Category Archive

Benefit Spotlight

Dependent Care FSA

Lynn White 2026 October, Benefit Spotlight September 9, 2026

Dependent Care FSAs help you save money and take care of your loved ones at the same time.

Once your child turns 13, you can no longer use Dependent Care FSA funds for their care.
If they turn 13 mid-year, only expenses prior to their birthday qualify.

FSAs, or Flexible Spending Accounts, are helpful tools sometimes offered by your employer as part of their healthcare benefit packages. The Dependent Care FSA allows you to set aside money from your paycheck for the specific purpose of caring for a dependent. In this case, a qualifying dependent would be a child (including stepchild or foster child) below the age of 13, or a dependent incapable of caring for themselves. This covers adult children with disabilities, elderly relatives who live with you, or a spouse who is incapable of self-care. The IRS defines “incapable of self-care” as someone who cannot dress, clean, or feed themselves because of a disability, or someone who needs constant supervision for their own safety or the safety of others.

The money placed within the Dependent Care FSA is not subject to taxes, which includes the federal income tax, Social Security tax (6.2%), and Medicare tax (1.45%). This means that you save more money through a Dependent Care FSA than you would if you simply used your paycheck to pay for dependent-related costs. You may use the Dependent Care FSA funds for certain qualifying purchases. These include:

  • Education: Fees for nursery school, preschool, and daycare centers qualify, as long as they’re below the kindergarten level. You cannot use Dependent Care FSA funds for fees related to the kindergarten level or higher, nor can you use them for summer school or tutoring programs.
  • Before- and after-school care: You can use Dependent Care FSA funds to pay for programs that watch your child outside of school hours, even if your child is in kindergarten or a higher grade.
  • Day camps: As long as your child doesn’t stay overnight, summer camps and specialty camps, like ones focused on sports, arts, or computer programming, are considered qualifying Dependent Care FSA expenses. If you are caring for an older dependent, adult daycare also qualifies.
  • In-home caregivers: You may use Dependent Care FSA funds to pay nannies or babysitters to watch your dependent while you work. If your caregiver lives in your home, their rent, utility fees, and meals are also considered qualifying expenses. However, if you pay them more than $3,000 in cash during 2026, you are considered a household employer and must withhold Social Security and Medicare taxes on those wages.

There are also certain non-qualifying expenses you should also be aware of. This includes:

  • Entertainment, food, or clothing: These are not considered as “caring for a dependent,” and therefore do not qualify.
  • Overnight camps: You cannot use Dependent Care FSA funds to pay for sleep-away camps, even if the camps have a focus on education.
  • Certain relatives when babysitting: Spouses, ex-spouses, or your own children below the age of 19 cannot be paid from your Dependent Care FSA, even if they’re acting as a babysitter. However, you may use Dependent Care FSA funds to pay grandparents, aunts and uncles, or children above the age of 19 (as long as they’re not considered a dependent)

Starting in 2026, you can contribute up to $7,500 into the Dependent Care FSA, which is the maximum per household. This means that if you and your spouse both have Dependent Care FSAs through different employers, your combined total cannot exceed $7,500. If you’re married but file your taxes separately, your limit is $3,750. It’s important to note that employer contributions also count toward the Dependent Care FSA limit. Dependent Care FSAs are use-it-or-lose-it accounts. Once the plan year ends, the money left in the account is forfeited, so be mindful of your expenses. It’s also a good idea to save your receipts for every Dependent Care FSA expenditure, since they’re more than likely needed for claim verification.

FMLA

2026 September, Benefit Spotlight August 26, 2026

In 1993, the Family and Medical Leave Act (FMLA) was signed into law. This act protects your right to take leave from work when dealing with your own or a family members’ serious health condition. Eligibility for the FMLA is determined by a couple criteria:

  • Private vs. Public Sector: If you are a private sector worker or, in other words, you don’t work for the government, you would qualify for FMLA if your workplace has 50 or more employees that have worked at least 20 work weeks. You must also work at a location that has at least 50 employees within a 75-mile radius. Public sector workers, or government employees, qualify regardless of employee count. Similarly, educational workplaces, which include public school boards and elementary, middle, and high schools (both private and public), also qualify for FMLA even if there are less than 50 employees.
  • Tenure: In order to qualify for FMLA, you must have worked at least 12 months and 1,250 hours at your workplace. The 12 months do not need to be consecutive, but paid time off, sick leave, and previous FMLA leave do not count towards the hour quota.

