Card Holder

  • How can a consumer use their FSA funds for Prescribed OTC Medicines and Drugs?

    The IRS guidance provides for two methods for consumers to access FSA Funds:

    • Consumers can use another form of payment for purchase then submit the items for manual reimbursement with their plan administrator.  Consumers will need to submit either a) receipt showing the date with amount of purchase and a copy of the prescription or b) a receipt that includes prescription number, patient name, date and amount.
    • Consumers can use their FSA/HRA card for payment at an IIAS merchant that supports IRS Notices 2010-59 and 2011-05 regulatory requirements by presenting the prescription to the pharmacist and having the pharmacist dispense the OTC drug or medicine in accordance with applicable law and regulations by which an Rx Number in generated and processed.

    Consumers should check with their plan administrator and merchant to find out what options are supported.


  • Who is eligible to participate in SIGIS?

    SIGIS is a membership company open to all participants involved in offering, processing or accepting health care payment cards for FSAs and HRAs. Thus, membership is open to merchants, card issuers, third-party plan administrators, merchant acquirers, processors, financial institutions, trade association groups, and payment card associations.

  • Will a merchant’s store name be listed on the SIGIS Merchant List?

    SIGIS has two merchant lists: first, the SIGIS IIAS Merchant List for merchants that are SIGIS-certified to process IIAS transactions, and second, the SIGIS 90% Rule Merchant List for merchants that have registered with SIGIS as meeting the IRS requirement as a store with 90% or more of gross sales from Rx/prescription and qualified medical products.

  • Will all FSA/HRA plan administrators permit their clients to use FSA/HRA cards at 90% Rule merchants?

    While a majority of plan administrators permit FSA/HRA cards to be used at 90% Rule merchants, there may be some that do not or whose employer clients do not permit it. This could mean that plan administrators in a merchant's market area may have elected not to authorize FSA/HRA card transactions at 90% Rule merchants.

  • If a merchant can qualify its stores under the 90% Rule, will customers that pay with a FSA/HRA card need to submit sales receipts to their plan administrator?

    Generally, yes. Unlike an IIAS where the merchant substantiates the items being purchased at the point of sale, the 90% Rule indicates that stores that qualify as 90% locations can be viewed as "health care merchants." This means that plan administrators will apply their standard substantiation processes to transactions at these locations - and the customer may be asked to submit a sales receipt to document that the items being purchased were Rx/prescriptions or Eligible Health Care Products. It is possible that in some cases the card issuer processor will be able to match a transaction amount with Pharmacy Benefit Management (PBM) system information, and can determine that the card transaction amount matches the plan's co-pay on prescriptions, for example. In this case, the customer may not be asked to submit a sales receipt. But in the absence of an automated matching program like this, it is likely that customers using a FSA/HRA card will be asked by their plan administrator to submit a sales receipt.

  • If a merchant implements the SIGIS IIAS standard, is there a guaranteed 100% acceptance of the health care debit cards in the marketplace?

    While an IIAS system is required for non-health care merchants to accept FSA and HRA cards under the IRS guidelines, a merchant that implements an IIAS solution is not guaranteed 100% acceptance of all FSA/HRA cards. SIGIS Member card issuers/processor and the majority of their third-party plan administrator clients supporting FSA and HRA cards have enabled SIGIS IIAS processing to authorize and auto-substantiate transactions; however some employer benefit plans may require a level of transaction detail that is not supported with an IIAS solution, thereby, preventing acceptance even at merchants with a fully certified IIAS solution. In addition, normal decline issues can occur for expired cards, insufficient funds, cards not activated and other business reasons.

  • What if a plan administrator and/or consumers have questions or inquiries about a possible error with the SIGIS 90% Rule merchant information, who will address the questions?

    Consumers contact their plan administrator to ask questions about merchants at which their FSA/HRA card will work. Only plan administrators can answer these questions. Plan administrators should research cardholder questions via their transaction processing systems to determine what may have caused a cardholder's problem. If the plan administrator believes that SIGIS 90% Rule merchant information may not be accurate, they should contact their card issuer processor for assistance.

  • How can we get more information?

    Plan administrators should contact their card issuer or processor, and merchants should contact their acquirer. Card holders should contact their Plan Administrator. Contact us for membership information.