State law effects the health insurance providers each having various products and costs. States also have varying criteria for full time employment and rules affecting qualifying corporation for group rates.
Yep. Health insurance plans are designed state by state an managed at the state level by the insurance companies. That's why the BCBS (Blue Cross Blue Shield) plans in Texas are different than the BCBS plans in California.
But what does that have to do with Flexible Spending Account plans? Two different animals. FSA’s were established as part of IRS Section 125 Cafeteria Plan laws.
Do you realize that you can enroll in a Flexible Spending Account plan WITHOUT enrolling in any health insurance? They are both considered “benefits” but that is where the similarity ends. Not being condescending here just saying one has nothing to do with the other. Health insurance plans are state based and regulated "insurance" plans and FSA plans are federal pre tax reimbursement plans.