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Frequently Asked Questions
  • Filing A Claim
    • How do I file a Flexible Spending Account (FSA) claim?
      After you incur an eligible expense, you have two options for filing a claim.
      • You can submit a claim online. You can then upload, mail or fax your documentation along with the fax cover sheet. Once logged in, from the left navigation bar select File a Claim.
      • You can complete a paper claim form. You can download a claim form. From the Quick Links in the left navigation, select My Resources. Click on Administrative Forms. You would mail or fax the completed claim form along with your documentation.

      What type of documentation do I need to include with my claim?

      Acceptable documentation is one of the following.

      • If the claim first goes through your medical or dental plan, you will receive an Explanation of Benefits (EOB) from the insurance plan. This is the best form of documentation.
      • If the claim is not run through your medical or dental plan (for example, an OTC expense), you can use the itemized receipt or statement. The receipt must show the date the purchase or service is incurred; the amount for which you are financially responsible; a description of the item or service; and the name of the merchant or provider. Note: If the claim is for an OTC medicine, you must also include a written prescription.
      • If you are sending in a prescription drug receipt, it must contain the pharmacy name; patient name; drug name (if listed); date the prescription was filled; and amount you paid.
      • If the claim is for dependent care, the dependent care provider signs the claim form or provides an itemized receipt.

      Note: A cancelled check,  credit card receipt or balance due statement is not acceptable documentation.
       

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  • Health Care Flexible Spending Account (FSA) Claim Tips
    • *Note:  This information is general in nature for informational purposes only.  Please refer to your employer’s plan for specific information about your plan.

      I have a Health Care FSA. If I am contributing throughout the year, how much will my FSA cover for a claim in the beginning of the year?
      With a Health Care FSA your full election amount is available on the first day of the plan year. This means that you can use your entire election on day one of the plan year. This is true even though you have not yet made all of your contributions for the year. For example, you elect to contribute $1,200 for the year. In January you have contributed $100. ($100 x 12 months = $1,200) In January you receive Health Care services. This costs you $1,000. You have not made any other claims to the FSA. The Health Care FSA must pay the full amount of the claim for eligible expenses. You do not have to wait until you have contributed this amount to your FSA.

      Why do I have to show that an expense was medically necessary?
      There are some products or services that are not always used for medical care. Two examples are massage therapy and a weight loss program. If you use the item or service to treat a medical condition, you will need to show that. This is “evidence of medical necessity.” You can submit a prescription or letter from your health care provider. You can also download a Letter of Medical Necessity form. Your Health Care provider can fill it out and sign it. Once logged in, go to My Resources on the left hand navigation. The form is in Administrative Forms.

      Can I pay my spouse's health insurance premiums through my Health Care FSA?
      No. Premiums are not an eligible expense for the Health Care FSA. You can view a standard list of eligible expenses online. Once logged in, go to My Resources on the left hand navigation. Click on Planning Tools, then Eligible Expense Items. For additional information on eligible expenses, please refer to IRS Resources within My Resources. Here you will find links to IRS Publication 502 and IRS Publication 969.

  • Dependent Care Flexible Spending Account (FSA)
    • *Note:  This information is general in nature for informational purposes only.  Please refer to your employer’s plan for specific information about your plan.

      How does the Dependent Care FSA work?
      With a Dependent Care FSA, expenses must be work-related. This means that you need the care so that you can work.

      • If you are married, you must both be working. If just one of you is working, the other spouse must be actively looking for work; be a full-time student; or be unable to care for him or herself. Note: Unpaid or minimally paid volunteer work does not count as employment.
      • The expenses must be for a qualifying person. A qualifying person is your dependent child who is younger than age 13 or a spouse or tax dependent who is not physically or mentally able to care for him or herself.
      • You must receive these services from an eligible care provider. This can include providers such as a licensed child care facility, an adult day care center and possibly a summer day camp. Check your specific plan for further details.
      • The care provider cannot be your tax dependent, your child who is under age 19 at the end of the year, a person who was your spouse any time during the year or the parent of your qualifying person. The expenses must be for services you received during the plan year and while the qualifying person regularly spends at least 8 hours each day in your home. They cannot be for future services. For example, you prepay your child’s summer day camp. You cannot receive reimbursement until after your child attends the camp.
      • The annual reimbursement is limited to the lesser of your earned income for the year or the cost of care, up to $5,000. If you are married, this limit is based on the income of the lower paid spouse and whether you file separate tax returns.
      You must file Form 2441, Child and Dependent Care Expenses, with your tax return.

