Year-end “use your benefits” campaigns: plan years, FSA deadlines and honest reminders

From October to December, dental offices, eye care practices, chiropractors and physical therapy clinics send the same kind of message: your benefits reset on January 1, so book now before you lose them. The reminder can be useful. A patient who has a crown planned, or FSA money left, may want to know. It can also be wrong for the reader, because a plan year need not be the calendar year, FSA money does not disappear on December 31 under each plan, and a message that pushes people to book care they do not need is a problem in its own right.

This guide covers what to check before you say benefits reset, the federal FSA rules on grace periods and carryover, the treatment date and unnecessary services lines in the ADA Code of Ethics, free offers to people with Medicare or Medicaid, and the consent rules for the emails, texts and calls that carry the campaign. What makes a service an eligible HSA or FSA expense is in our guide to HSA and FSA eligible claims in practice ads. Deadlines, countdown timers and was and now prices for seasonal offers are in our guide to holiday and limited-time procedure sales, and the recall list that a year-end campaign draws on is in our patient recall system guide.

The short version

• Do not assume the reset date. A group health plan’s plan year is the one designated in the plan document, and a plan year can start in a month other than January. Write “if your plan year ends December 31” or “check when your plan year ends”.
• Do not say FSA money is lost on December 31. Under IRS Notice 2013-71 a health FSA can offer a grace period of up to two months and 15 days or a carryover, but not both, and the plan chooses. The maximum carryover for plan years beginning in 2026 is 680 dollars.
• Do not promise what the plan will pay. The remaining maximum, the deductible and what is covered are in the patient’s plan and their benefit statement, not in your ad.
• Recommend only care the patient needs. The ADA Code calls recommending unnecessary services unethical, and a deadline is not a clinical reason.
• Never move treatment dates across the reset. The ADA Code calls incorrect treatment dates on a claim form a false or misleading representation.
• Be careful with free offers to people with Medicare or Medicaid. Free items or services that are likely to influence their choice of provider can be remuneration under 42 U.S.C. 1320a-7a(a)(5).
• Check consent before you text or call. 47 CFR 64.1200 sets consent rules for autodialed and prerecorded calls and texts, and CAN-SPAM covers commercial email.

What “your benefits reset” can get wrong

Under 45 CFR 144.103, the plan year of a group health plan is the year designated as the plan year in the plan document. Only when the document does not designate one does the regulation fall back, in order, to the deductible or limit year, the policy year, the employer’s taxable year and, last, the calendar year. So a calendar plan year is a fallback, not a rule. An employer whose plan year starts on July 1 has employees whose deductible and limits may reset on July 1, and a December email telling them their benefits are about to reset is wrong for them.

The same caution applies to the numbers. Dental plans can have an annual maximum, a deductible, frequency limits on cleanings and X-rays, and waiting periods on larger work. Those terms are set by the plan, and the amount left for a given patient depends on what was already paid this year. A practice that writes “you have money left in your benefits” to its whole list is making a claim about each reader’s account that it has not checked.

Section 5 of the FTC Act, 15 U.S.C. 45(a)(1), declares deceptive acts or practices in commerce unlawful. Under the FTC Policy Statement on Deception, the FTC looks at the net impression a reasonable consumer takes from the whole message, and a statement can mislead through what it leaves out. Information about cost has been found material. “Your benefits expire December 31” sent to someone whose plan year ends in June leaves them with a wrong idea about their money.

What you can say safely is conditional and accurate. “If your dental plan year ends December 31, unused annual benefits do not carry into next year under plans that work that way. Check your plan or call us and we can look at your benefit information with you.” If you have the patient’s plan details on file and have checked them, a personal message based on those details is more useful than a general blast, and it is a treatment communication rather than an ad.

FSA money: grace periods and carryover

Health flexible spending arrangements are where the year-end message is closest to the truth, and where it is easiest to state too strongly. The use-or-lose rule for health FSAs comes from the proposed regulations under section 125 of the Internal Revenue Code, and IRS Notice 2013-71 describes two forms of relief a plan may offer:

• A grace period. A period of up to two months and 15 days right after the end of the plan year, during which a participant may use amounts left from the previous plan year for expenses incurred in that period. The notice points to Notice 2005-42 and Proposed Treasury Regulation 1.125-1(e).
• A carryover. The plan may let participants carry unused amounts into the following plan year, up to a dollar limit. Notice 2013-71 set it at 500 dollars. For plan years beginning in 2026, Revenue Procedure 2025-32 and IRS news release IR-2025-103 (October 9, 2025) set the maximum carryover at 680 dollars, with a salary reduction limit of 3,400 dollars.
• Not both. Under Notice 2013-71, a plan that has a carryover may not also provide a grace period in the plan year to which amounts are carried over, and a plan has to be amended to offer the carryover.
• A run-out period is different. The notice describes a run-out period as time after the plan year during which a participant can submit claims for expenses incurred during the plan year. It extends the time to file, not the time to spend.

