections so until the IRS provides guidance to the contrary, employers may not want to allow their employees to increase their HFSA elections.  You should seek your benefit attorney’s opinion on this matter.  If you do allow the change, employees should only be able to increase their elections and not decrease them.

As a reminder, we previously sent our clients information about other health and dependent flexible spending account status changes due to COVID-19 and posted information to our blog.  Click here to review the information.

HSA Operational Changes

HSA participants may not be limited on purchasing these items with their benefit cards but this is based on their specific cards.  HSA participants should keep their receipts for these items to prove they are eligible expenses paid from the HSA.

HRA Operational Changes

Participants may submit manual claims with appropriate receipts dated January 1, 2020 and prospectively. The receipts should clearly specify the items that were purchased for the expense to be eligible for reimbursement.

Student Loan Repayments Eligible under Education Assistance Programs During 2020

The CARES Act allows employers to pay for student loan payments via their educational assistance programs established under Internal Revenue Code Section 127.  The student loan payments paid by the employer are not taxed to the employee and when combined with other covered educational reimbursements covered under the program, cannot exceed $5,250.  This provision is only effective through the end of 2020 was extended to December 31, 2025.  The employer may pay the lender or reimburse the employee for the loan payments.  The employee may not deduct student loan interest on their personal tax return if such payments were paid by the employer.

Employers with educational assistance programs should discuss this change with their service providers and/or benefits attorney to determine if they want to add student loans as a reimbursable expense during 2020.  TRI-AD is prepared to assist our clients if they wish to add this expense.

TRI-AD is Implementing Now

Employers are not mandated to include the  over-the-counter drugs/medicines and feminine products as reimbursable expenses in their cafeteria plans, however, we believe that most employers will want to implement these changes so their employees have an opportunity to save additional tax dollars for these added items.

TRI-AD is manually reviewing and substantiating these new eligible expenses based on the law as it is written and retroactive to January 1, 2020.  We can also assist clients with the new educational assistance provisions for 2020.  The IRS must provide additional guidance for these changes and this may take some time, however we know employers will want to implement these new rules now and not wait for the guidance.  We will modify our processes in the future in the event IRS guidance conflicts with our understanding and interpretation of the CARES Act provisions.

Please contact your TRI-AD Client Service Manager if you have any questions about this information or email us.


TRI-AD and our Associates’ suggestions or recommendations shall not constitute legal advice. No content on our website can be construed as tax or legal advice and TRI-AD may not be considered your legal counsel or tax advisor. Clients are encouraged to consult with their tax advisor and/or attorney to determine their legal rights, responsibilities, and liabilities. This includes the interpretation of any statute or regulation, federal, state or local; and/or its application to the clients’ business activities.