      What expenses are eligible under a Dependent Care FSA?
      You can view a standard list of eligible expenses online. Go to My Resources. Click on Planning Tools. You can find more information at www.irs.gov. Please refer to IRS Publication 503, Child and Dependent Care Expenses.

      If I participate in the Dependent Care FSA, do I need to report this on my income tax return?
      Yes. When you have a Dependent Care FSA, you must include this information as part of your tax return. You will do this on IRS Form 2441: Child and Dependent Care Expenses. (See Instructions for IRS Form 2441 for more information.) If you have questions, please speak with your tax advisor.

      How much can I contribute to a Dependent Care FSA?
      Typically, the most that you can contribute to a Dependent Care FSA is $5,000. This is per household per year. This means that if you and your spouse each have a Dependent Care FSA, you are limited to $5,000 between you. Keep in mind, this amount may be less based on earned income and tax filing status.

      What does "work-related" mean?
      Work-related means that you pay for dependent care so that you can work and earn an income. If you are married, your spouse must also work. If just one of you is working, then the other one must be actively looking for work; be a full-time student; or be unable to care for him or herself. Note: Unpaid or minimally paid volunteer work does not count. For the IRS definition of work-related expenses, please refer to IRS Publication 503.

      If I have the Dependent Care FSA, can I also use the Child and Dependent Care Tax Credit?
      Generally, if you have a Dependent Care FSA you cannot also take the full tax credit. Please consult your tax advisor for specific information based on several variables such as tax filing status, number of dependents, earned income, tax bracket, etc. to learn which option is most beneficial for your unique situation.
  • Health Care Flexible Spending Account (FSA)
    • *Note:  This information is general in nature for informational purposes only.  Please refer to your employer’s plan for specific information about your plan.

      Do I have to enroll in my employer’s medical or dental plan to participate in the Health Care FSA?
      Your benefit plan will determine this. Although your employer has the option to require that you take the medical or dental plan in order to have a Health Care FSA, not all plans are designed this way. Please check your plan documents. You may be able to participate in the Health Care FSA and not enroll in your employer’s medical or dental plans.

      What expenses are eligible under a Health Care FSA?
      Generally, expenses that are medically necessary are eligible expenses. For example: co-payments, co-insurance, physicals, dental fillings, xrays, prescription eye glasses. You can view a standard list of eligible expenses online. Go to My Resources. Under Planning Tools you will find standard eligible and ineligible expenses listed. In addition, under IRS Resources you will find helpful information in IRS Publications 502 and 969. Generally, eligible expenses include those that are medically necessary and not reimbursed by any insurance you may have or any other form of reimbursement. Please check your plan documents for eligible expenses under your plan.

      May I submit expenses incurred by my spouse and dependents?
      You can be reimbursed for eligible medical expenses incurred by you, your spouse and eligible dependents. This is true even if your spouse and dependents are not on your health plan.

  • Health Savings Account (HSAs) Simplified
    • Note: This information is general in nature for informational purposes only. Please refer to your employer’s plan for specific information about your plan.

      What is a Health Savings Account?
      A Health Savings Account (HSA) is a tax-advantaged health care account that you own. You contribute to it with tax-free or tax-deductible funds. You can then use those funds to pay for qualified medical expenses now and in the future. You can use these funds for your own expenses and for those of your spouse and dependents. This is true even if your spouse and dependents are not on you health plan. To contribute to an HSA you must have a qualified High Deductible Health Plan (HDHP).

      Each year, the IRS sets the maximum amount you can contribute to the HSA. The funds that you contribute but do not use will roll over year to year. In addition, an HSA is portable. This means that if you change employers or leave the work force, the HSA stays with you. Finally, with an HSA you do not have to submit documentation for the funds you use. However, you should keep all your receipts. These will show that you used the funds for qualified expenses. You should also keep your receipts in the event of an IRS audit.

      Who is eligible for an HSA?
      To be eligible for an HSA, you must meet certain requirements. 

      • You must have a qualified High Deductible Health Plan (HDHP).  
      • You cannot have any non-permitted coverage.
      • You cannot be enrolled in Medicare.  
      • You cannot be claimed as a dependent on another person’s tax return.

      What is a qualified High Deductible Health Plan (HDHP)?
      A High Deductible Health Plan (HDHP) has a higher deductible than most health plans. With this type of plan, you must first pay a deductible. Once you pay the deductible, then the HDHP can pay claims. For HSA, a qualified HDHP has the following requirements.

