or coverage by an employer-sponsored health plan, a change in the residence or work site of the employee or employee's spouse or dependent, the participant's failure to pay premiums, a change based on special enrollment rights under the Health Insurance Portability and Accountability Act, a court-ordered change, and entitlement to either Medicare or Medicaid. In 2000, employers began to issue debit cards to participating employees to make it easier to access flexible spending account funds. In September 2003, the Internal Revenue Service issued a ruling saying that certain over-the-counter medical expenses could be covered under flexible spending account plans. Effective January 1, 2013, the Patient Protection and Affordable Care Act ((PPACA) essentially required flexible spending accounts to limit employees' annual elections to no more than $2,500, with small increases each year based on inflation. Over-the-counter medications became ineligible expenses as well. In 2013, the Internal Revenue Service issued a ruling that permitted flexible spending plans for health care expenses to allow employees to roll over up to $500 in unused funds from one plan year to the following plan year. Due to the COVID-19 pandemic, between January 1 and December 31, 2020, the Internal Revenue Service allows a health flexible spending account plan and a dependent care flexible spending account plan to allow employees to enroll mid-year, revoke an existing election on a prospective basis, or replace an existing election on a prospective basis. In response to Executive Order 13877, the Internal Revenue Service said that a health flexible spending account plan may increase the unused carryover amounts from $500 to a maximum of $550. See also FSA Eligibility List Health savings account Revenue Act of 1978, the first law that created this kind of account. References Employee compensation in the United States Healthcare in the United States Personal taxes in the United States Tax terms Tax-advantaged savings plans in the United States