Glossary

F

FMLA is a federal law that requires employers with 50 or more employees to provide up to 12 weeks of unpaid leave per year in certain situations, during which the employee must continue to be treated as an active employee under the benefits plan.  Upon a plan participant's return from FMLA leave, an employer must waive all eligibility periods and exclusions unless such provisions would have applied had the participant not gone on FMLA leave.

A fee for service is a payment made to a provider for services rendered.

Related Terms: Claim, Provider

A fiduciary is any person who has discretion over plan assets, benefit levels, accounting and record keeping, investments, or benefit and eligibility decisions.  A fiduciary has a duty under federal law to operate a benefits plan in a prudent (conservative) manner and in the exclusive interest of the persons covered under the plan.  A third-party administrator is not a fiduciary.

Related Terms: Custodian, Trustee

A flexible benefits plan may consist of pre-tax benefits, premium payments, a medical reimbursement account, or a dependent care reimbursement account, all of which employee contributions solely fund.  A flexible benefits plan is also known as a Section 125 plan.

An FSA is a reimbursement plan, including a medical reimbursement program or a dependent care reimbursement program, that provides employees with coverage.  Qualifying expenses may be reimbursed under an FSA, subject to certain conditions (e.g., a maximum limit).  The most common FSA is one that is offered through a cafeteria plan with employees paying the entire premium for coverage through pre-tax dollars.

The term "FMLA" means the Family and Medical Leave Act of 1993.

A Form 5500 is an annual information return form that employers must file with the Internal Revenue Service (IRS) and the Department of Labor (DOL).  The Form 5500 reports the qualification, financial condition, and operations of an employer's ERISA benefits plan.  It is also known as an annual report.

Related Terms: Plan Year

The term "FSA" means flexible spending account.

Related Terms: Flexible Spending Account

A full-time student is a participant's dependent child who is enrolled in and regularly attends a secondary school, college, or university, or a vocational/technical school in which completion of course work culminates in a licensed vocation.  The educational institution must be accredited by the state where it is located and operate on a system of academic years or subdivisions of years, i.e., semesters or trimesters.  The dependent child must attend for the minimum number of credit hours required by that secondary school, college, university, or vocational/technical school in order to maintain full-time student status.  If the child experiences an injury or illness that prevents him or her from maintaining full-time status, the child is considered a full-time student until the end of the current academic session.  A child is considered a full-time student during any period classes are not in session.

Related Terms: Dependent, Eligibility

A fully insured arrangement is when an employer pays a fixed, monthly premium to an insurance carrier to assume all of the risk associated with the group insurance claims of its employees.

Funding is the providing of money for payment of claims that are incurred under a self-funded plan.

Related Terms: Self-Funding