Each employer decides which of these its plan offers, if any, and the plan year may not be the calendar year. So the accurate message is: “FSA money may expire at the end of your plan year, depending on your plan. Your plan may give you extra time or let you carry part of it over. Check your plan’s rules.” Do not quote a carryover amount as if it applies to the reader; quote it as the federal maximum, with the year.

Whether a service is an eligible expense at all is a separate question, covered in our HSA and FSA guide. A year-end campaign that tells people to spend FSA money on a cosmetic service the tax code excludes sends them into a problem with their plan administrator.

Care the patient needs, on dates that are true

The ADA Principles of Ethics and Code of Professional Conduct, with advisory opinions revised to October 2025, speak directly to two year-end risks. Advisory opinion 5.B.6 says a dentist who recommends or performs unnecessary dental services or procedures is engaged in unethical conduct, regardless of the practice arrangement or contracts. Advisory opinion 5.B.4 says a dentist who submits a claim form reporting incorrect treatment dates to help a patient get benefits that would otherwise be disallowed is making an unethical, false or misleading representation to the third party.

In practice, that means two things for the campaign. First, the message should be about treatment that is already planned or care that is due, such as an unfinished treatment plan or a missed cleaning, not about finding something to spend the benefit on. Second, staff must never date a visit in December that happened in January, or split one procedure across two plan years on paper when it was done in one. If a treatment can be properly staged over two plan years for clinical reasons, the dates on the claims must match the dates of care.

Section 5.F of the same code says no dentist shall advertise or solicit patients in a manner that is false or misleading in any material respect. Other professions have their own codes and state boards, so check the rules that apply to your license.

Free offers to people with Medicare or Medicaid

A year-end campaign may add a sweetener: a free exam, a free whitening kit or a gift card for booking before December 31. For readers with Medicare or a state health care program, 42 U.S.C. 1320a-7a(a)(5) provides civil money penalties for offering or transferring remuneration to a beneficiary that the person knows or should know is likely to influence the beneficiary to order or receive, from a particular provider, any item or service payable by Medicare or a state health care program.

Under 1320a-7a(i)(6), remuneration includes the waiver of coinsurance and deductible amounts and transfers of items or services for free or for other than fair market value. The statute lists exceptions, and a waiver of cost sharing falls outside the definition only if it is not offered as part of any advertisement or solicitation, is not routine, and follows a good faith finding of financial need or reasonable collection efforts. An advertised “we waive your deductible if you book before year end” does not meet that test.

If your list includes people with Medicare or Medicaid, have an attorney review any free offer before it goes out, or leave the offer out and keep the reminder.

Email, texts and calls

A year-end campaign reaches patients through the channels your recall system uses, and the rules depend on the channel and the content.

• HIPAA. Under the definition of marketing in 45 CFR 164.501, a communication by a covered entity describing a health-related product or service that the covered entity itself provides is not marketing, nor is a communication for the treatment of the individual, provided the covered entity receives no financial remuneration for making it. A reminder about your own services or a planned treatment fits those exceptions; a message paid for by a third party does not.
• Calls and texts. Under 47 CFR 64.1200(a)(2), an autodialed or artificial or prerecorded voice call that includes or introduces an advertisement or constitutes telemarketing needs the called party’s prior express written consent, unless it delivers a “health care” message made by or on behalf of a covered entity or its business associate, as HIPAA defines those terms. A message whose purpose is to sell a service before a deadline is harder to defend as a health care message than a reminder about care that is due, so collect written consent for promotional texts.
• Email. CAN-SPAM, 15 U.S.C. 7704, applies to commercial electronic mail messages: no false or misleading header information or deceptive subject lines, a working opt-out that is honored, identification as an advertisement where required, and a valid physical postal address. Section 7702 defines commercial electronic mail messages defined by primary purpose, and treats transactional or relationship messages separately.

Keep the content of the message minimal. A text that says “you still have 1,200 dollars for your root canal” puts treatment details on a lock screen. “[Practice name]: your plan year may be ending. Call us if you want to finish your treatment plan” does the job.