      1. Minimum Deductibles – A qualified HDHP must have minimum deductibles. If the plan has a deductible that is lower than this minimum, it is not a qualified plan for the HSA.
        • For 2012, the deductible for a self-only plan must be at least $1,200. For a family plan the deductible must be at least $2,400.
        • For 2013, the minimum deductibles will be $1,250 (self-only) and $2,500 (family).
      2. Limit on Out-of-Pocket Expenses – A qualified HDHP limits what you pay out of pocket in the plan year. This limit includes what you would pay for deductibles, co-payments and co-insurance. Note: These apply to in-network services only. This limit does not include what you pay for premiums, expenses that are not covered under the plan or lifetime limits.
        • For 2012, the out-of-pocket limit for a self-only plan is $6,050. For a family plan, the limit is $12,100.
        • For 2013, these limits will be $6,250 (self-only) and $12,500 (family).
      3. Preventive Care – The HDHP can cover preventive care while you are still meeting your deductible. The plan can cover preventive care at 100%. It can also cover it at the co-pay or co-insurance amounts. Preventive care includes annual health exams, routine prenatal and well-child care, child and adult shots, stop-smoking programs, weight-loss programs and certain screening services.

      Note: The IRS sets these limits each year. They may change from year to year for the Cost-of-Living Adjustment (COLA).

      Can I have a Flexible Spending Account (FSA) with an HSA?
      If you are contributing to an HSA, you cannot have a regular Health Care FSA. However, you can have a Limited Purpose FSA (LPFSA). Note: Your employer must offer an LPFSA for you to enroll in one. An LPFSA is “permitted” coverage for an HSA. An LPFSA can reimburse you for eligible dental and vision expenses.

      What other types of health coverage can I have and still be eligible for an HSA?
      You can still be eligible for an HSA if you have certain other coverage. You can have other insurance that covers the items listed below. You may also have a discount card. A discount card gives you discounts on health care services or products.

      • Coverage relating to liabilities from workers’ compensation laws, torts, or ownership or use of property (such as automobile insurance)
      • Specified disease or illness
      • A fixed amount per day (or other period) for hospitalization
      • Accidents*
      • Disability*
      • Dental care*
      • Vision care*
      • Long-term care*
      • Most Employee Assistance Program (EAP)

      * This coverage can be through insurance or some other form of coverage. 

      Who may contribute to my HSA?
      Anyone can contribute to your HSA. This means that you, your spouse, your employer, a family member and any other person can contribute. Though anyone can contribute to your HSA, all of those contributions count toward your annual limit.

      How much can I contribute to my HSA?
      Each year, the IRS sets the HSA contribution limits. These limits are for HDHP coverage (self-only or family).  In 2012, the limit for a self-only plan is $3,100. The limit for a family plan is $6,250. For 2013, the limits will be $3,250 (self-only) and $6,450 (family). You can contribute any amount up to these limits.  In addition, you can change your scheduled contribution amount at any time.  If you are age 55 or older, you can contribute another $1,000. This is a “catch-up” contribution. 

      This means that the amount that you can contribute is based on a few things.

      1. What do you have for HDHP coverage? Do you have self-only or family? 
      2. How long are you in the HDHP? Did you have the plan for the entire year? Did you have the same coverage for the entire year?
      3. How old are you? Are you 55 or older?

      You may want to speak to your tax advisor. He or she can help you understand how much you can contribute to your HSA.  See also IRS Publication 969.

      How much can I contribute if I do not have the HDHP for the entire year?

      How much you can contribute depends on when you had the HDHP. 

      If you had the HDHP on December 1, then the Last-month rule applies. This means that if you are eligible on December 1 then you can contribute as if you were eligible for the entire year. If you do contribute for the full year, then you will have to keep the HDHP through the end of the next tax year. This is the Testing Period. If you do not keep the HDHP during the testing period, then the contributions you made for the months you did not have the HDHP are no longer tax-free.

      Example: You have an HDHP starting on May 1, 2012. You still have the HDHP on December 1, 2012. You may contribute the full 2012 contribution amount. At some point in 2013 you no longer have an HDHP.  You will have to pay income taxes on the amount for those months in 2012 that you were not actually eligible. In this example that would be for the months of January through April, 2012. You would also have to pay a 20% tax penalty on that amount. 
      If you have an HDHP for part of the year but not on December 1, then the Proration rule applies. Proration means that you will contribute just for the months that you are eligible. To prorate, you will first have to calculate your contributions on a monthly basis. How much you can contribute for each month is based on the HDHP (self-only or family) that you have on the first day of that month.
      Example: On January 1, 2012, you enroll in a family HDHP. On May 1, you no longer have the HDHP. At that point, you have a non-HDHP. The most that you can contribute for the year is $2,083.32 ($6,250/12 = $520.83 x 4 months). 
      You may want to speak with your tax advisor. He or she can help you to figure out how much you can contribute.  

