FSA Tax Advantage Account

To report Health Insurance Tax Advantage Account information

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Position

Element

Name

Type

Requirement

Min

Max

Repeat

Maintenance Type Code

Identifier (ID)

Mandatory

3

3

1

Code identifying the specific type of item maintenance

Flexible Spending Account Selection Code

Identifier (ID)

Optional

1

1

1

Code indicating selection of a type of Flexible Spending Account

Maintenance Reason Code

Identifier (ID)

Optional

2

3

1

Code identifying the reason for the maintenance change

FSA-04

Tax Advantage Account Information

Composite (composite)

Optional

1

Account Relationship Code

Identifier (ID)

Mandatory

1

2

-

Code indicating relationship or type of account an entity maintains with a vendor or financial institution

Account Number

String (AN)

Optional

1

35

-

Account number assigned

Frequency Code

Identifier (ID)

Optional

1

1

1

Code indicating frequency or type of activities or actions being reported

FSA05 specifies the frequency of contribution.

Plan Coverage Description

String (AN)

Optional

1

50

1

A description or number that identifies the plan or coverage

Product Option Code

Identifier (ID)

Optional

1

2

1

Code indicating an option chosen for the product

Product Option Code

Identifier (ID)

Optional

1

2

1

Code indicating an option chosen for the product

Product Option Code

Identifier (ID)

Optional

1

2

1

Code indicating an option chosen for the product