Plan Administrators

  • At times, we see that FSA or HRA cards may work at some stores of a certified merchant, but not at other store locations. What could cause that?

    It is possible that the merchant has a phased implementation of IIAS capabilities. If a merchant is listed as certified and a plan administrator continues to experience problems with card usage, please speak with your transaction processor.

  • How do FSA/HRA card issuers know which merchants have registered under the 90% Rule with SIGIS?

    SIGIS will publish a list of SIGIS Members that have registered as 90% Rule merchants. Additionally, SIGIS will publish the acquirer IDs and Card Acceptor IDs of these merchants each week. Issuers and issuer processors that elect to participate in the 90% Rule should use the 90% Rule SFTP Report. The issuer processor should use the MasterCard ICA, Visa BIN, Maestro ICA, Visa Interlink ID, STAR ABA, NYCE ID, ACCEL ID, PULSE ID, CAID and MCC code in the authorization process to determine if it is a 90% Rule merchant. Other fields should not be used, as doing so may cause unnecessary declines. The public 90% Rule report should be used as an informational guide when working with merchants. Issuer and issuer processors must be a SIGIS Member to download the list.

  • 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. The IRS requires that FSA/HRA purchases be substantiated. As the 90% rule does not provide substantiation, plan administrators will apply their standard substantiation processes to transactions at these locations. 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. In some cases the plan administrator may be able to match a transaction amount with other data such as Pharmacy Benefit Management (PBM) co-pay on prescriptions to complete substantiation and not require the customer to submit a sales receipt. But in the absence of an automated matching program like this, it is likely that customers using an FSA/HRA card will be asked by their plan administrator to submit a sales receipt.

  • If a merchant implements IIAS, is it at all their registers?

    It is possible that the IIAS system has been installed in specific locations within a store, the pharmacy for example, and not all registers within the store. If there is any question, please ask the store for more information.

  • What about a merchant’s data retention requirements?

    The IRS requires that merchants be able to retrieve the product detail associated with an IIAS transaction for a period of five (5) years. The data retention requirements are published in the SIGIS Technical Specification.

  • 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 a 90% Rule Registration or IIAS Certification status be confirmed?

    As a paid Member of SIGIS in good standing, a merchant is able to confirm the status of its SIGIS 90% Registration or IIAS Certification status by visiting the Publications page.

    Please note that the 90% Merchant list is updated each Monday morning and the IIAS Merchant list is published at 5 am PST each business day.

  • Is a Merchant required to make IIAS changes to accept FSA/HRA cards?

    No. A merchant is not required to implement an IIAS; however, FSA/HRA card issuers will not be able to approve FSA/HRA card transactions when a merchant does not support an IIAS. If you are a merchant and choose not to implement an IIAS, you do not need take additional steps.  Merchants that are pharmacies/drug stores and primarily sell prescriptions and medical items may qualify under the IRS rules as a “90% Rule” merchant.  See the 90% Rule Merchant FAQs for more information.

    For merchants that would like to accept the FSA/HRA cards from their customers, the IRS requires Merchants selling health care eligible products to support an Inventory Information Approval System (IIAS). The IIAS system is a combination of inventory management and point-of-sale systems that can verify the health care eligibility of items purchased with an FSA or HRA debit card, generate a payment transaction that contains the required IIAS information, and includes an information archive system that allows the merchant to respond to an IRS audit(s) as required. As noted above, for Drug Stores / Pharmacies where 90% of the sales on a store-by-store basis qualify as FSA-eligible, a 90% Rule registration program is an alternative option.

    Merchants have the option to not become a Member of SIGIS by establishing their own IIAS standards or 90% Rule Exemption and working with third-party plan administrators individually.

    With the IIAS Certification developed by SIGIS, a non-profit standards organization, a broad range of participating merchants have been able to implement a solution that is recognized industry-wide, which enables acceptance of most FSA/HRA payment cards. Likewise, third-party plan administrators have implemented a common set of procedures that are applied to IIAS transactions at participating merchants.

  • Why do TPAs see some transactions with an Rx Amount and some without?

    The prescription subtotal is optional for merchants to support when implementing their IIAS systems. For a list of merchants that support the Rx subtotal, please go to the IIAS Merchant List under Governance Documents & Publications. The "Supporting Prescription Subtotal" column indicates which merchants have chosen to provide the prescription subtotal in their card authorization requests.

  • The cardholder swiped their card, but the TPA does not see a transaction, why?

    When TPAs experience transaction issues, they should speak with their card processor for specific details. It is possible that the cardholder was attempting to purchase items that the merchant did not have identified as SIGIS qualified items and, therefore, did not submit the transaction for authorization against the card identified as being for health care purchases.

  • 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.