      How much can I contribute if I change my level of HDHP coverage during the year?
      How much you can contribute depends on the coverage that you have when you start and end the year. 

      If you have a self-only HDHP on January 1 and end the year with a family HDHP, the last-month rule applies. With the last-month rule, you can contribute as if you were eligible for the entire year. This means that you can contribute as if you had family coverage all year.

      So, if you are eligible on December 1 then you can contribute as if you were eligible for the entire year. If you do contribute for the full year, then you will have to keep the HDHP through the end of the next tax year. This is the Testing Period. If you do not keep the HDHP during the testing period, then the contributions you made for the months you did not have the HDHP are no longer tax-free.

      If you start the year with a family HDHP and have a self-only HDHP by December 1, the Proration rule applies. Proration means that you will contribute just for the months that you are eligible. You would have to prorate the months when you had a family HDHP. You would then prorate the months you had a self-only HDHP. When you add the two together, you have the amount that you can contribute for the year. There is no testing period. 
      Example: From January 1 through July 31, 2012, you have a family HDHP. From August 1 through December 31, 2012, you have a self-only HDHP. For January through July, you can contribute $3,645.81. ($6,250/12 = $520.83 x 7 months) For August through December, you can contribute $1,291.65. ($3,100/12 = $258.33 x 5 months) In this example, you can contribute $4,937.46. ($3,645.81 + $1,291.65) 
      You may want to speak with your tax advisor. He or she can help you to figure out how much you can contribute.

      What is a “catch-up” contribution?
      If you are age 55 or older, you can contribute another $1,000 to your HSA. This is a catch-up contribution. For example, you have a self-only HDHP. For 2012, the contribution limit is $3,100. If you are 55 or older you can contribute up to $4,100 for the year. ($3,100 + $1,000)  Note: This is assuming that you are eligible for the full year. 

      If you have a family HDHP and your spouse is age 55 or older, he or she can make a catch-up contribution. If your spouse wants to do this, he or she would have to open up his or her own HSA. Only one person can own an HSA. This means that your spouse cannot contribute his or her catch-up contribution to your HSA. Note: This is assuming that your spouse does not yet have Medicare.  

      Can I transfer funds from my IRA into my HSA?
      Yes. You can make a one-time transfer from your IRA into your HSA. You would do this as a trustee-to-trustee transfer. The transfer amount is tax-free. It also counts toward your HSA contribution limit for the year. You must stay in a qualified HDHP for 12 months after the transfer date. This is the testing period. If you do not keep HDHP coverage for the entire testing period, you will have to pay income taxes on the transfer amount. You may also have to pay a 10% penalty tax. If you have additional questions, you should talk to your tax advisor.

      When is the deadline for making contributions to an HSA?
      For any year that you have an HSA, you can contribute up to the tax filing deadline (typically April 15th of the following year). If you make a prior year contribution between January 1 and the tax filing deadline, please make sure you tell us that by indicating that it is a prior year contribution on both the contribution form and your check. If you do not let us know, we will post the contribution for the current year.

      Contributions can be made by either check or online through your HSA account.  You are able to setup a one-time or recurring contribution to your HSA from a linked bank account.  You may also make one-time contributions via check with the appropriate contribution form.

      How can I keep track of my balance?
      You can view your account balance online. After logging in, go to on My Dashboard. If you want more detailed information, click on View My Account.

      Will I receive a statement of my account activity?
      Yes. You will receive statements for your account activity. You choose how you receive them. You may receive them online or via US Mail. Note: There may be a fee for paper statements.  For a listing of fees, please refer to the Fee Schedule located on the left hand navigation within the Financial Center.

      What happens if I contribute more than the allowable annual amount?
      The amount that you can contribute to your HSA each year is based on a number of factors. These include your level of HDHP coverage, how long you had the HDHP and your age. If you (or anyone else) contribute more than that amount, you have an “excess contribution.” You should remove the excess contribution from your HSA either by requesting a withdrawal online or in writing to us using the address below.  In either case, please note that you are requesting a withdrawal that is “a return of excess contribution”. You should do this by the tax filing deadline for that year. If you do not remove the excess contribution, that amount will be subject to income taxes and a 6% penalty tax. Please talk to your tax advisor if you have more questions. 

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      What expenses can I use my HSA for?
      You can use your HSA to pay for qualified medical care as defined by IRS Publication 969. Medical care is the diagnosis, cure, mitigation, treatment or prevention of disease, and the costs for treatments affecting any part or function of the body. This includes the cost of medical services rendered by medical practitioners, equipment, supplies and diagnostic tests. The medical care can be for you, your spouse and your dependents. This is true even if they are not on your HDHP.  

