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How does a Medical Reimbursement Account affect the new Health Savings Account (HSAs) established under IRC 223?

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The Treasury Department recently addressed this issue in Rev Rul 2004-45. An employee may participate in a medical reimbursement account (FSA) and establish a HSA (assuming all other eligibility requirements are met) as long as the FSA: • Does not reimburse medical expenses before the Deductible is met and/or • Only reimburses for expenses that are not covered under the HDHP (for example: Dental or Vision expenses). Consequentyly, an employee who has eligible medical expenses that exceed the annual Deductible can still receive the tax savings associated with the FSA plans.

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