Due to the 50/75 rule, or the fact that your location must have at least 50 employees within a 75-mile radius, you may be ineligible for FMLA if you work at a remote, satellite office. An estimated 40% of the American workforce are not eligible for FMLA due to working for a small employer, not meeting the month or hour requirement, or working at remote office.

Qualifying for the FMLA results in several protections:

  • Keeping Your Job: If you take FMLA leave, then you are assured your original job or an “equivalent” position. If you are given a different position following FMLA leave, then the new job must have identical pay, benefits, skill requirements, and working conditions to your previous position.
  • Continuing Health Benefits: During FMLA leave, your employer is required to maintain your health insurance coverage. The benefits should be the same ones you receive while working, so your employer will continue to pay its share of the premium, and you pay what’s left.
  • Reinstating Other Benefits: Once you return to work, your other benefits, such as life and disability insurance, sick leave, and vacation time will be restored to the level they were at before you took FMLA leave.

If you are eligible under the FMLA, you may take FMLA leave in the following situations:

  • Pregnancy, Prenatal, or Adoption: You are entitled leave for the birth of your child, plus time to bond with your newborn. Bonding leave can be taken by both parents and must occur within 12 months of the birth. Complications of pregnancy, including severe morning sickness, doctor-ordered bed rest, and routine appointments also qualify under the FMLA. You may also take FMLA leave when placing children into foster care or adoption, but the leave must occur within 1 year of placement.
  • Family Member’s Health: If a family member is experiencing a serious health condition, you may take up to 12 weeks of leave to care for your spouse, child, or parent. Your child, regardless of whether they are biological, adopted, or foster children, are covered by the FMLA’s definition of “child.” However, they must be under the age of 18. For adult children, the FMLA only applies to those who cannot care for themselves due to a disability. Siblings, grandparents, and in-laws are not considered qualifying family members.

Your Own Health: If you are experiencing a serious health condition that makes you unable to continue working, you may take FMLA leave. Inpatient care, which includes overnight hospital stays, recovery, and follow-up appointments are covered by the FMLA. Continuing treatment for on-going health conditions, such as asthma, diabetes, epilepsy, Alzheimer’s, severe stroke, or terminal illness are also covered by FMLA. Common colds, minor health issues, or routine physicals do qualify for FMLA leave. The condition must impair your ability to do your job and require meaningful medical treatment to qualify.

FMLA leave does not need to be taken in a single block. You can take intermittent leave or reduce your working hours in certain situations.

Your health and the health of your family should always be your priority in an emergency. Utilizing FMLA leave allows you to focus completely on recovery, without having to worry about job security or health insurance.

Orthodontia

Keesha Maybank 2026 August, Benefit Spotlight July 27, 2026

Not all dental plans are made equal, and not all dental plans cover orthodontics. If you or one of your children are looking to start braces, it’s best to double-check your policy before going forward. The average cost of orthodontic care can vary between $5,350 – $12,000, which are steep costs to be paying out of pocket. Most dental insurance policies separate dental care into three categories:

  • Preventive care: Refers to cleanings, oral exams, and X-rays, and other services you may get in a routine dentist’s appointment. Most dental plans cover the costs for these services.
  • Basic procedures: These procedures are slightly more complex than routine care and include things like extractions, filings, and gum disease treatment. Basic procedures may be partially covered by dental insurance, with the rest paid out of pocket.
  • Major procedures: Refers to more in-depth procedures like crowns, bridges, dentures, root canals, or inlays. Dental insurance may partially cover major procedures, but often at a smaller percentage than basic procedures.

Orthodontics is a separate category from the three mentioned above and is often not included in standard dental policies. If orthodontics is included, the policy may only apply to dependent children.