Questions to ask before the campaign goes out

• Does any line assume a December 31 reset that the reader’s plan may not have?
• Does any line state what the reader has left, without checking their plan?
• Is the FSA wording conditional, and does it mention grace periods and carryover?
• Is the 680 dollar carryover quoted as a federal maximum for 2026 plan years, not as the reader’s amount?
• Is the campaign about planned or due care, not about finding care to use the benefit on?
• Do our claim dates match the dates of care for any treatment staged across plan years?
• Does any free offer reach people with Medicare or Medicaid, and has an attorney reviewed it?
• Do we have the right consent for each text and prerecorded call, and does each email have an opt-out and a postal address?
• Does any text or email put treatment details where others can read them?

Use and avoid

• Use: “If your plan year ends December 31, now is a good time to check your remaining benefits.” Avoid: “Your benefits expire December 31.”
• Use: “FSA money may expire at the end of your plan year, depending on your plan.” Avoid: “Use it or lose it: your FSA resets on January 1.”
• Use: “Call us and we can review your plan information with you.” Avoid: “You have money left. Book now so it does not go to waste.”
• Use: “If you have treatment planned, the end of your plan year may affect what your plan pays.” Avoid: “Max out your benefits: add whitening to your cleaning.”
• Use: dates on claims that match the dates of care. Avoid: “We can date it in December.”
• Use: a reminder with no gift for Medicare or Medicaid readers unless an attorney has approved the offer. Avoid: “Free exam for anyone who books by December 31.”

An illustration

This example is invented. [Practice name], a dental office in [Town], drafts a November email to its full patient list: “Your dental benefits expire December 31! You have money left, so do not let it go to waste. Book a cleaning and get free whitening. FSA funds disappear at midnight on New Year’s Eve.” The same text goes out by automated text message to the list, including patients who never gave written consent for promotional texts, and the list includes patients with Medicare.

The rewrite splits the campaign. Patients with an unfinished treatment plan get a personal message from the office: “[Patient first name], our records show you have treatment planned. If your plan year ends December 31, finishing before then may affect what your plan pays. Call us at the office if you would like to look at your options.” The general email says: “If your dental plan year ends December 31, now is a good time to check your remaining benefits. If you have an FSA, your plan may give you extra time or let you carry part of it over, up to a federal maximum of 680 dollars for 2026 plan years. Check your plan’s rules.” The free whitening offer is dropped, texts go only to patients with written consent on file, and the front desk is told that claim dates must match the date of care.

Checklist

• Plan year wording is conditional: “if your plan year ends December 31”.
• No statement about what the reader has left unless it comes from their checked plan details.
• FSA wording mentions grace periods and carryover, with the 680 dollar maximum labeled as a 2026 federal limit.
• The campaign is limited to planned or due care.
• Claim dates match the dates of care, and staff know it.
• Any free offer reviewed for Medicare and Medicaid readers, or left out.
• Written consent on file for promotional texts and prerecorded calls.
• Emails carry an opt-out and a physical postal address, with an honest subject line.
• No treatment details in texts or email subject lines.
• Campaign pages and emails saved with their send dates.

How we help

We build practice websites, local SEO, Google Ads and lead generation and an AI front desk for independent practices. For year-end campaigns, we write reminder emails and landing pages with conditional plan year and FSA wording, split treatment-plan reminders from general promotions, and set up text campaigns so they reach only patients with consent on file. Our tools are built with HIPAA in mind. We confirm in writing what a BAA covers before any patient information flows through a tool, and if it is not covered, we do not route patient information through it. We are not a healthcare provider and we do not give legal or medical advice. For the wider rules, see our healthcare marketing rules guide.

Sources

• IRS Notice 2013-71: Modification of use-or-lose rule for health flexible spending arrangements
• IRS Revenue Procedure 2025-32 (section 3.15, cafeteria plans)
• IRS news release IR-2025-103: Tax inflation adjustments for tax year 2026 (October 9, 2025)
• 45 CFR 144.103: Definitions (plan year)
• ADA Principles of Ethics and Code of Professional Conduct (advisory opinions revised to October 2025)
• 42 U.S.C. 1320a-7a: Civil monetary penalties
• 15 U.S.C. 45: Unfair methods of competition unlawful; prevention by Commission
• FTC Policy Statement on Deception (October 14, 1983)
• 45 CFR 164.501: Definitions (marketing)
• 47 CFR 64.1200: Delivery restrictions
• 15 U.S.C. 7704: Other protections for users of commercial electronic mail
• 15 U.S.C. 7702: Definitions

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