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in my experience that is indeed the case.

for flexible spending accounts, or healthcare spending accounts, reimbursement is made as expenses are incurred and submitted, up to the elected contribution amount for the year.

if the employee indeed incurs and gets reimbursed for the expense early in the year and then leaves, the employer is stuck. however, across many employees it does wash out, because any unused contributions by employees the employee loses. also, in the case of a merger or sale of your division your plan may terminate and instead of having until yearend to incur the expenses you planned and are contributing for, you have only until the date the acquisition closes and your existing plan terminated. if you had expenses backended in the year and the deal closes mid year the employee may again lose the portion of his contribution not used by the acquisition date instead of his planned yearend date.

note: this contrasts with dependent care spending accounts, where you are not reimbursed for more than you have paid in. if you submit an expense for more than you paid in, the unreimbursed amount is tracked and paid out as more funds are contributed.
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