If your dental plan covers orthodontics, you’ll want to be aware of coinsurance amounts and annual and lifetime maximum benefits. For example, a dental plan that covers 50% with a lifetime maximum of $1,000 will only cover $500 of the cost of braces — 50% of the $1,000 lifetime maximum. Every dollar spent after that will need to be paid out of pocket.

Cigna offers orthodontic coverage on select plans. Their full-coverage dental insurance plans often include orthodontics, and, on the plans that don’t cover orthodontics, may include discounts for those procedures. Some Cigna plans have waiting periods, which means you can’t start using the plan’s benefits immediately. For basic procedures, you may need to wait 6 months before the coverage applies, while major and orthodontic services may require you to own the policy for at least a year.

Guardian offers orthodontics on several different plans. Each of their plans have a waiting period of 1 year before the coverage applies. It’s also important to note that Guardian’s orthodontic coverage only applies to children under the age of 19.

Anthem plans may be slightly higher than Cigna and Guardian, but their waiting period is much shorter. Waiting periods on Anthem’s more in-depth plans can vary from none at all to 6 months. Orthodontics are only covered on select plans, so be sure to double check with your provider that your procedures will be covered.

If you qualify for Medicaid, your child’s braces may be covered if they are deemed medically necessary. The Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit provides preventive healthcare to Medicaid-enrolled children under the age of 21 if a screening reveals a condition that needs treatment. This includes orthodontics.

If you’re already on a dental plan, supplemental orthodontic insurance may be an option. This allows you to add coverage for braces and other related services to an existing dental plan. Not all insurance companies offer supplemental insurance, so check with your provider to see if this is an option for you.

It’s important to understand what is and isn’t covered under your dental plan, especially when it comes to orthodontic investments. Always double-check your benefits, coverage amounts, and annual and lifetime maximums to ensure you’re getting the most out of your plan (and paying the least out of pocket).

Braces for adults are often considered cosmetic procedures, so insurance may not cover the cost.

Generic Medication

Kaylon Walton 2026 July, Benefit Spotlight June 6, 2026
Young pharmacist checking the shelves with a digital tablet at the pharmacy

Generic drugs are versions of brand-name medications that share active ingredients, strength, quality, safety, and intended use as their name-brand counterparts, but which are up to 85% cheaper.

Pharmacist and customer interact at pharmacy counter, exchanging payment and prescription.

Once a company develops a new drug, they are granted a patent under the Food and Drug Administration (FDA) to be the sole producer and seller of that medication. This is intended to help that company recover its losses from research and testing. After the patent expires, however, other drug companies are allowed to create generic versions of the newly developed medication. Generic drug manufacturers are not required to test the medication’s effects on animals or humans, which decreases the cost of production.

They also do not need to spend millions on research or marketing, since the original developer has already done the work. This cost reduction is reflected in the prices of the generic drugs, which are usually 80-85% cheaper than their name-brand counterparts. Even though generic brands are not required to do animal or clinical testing, they are still subject to strict guidelines, which means they’re just as safe as name-brand medications. Generic drug manufacturers must prove to the FDA that their version of the medication is identical to the name-brand in several ways, including:

  • Active ingredients: The active ingredient refers to the ingredient that makes the drug “pharmaceutically active” — in other words, the ingredient that makes the drug work against the disease or condition it’s targeting.
  • Strength
  • Dosage form (tablet, capsule, or injection)
  • Usage
  • How the medication is taken/applied
  • How the medication is absorbed by the body
  • Shelf life

Drug manufacturers are subject to the FDA Generic Drugs Program standards for drug approval. This means that the manufacturer must submit evidence to the FDA that proves the generic medication’s active ingredient matches the name-brand version. The manufacturers must further pass plant inspections to show that their product is produced in similar quality to the name-brand. The FDA also monitors plants to ensure drug safety.

