FSA Flexible Spending Account

To supply flexible spending account information

Position
Element
Name
Type
Requirement
Min
Max
Repeat
FSA-01
Maintenance Type Code
Identifier (ID)
Mandatory
3
3
-
Code identifying the specific type of item maintenance.
FSA-02
Flexible Spending Account Selection Code
Identifier (ID)
Optional
1
1
-
Code indicating selection of a type of Flexible Spending Account.
FSA-03
Maintenance Reason Code
Identifier (ID)
Optional
2
3
-
Code identifying the reason for the maintenance change.
FSA-04
Account Number
String (AN)
Optional
1
35
-
Account number assigned.
FSA04 is Flexible Spending Account (FSA) Policy Number.
FSA-05
Frequency Code
Identifier (ID)
Optional
1
1
-
Code indicating frequency or type of payment.
FSA05 specifies the frequency of contribution.
FSA-06
Plan Coverage Description
String (AN)
Optional
1
50
-
A description or number that identifies the plan or coverage.
FSA-07
Product Option Code
Identifier (ID)
Optional
1
2
-
Code indicating an option chosen for the product
FSA-08
Product Option Code
Identifier (ID)
Optional
1
2
-
Code indicating an option chosen for the product
FSA-09
Product Option Code
Identifier (ID)
Optional
1
2
-
Code indicating an option chosen for the product

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