Position
Element
Name
Type
Requirement
Min
Max
Repeat
FSA01
Maintenance Type Code
Identifier (ID)
Mandatory
3
3
1
Code identifying the specific type of item maintenance
FSA02
Flexible Spending Account Selection Code
Identifier (ID)
Optional
1
1
1
Code indicating selection of a type of Flexible Spending Account
FSA03
Maintenance Reason Code
Identifier (ID)
Optional
2
3
1
Code identifying the reason for the maintenance change
FSA04
Tax Advantage Account Information
Composite (composite)
Optional
1
01
Account Relationship Code
Identifier (ID)
Mandatory
1
2
-
Code indicating relationship or type of account an entity maintains with a vendor or financial institution
02
Account Number
String (AN)
Optional
1
35
-
Account number assigned
FSA05
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.
FSA06
Plan Coverage Description
String (AN)
Optional
1
50
1
A description or number that identifies the plan or coverage
FSA07
Product Option Code
Identifier (ID)
Optional
1
2
1
Code indicating an option chosen for the product
FSA08
Product Option Code
Identifier (ID)
Optional
1
2
1
Code indicating an option chosen for the product
FSA09
Product Option Code
Identifier (ID)
Optional
1
2
1
Code indicating an option chosen for the product