The main difference between generic and name-brand medications (besides the price tag) is the inactive ingredients. Inactive ingredients are fillers, coatings, or preservatives that help your body absorb the medication. While these ingredients are referred to as “inactive,” they, like any other ingredient in medication, can cause adverse reactions. But other than personal allergies, there is no significant difference between generic or name-brand medications. Generic medications may absorb into the body slightly faster or slower than name-brand versions, but the difference is small enough to be clinically acceptable by the FDA.

Pharmacist explains side effects of generic drug to unrecognizable customer

Due to trademark laws, generic drugs cannot look identical to the name-brand versions, even though their ingredients match. As a result, generic and name-brand medications may have different shapes, colors, or flavors. These changes do not affect the efficacy of generic medication.

There are a few ways to check whether an FDA-approved name-brand drug has a generic version:

  • Drugs@FDA: Search for a name-brand medication and check the section called “Therapeutic Equivalents for [name-brand].” Medications labeled with ANDA are generic drugs.
  • Orange Book: Search for a brand-name medication and find the active ingredient. Next, do another search for the active ingredient. Medications labeled with an “Appl No.” or “TE code” that begins with an A are FDA-approved generic drugs.
Brand and Generic medicine bottles with red price tags. 3d rendering

Generic drugs are a great way to save money on the medications you need. Most states allow pharmacists to substitute name-brand medications for cheaper generic alternatives, unless your doctor has specified to “dispense [the medication] as written,” or if the drug has a “narrow therapeutic window.” The narrow therapeutic window refers to the slight difference in absorption rates between generic and name-brand medications, which could result in side effects or loss in efficacy. If you have any questions or concerns about choosing generic medications over name-brand versions, speak with your doctor for more information.

In 2024, generic drugs saved patients and the U.S. healthcare system $467 billion.

Understanding EOI

Lynn White 2026 June, Benefit Spotlight May 18, 2026

At its core, Evidence of Insurability is a process insurance companies use to assess an individual’s overall health before approving certain types or amounts of coverage.

When enrolling in workplace benefits, most decisions feel straightforward — pick a health plan, choose your coverage levels, and you’re set. But occasionally, you’ll come across a requirement that feels a bit more involved: Evidence of Insurability (EOI).

It’s most commonly associated with life and disability insurance. While not every employee will need to complete EOI, it typically comes into play when you’re requesting coverage beyond a Guaranteed Issue amount or enrolling outside of your initial eligibility window.

Why EOI Exists

Insurance is built on shared risk. To keep premiums fair and manageable for everyone, insurers need to evaluate the likelihood of a claim. That’s where EOI comes in. By reviewing basic health information, insurers can determine whether to approve, modify, or deny additional coverage.

From an employer’s perspective, offering Guaranteed Issue coverage — coverage you can elect without medical questions — is a valuable benefit. It ensures employees have access to a baseline level of protection quickly and easily. However, when coverage exceeds that threshold, EOI helps balance accessibility with sustainability, ensuring plans remain viable long term.

When You Might Need to Complete EOI

There are a few common scenarios where EOI may be required:

  • Electing higher coverage amounts: If you choose life or disability insurance above the Guaranteed Issue limit during enrollment.
  • Late enrollment: If you decline coverage when first eligible and decide to enroll later.
  • Increasing coverage after initial enrollment: Some plans allow increases during annual enrollment, but those increases may require EOI.

It’s important to pay attention to these moments, as they can impact not only your coverage approval but also how quickly your benefits take effect.

What the Process Looks Like

Completing EOI is usually simpler than people expect. Most insurers require you to fill out a short questionnaire about your medical history, current health status, and lifestyle habits (such as tobacco use). In some cases, additional information may be requested, like a medical exam or physician records, but that’s less common for employer-sponsored plans.

The key is to answer all questions honestly and completely. The insurer uses this information to make a fair and accurate assessment. Once submitted, the review process can take anywhere from a few days to a few weeks, depending on the complexity of the request.

What Happens After You Apply

After reviewing your EOI, the insurance carrier will make one of the following decisions:

  • Approval: Your requested coverage is accepted as-is.
  • Conditional approval: Coverage is approved but may include certain limitations or higher premiums.
  • Denial: Coverage is not approved based on the information provided.

