Clarity COVID-19 Optional Plan Changes Form

To initiate your optional plan changes, please review and complete the applicable sections below. When finished, click “Submit”. As always, we are available to help you through this process. Should you need further explanation of these options or require assistance with anything regarding operation of your plan(s) please contact your Client Relationship Manager or call us at 888-423-6359.

The Employer ID must be completed, your ID was sent to you in the email communication.

Once submitted, the requested changes will be reviewed and made within 2-4 business days.

Please Note: In rare circumstances, your current plan design may conflict with the desired changes you choose. If so, we will contact you to discuss your options. We will also notify you when the changes have been completed so you can communicate the changes your participants.

FSA/DCA Plan Information – Required
PLAN CHANGES – Complete this section for changes or additions to plan features.

Extend Claims Runout Deadline for Dependent Care FSA (DCA): DCA plans can apply a runout period extension. The DCA runout extension is not tied to the Outbreak Period and employers can choose a deadline on or before 12/31/2020.

Plan(s) with existing Grace Period:

Extending your existing Grace Period will enable participants to spend down their prior year’s balance. *This may affect participants’ eligibility to make HSA contributions if participating in a Full-Purpose FSA.

Plan(s) without existing Grace Period:

Add Grace Period: For Plan Years ending in 2020 only

Adding a Grace Period through December 31, 2020 will enable participants to spend down their prior year’s balance. *This may affect participants eligibility to make HSA contributions if participate in Full-Purpose FSA.

Important Note: If your plan has adopted the Carry-Over feature, you can add the Grace Period feature in addition through December 31, 2020.


Adding the Grace Period feature now will extend to all future plan years on or after January 1, 2021 and will be limited to current IRS regulations, which is up to 2 ½ months following the end of the plan year.

Carry-Over Feature:

Participants can carry over up to the IRS allowed amount of unused funds from the prior plan year to the new plan year reducing the fear of use-it or lose-it. For Plan Years starting on or after January 1, 2020, you can increase the Carry-Over amount up to $550

Note: If your plan allows Carry-Over up to the IRS maximum, Clarity will automatically increase the amount to the new limit of $550

Election Changes:

Expand ability to make mid-year election or changes for health plan coverage, Health FSA and Dependent Care FSA through December 31, 2020