If your application is denied, it doesn’t necessarily mean you’ll never qualify. Changes in health status or future enrollment opportunities may allow you to reapply.

Why It Matters to Employees

EOI can feel like an extra hurdle, but it ultimately plays a role in protecting both you and your coworkers. It ensures that benefit plans remain affordable while still offering meaningful coverage options. More importantly, understanding EOI helps you plan ahead — especially if you anticipate needing higher levels of coverage in the future.

One of the easiest ways to avoid the EOI process is to take advantage of your initial enrollment period. This is often your only opportunity to secure certain levels of coverage without medical underwriting. Missing that window could mean additional steps later on.

If you’re unsure whether EOI applies to your situation, your HR team or benefits administrator can help guide you.

EOBs: What Are They?

Keesha Maybank 2026 April, Benefit Spotlight March 20, 2026

An Explanation of Benefits (EOB) is a statement from your health insurance company that outlines how a claim was processed. It’s not a request for payment — though many people mistake it for a bill. Instead, it’s a detailed summary of the services you received, what your provider charged, what your insurance covered, and what portion (if any) you may owe. Think of it as a receipt that shows the behind‑the‑scenes math of your healthcare costs.

What makes EOBs so valuable is the transparency they provide. They show whether your provider billed correctly, whether your insurance applied your benefits accurately, and whether you’re being asked to pay the right amount. In a healthcare system where costs can feel unpredictable, the EOB is one of the few documents designed to give you clarity rather than confusion.

Why EOBs Matter More Than You Think

It’s easy to overlook an EOB, especially when you’re juggling appointments, prescriptions, and follow‑up care. But reviewing it carefully can protect you from unnecessary expenses. Billing errors are more common than most people realize — duplicate charges, incorrect procedure codes, or services you never received can slip through the cracks. Your EOB is your first line of defense against these mistakes. Beyond error‑checking, EOBs help you understand how your insurance benefits are being used. They show how much of your deductible has been met, how close you are to your out‑of‑pocket maximum, and how cost‑sharing (like copays and coinsurance) is applied. This information can help you plan future care, anticipate costs, and avoid surprises. In other words, your EOB isn’t just paperwork — it’s a financial roadmap.

How to Read Your EOB

The layout of an EOB varies by insurer, but most include the same core elements. You’ll typically see the date of service, the provider’s name, the services performed, the amount billed, the amount allowed by your insurance, the portion paid by the insurer, and the amount you may owe. Once you understand these sections, the document becomes far less intimidating. A helpful next step is to compare your EOB with any bill you receive from your provider. The numbers should align. If they don’t, it’s a signal to call your provider or insurer for clarification. Many discrepancies are simple errors that can be corrected quickly when caught early. And if something doesn’t make sense, don’t hesitate to ask questions — your insurer’s customer service team is there to help you interpret the details. The more familiar you become with your EOBs, the easier it becomes to spot patterns, understand your coverage, and make informed decisions about your care.

Since EOBs can provide both short- and long-term value, it’s a good idea to save your EOB at least until you get the final bill from your doctor or clinic.

Primary Care or Specialist? Making the Right Choice

Kaylon Walton 2026 March, Benefit Spotlight January 18, 2026
A smiling mid adult female doctor listens as a female patient discusses her health.

Primary Care Physicians: Your First Point of Contact

Think of a Primary Care Physician (PCP) as your healthcare home base. They’re the provider you turn to for everyday concerns, annual check-ups, preventive screenings, and the “something isn’t quite right” moments that don’t clearly point in one direction.

What PCPs excel at:

  • Whole-person care: They look at the big picture — your history, lifestyle, habits, and changes over time.
  • Preventive health: Vaccinations, screenings, routine labs, physicals — they’re your partner in staying ahead of illness.
  • Early diagnosis: For most symptoms, a PCP can evaluate, diagnose, and treat without sending you elsewhere.
  • Coordinating care: If you do need specialized treatment, your PCP is the one who guides you to the right specialist and ensures communication stays clear.

In many ways, your PCP is the quarterback of your health team — calling plays, coordinating strategies, and helping you navigate every twist and turn.

Teenager at a Medical Appointment

Specialists: The Experts for Specific Conditions

A specialist steps in when a condition requires deeper, more targeted expertise. While PCPs have wide-ranging knowledge, specialists have laser-focused training in one specific area of medicine.

For example:

  • Cardiologists focus on the heart
  • Dermatologists focus on the skin
  • Endocrinologists focus on hormones
  • Orthopedic surgeons focus on bones and joints

Specialists bring advanced diagnostics, treatments, and procedures that go beyond the scope of primary care.

You might need a specialist if:

  • Your PCP identifies something that requires deeper evaluation
  • You have a chronic condition needing expert management
  • You need a procedure or specialized imaging
  • Your symptoms are complex or persistent

Specialists are crucial — but they work best with your primary care doctor, not instead of one.

How PCPs and Specialists Work Together to Create Better Outcomes

The most effective healthcare isn’t about choosing one over the other — it’s about having both in your corner. Primary care physicians and specialists form a coordinated system that keeps you healthy, supported, and informed.

Here’s how they complement each other:

  • PCPs provide continuity; specialists provide precision. Your primary doctor keeps track of your overall health while specialists focus on specific problems.
  • Better communication = better care. When a PCP refers you to a specialist, they share your medical history, medications, and relevant test results. This prevents duplication and improves accuracy.
  • You avoid unnecessary tests and visits. PCPs can often treat issues without specialist intervention — saving you time and money.
  • Chronic conditions stay on track. If you have diabetes, heart disease, asthma, or any ongoing condition, PCPs coordinate the bigger picture while specialists fine-tune your treatment.

In short, your PCP ensures everything fits together, while specialists handle the pieces that require expert-level attention.

When you’re unsure where to turn, start with your primary care physician. They’re trained to evaluate your symptoms, treat what they can, and guide you to the right specialist when needed.

85.2% of adults who had a visit with a doctor or other health care professional in the past year.

Is Online Therapy for You?

Kaylon Walton 2025 November, Benefit Spotlight October 19, 2025
Young woman sitting on couch at her apartment and discussing with her therapist on digital tablet during online session

Online therapy, also known as teletherapy or e-counseling, has transformed the landscape of mental health care, offering new opportunities for support and healing. As technology continues to evolve, so does the accessibility of therapeutic services. While online therapy presents numerous advantages, it also comes with limitations that may affect its suitability for certain individuals and conditions. Understanding both sides of the equation is essential for making informed decisions about mental health treatment. 

The Pros of Online Therapy 

One of the most significant advantages of online therapy is accessibility. Individuals living in rural or underserved areas often face limited options for in-person counseling. Online platforms bridge this gap, allowing people to connect with licensed therapists regardless of geographic location. This is especially beneficial for those with mobility challenges, chronic illnesses, or transportation barriers. Additionally, online therapy can be more approachable for individuals who feel uncomfortable in traditional clinical settings, helping to reduce the stigma often associated with seeking mental health care. 

Convenience and flexibility are other major benefits. Online therapy allows clients to schedule sessions around their daily routines, eliminating commute times and offering greater privacy. Many platforms also provide asynchronous communication options, such as messaging or email, which can be helpful for those who prefer written expression or need support between sessions. For busy parents, caregivers, or professionals, this flexibility can make therapy more sustainable and consistent. 

Cost-effectiveness is another appealing aspect. Therapists offering online services often have lower overhead costs, which can translate into more affordable rates for clients. Some insurance providers now cover online therapy, making it a viable option for those with limited financial resources. Moreover, the ability to choose from a broader pool of therapists, including specialists in niche areas, can lead to better therapeutic matches and outcomes. 

Doctor on video conference for medical consultation
Man using AI therapy chatbot and AI therapy app

The Drawbacks of Online Therapy

Despite these advantages, online therapy has its drawbacks. One of the most notable is the lack of nonverbal communication. In video or text-based sessions, therapists may miss subtle cues such as body language, facial expressions, or tone of voice, which are often critical for accurate assessment and deeper understanding. This limitation can affect the therapeutic alliance and reduce the effectiveness of treatment, especially for clients who struggle to articulate emotions verbally. 

Technology-related issues also pose challenges. Unstable internet connections, software glitches, or device malfunctions can interrupt sessions and hinder progress. For individuals in crisis or those with severe psychiatric conditions, such as schizophrenia or suicidal ideation, online therapy may not provide the immediacy or intensity of care required. In such cases, in-person intervention or hospitalization may be necessary. 

Privacy and confidentiality are additional concerns. While reputable platforms use encryption and secure servers, the risk of data breaches or unauthorized access remains. Clients must also ensure they have a private space for sessions, which can be difficult in shared living environments. Without a secure setting, the therapeutic process may be compromised, and clients may feel hesitant to share openly. 

Another limitation is insurance coverage and licensing restrictions. Not all insurance plans cover online therapy, and therapists may be limited to practicing within certain states or regions due to licensing laws. This can restrict access for clients seeking specialized care or continuity across state lines. 

African-American woman Video Conferencing With Doctor On smartphone while sitting on sofa in her home.

Choose What’s Best for You

Online therapy offers a modern, flexible, and often effective alternative to traditional counseling. Its accessibility, affordability, and convenience make it an attractive option for many, especially those facing logistical or emotional barriers to in-person care. However, it is not a one-size-fits-all solution. Individuals must weigh the benefits against the potential limitations, such as reduced nonverbal communication, technological challenges, and privacy concerns, to determine whether online therapy aligns with their needs. As digital mental health services continue to expand, ongoing research and innovation will be key to enhancing their effectiveness and inclusivity. 

As of 2024, approximately 54% of Americans have participated in at least one telehealth visit,
with nearly 38% of these visits pertaining to medical or mental health needs. 

Considering a Limited Purpose FSA?

Keesha Maybank 2025 September, Benefit Spotlight August 21, 2025

Making out-of-pocket payments for frequent trips to the eye doctor and dentist can add up to hundreds, if not thousands, of dollars — even with health insurance.

A High-Deductible Healthcare Plan (HDHP) often results in lower monthly premiums but can lead to significant healthcare expenses. A limited-purpose (also called limited-use) flexible spending account (LPSA) can help offset these costs, making regular or specialized treatment more affordable. While not everyone may benefit from an LPFSA, those who frequently pay for vision and dental treatments can significantly reduce their expenses with this type of account.

What Is an LPFSA?

A limited-purpose flexible spending account functions similarly to a general healthcare FSA, which employers offer to help employees save money on healthcare expenses. However, it provides more specific benefits for individuals with vision and dental needs. To determine whether an LPFSA is the right choice, it’s essential to weigh its advantages and disadvantages before enrolling.

Pros of an LPFSA:

  • 2025 contribution limit: Set to $3,300
  • Eligible expenses: Covers braces, fillings, eyeglasses (prescriptions), teeth cleaning, and eye exams
  • Tax-free funds: Contributions reduce taxable income
  • Employer contributions: Some companies contribute to employees’ LPFSA accounts
  • HSA compatibility: Employees can have a Health Savings Account (HSA) alongside their LPFSA to maximize savings
  • Additional expenses covered: Funds may be used for supplements, dental, and menstrual products

Cons of an LPFSA:

  • Eligibility: LPFSAs are only available to those enrolled in an HDHP with an HSA
  • Employment requirement: Self-employed or retired individuals do not qualify
  • Expiration of funds: Funds typically expire at the end of the year. For 2025, a rollover of up to $660 may be allowed, depending on the plan
  • Loss of funds upon job change: If you leave or are terminated, funds cannot be transferred to another account

Should You Enroll in an LPFSA?

The average out-of-pocket medical expense per capita in the U.S. has more than doubled from 1970 to 2022 and continues to rise. In 2024, Americans spent an average of $1,142 on medical bills, with individual costs varying based on healthcare needs. What sets an LPFSA apart from other FSAs is the ability to pair it with an HSA, which can maximize savings significantly.

Benefits of an HSA

Having an HSA alongside an LPFSA can increase savings over time. Unlike FSAs, health savings accounts (HSAs) are tax-free, never expire, and remain yours even if you leave your job. This means that withdrawals will not be taxed as long as the funds are used for eligible medical expenses. Since HSA funds roll over annually, pairing an LPFSA with an HSA allows individuals to save money year after year while reserving their HSA contributions for future expenses. This approach is ideal for those whose medical expenses are equal to or less than the $3,300 LPFSA contribution limit.

Drawbacks of an HSA 

To qualify for an HSA, individuals must be enrolled in an HDHP. HSAs are only compatible with LPFSAs, meaning other flexible spending arrangements do not qualify. Additionally, individuals cannot contribute to an HSA if they:

  • Are claimed as a dependent on someone’s tax return
  • Have Medicare coverage
  • Are included in a spouse’s healthcare plan

The IRS also limits contributions to HSAs. In 2025, singles can contribute up to $4,300, while families with HDHP coverage can contribute up to $8,550.

Choosing the Right Healthcare Plan

Making informed decisions about healthcare savings can lead to significant financial benefits in the long run. By carefully evaluating the advantages of an LPFSA and pairing it with an HSA, individuals can maximize tax savings while covering essential medical expenses. Planning ahead and utilizing employer-sponsored benefits ensures greater financial security, especially for those with frequent vision and dental needs. Ultimately, choosing the right healthcare plan means balancing current expenses with future savings, allowing individuals to feel confident in their financial and medical decisions. Taking proactive steps today can lead to better financial stability and improved healthcare access over time.

Since HSA funds roll over annually, pairing an LPFSA with an HSA allows individuals to save money year after year while reserving their HSA contributions for future expenses.

Lantern (Formerly SurgeryPlus)

Lynn White 2025 October, Benefit Spotlight August 12, 2025

Lantern is a benefit program offered by some employers to help employees and their families access high-quality, non-emergency surgeries.

Think of it like a concierge service for surgery — handling everything from finding a top-rated doctor to coordinating your travel (if needed). Lantern covers over 1,500 planned surgical procedures, including those in categories like spine, general surgery, orthopedic, ear, nose, and throat, cardiac, gastrointestinal, and injections.

The program partners with a nationwide network of carefully selected surgeons and facilities that meet strict quality and safety standards. And here’s the best part: when you use Lantern, your costs could be dramatically reduced — or even eliminated completely depending on your employer’s plan. This isn’t just a different way to schedule surgery. It’s a better, smarter, more supportive experience from start to finish.

Benefits

  • Lower (or No) Out-of-Pocket Costs – One of the biggest perks of Lantern is the cost savings. When you use the program, you may pay little to nothing out of pocket. That means no surprise bills later, and no guessing what your surgery is going to cost. Everything is explained upfront, so you can focus on healing.
  • Access to High-Quality Surgeons – Lantern doesn’t just partner with any providers. Every surgeon in the network has been vetted for training, experience, and outcomes. So instead of sorting through hundreds of options on your own, you’re matched with a specialist who’s proven to deliver great care.
  • Full-Service Support – From the first phone call to your post-surgery check-up, Lantern is with you every step of the way. You’ll be assigned a Care Advocate who will schedule appointments, help with paperwork, and even assist with travel arrangements if the best provider isn’t local. It’s like having a personal assistant just for your surgery.

How to Use Lantern

Getting started with Lantern is easy, and your HR team or benefits provider can confirm if it’s part of your plan. Once you’re enrolled, just follow these steps:

  1. Call the Lantern Member Services Line: You’ll speak with a friendly Care Advocate who will walk you through the process and ask a few questions about your needs.
  2. Get Matched With a Top Surgeon: Based on your procedure and location, you’ll be paired with a high-quality provider. If travel is required, they’ll help you plan that too — and in most cases, those travel costs are covered!
  3. Schedule and Prepare: Your Care Advocate will coordinate everything, from the consultation to surgery day and follow-up appointments. You’ll know what to expect every step of the way.

If you or a family member has a planned surgery coming up, check with your HR department or benefits provider to see if Lantern is available to you.

‹  Older posts