      You can use your HSA funds to pay for your out-of-pocket costs. To use your HSA funds, you must have received the care on or after the effective date of your HSA. For more information, please refer to IRS Publications 969 and 502.  Links to these sites are accessible within My Resources, then IRS Resources.  

      Do I need to keep my receipts?
      You should keep all your receipts. These will show that you used your HSA funds for qualified medical expenses. You will also need them if the IRS ever audits your tax return. 

      When can I receive distributions from my HSA?
      Once you have funds in your HSA, you can use the funds at any time. You can keep the funds there to save for future expenses. You can use the funds to pay for expenses you now have. You can go online to make a payment to your provider or pay yourself back. If you have a PayFlex Card®, you can use it at the point of service. If you paid out of your pocket, you can go online and reimburse yourself.  After logging in, from the top navigation bar click on Financial Center. Under Health Savings Account, select Make a Withdrawal. Enter all the required fields, making sure you input your name as the “payee” and click Submit.

      If you linked your bank account, you will receive the reimbursement as a direct deposit to your personal account. This can take up to 48 hours for you to see the funds in your account. To do this, from the top navigation bar, click on Financial Center.  Under My Account on the left hand navigation, click on Link My Bank Accounts and following the instructions.

      If you would prefer to receive a check, simply complete the fields, making sure you input your name as the “payee” and click Submit.

      Can I use my PayFlex Card with my HSA?
      Yes. You can use your PayFlex Card with your HSA. If you have more than one account with us, you will receive just one card. For example, you have an HSA and a Limited Purpose FSA.  You will receive one card for both accounts. The PayFlex Card is a MasterCard® that you can use at qualified merchants. Please remember to save all of your receipts.   

      I have an HSA and a Limited Purpose FSA. When I use my PayFlex Card®, how do I know which account is being used?
      When you have an HSA and a Limited Purpose FSA (LPFSA), the type of charge determines which account pays. If you are paying for dental or vision care, we will first look to your LPFSA. If the LPFSA balance can cover the expense, then that account will pay. If the balance in your LPFSA cannot cover the entire expense, then with any unpaid amount we will take the funds from your HSA.  If the HSA balance can cover the expense, then the HSA will pay. For all other eligible Health Care expenses, the funds will come from your HSA.  

      How do I get reimbursed if I did not use my PayFlex Card® for a HSA expense?
      You can go online to request a reimbursement.  After logging in, from the top navigation bar click on Financial Center. Under Health Savings Account, select Make a Withdrawal. Enter all the required fields, making sure you input your name as the “payee” and click Submit.

      If you linked your bank account, you will receive the reimbursement as a direct deposit to your personal account. This can take up to 48 hours for you to see the funds in your account.  After logging in, from the top navigation bar, click on Financial Center.  Under My Account on the left hand navigation, click on Link My Bank Accounts and following the instructions.

      If you would prefer to receive a check, simply complete the fields, making sure you input your name as the “payee” and click Submit.

      Can I name a beneficiary for my HSA?
      Yes. You can go online to name your beneficiar(ies). You may name up to four primary beneficiaries and up to four contingent beneficiaries. You most likely did this when you first registered your HSA online.  However, if you didn’t or you would like to make any changes, you can change your beneficiaries at any time online.  After logging in, click on the Financial Center, then select Health Savings Account from the “Select Account” drop down menu. In the left navigation, click on My Profile. Select Beneficiaries. Enter the required information.

      Will I have to pay taxes when I use my HSA funds?
      When you use your funds for qualified medical care, you do not pay taxes on that amount. If you use your HSA funds for a non-qualified expense, then you will have to pay income taxes. You may also have to pay a 20% penalty tax. There are times when the penalty tax does not apply. If you are disabled or age 65 or older at the time you use the funds, you do not have to pay the penalty.  Upon the death of the account owner, the account becomes the property of the named beneficiary.  If the beneficiary is the surviving spouse, distributions not used for qualified medical expenses are subject to ordinary income tax. If the beneficiary is a person other than the surviving spouse, the HSA ceases to be an HSA as of the date of the account holder's death, and the beneficiary is required to include in gross income the fair market value of the HSA assets as of the date of death.


      Who is responsible for determining whether HSA distributions are used for medical expenses?
      As the account owner, you have to make sure that you use your HSA funds for eligible medical expenses. You should keep all of your receipts. Also make sure to keep good records of your withdrawals. You should talk to your tax advisor if you have more questions. 

      I am age 65 (or older). I have Medicare. I also still have coverage through my employer’s health plan. May I use my HSA funds to pay my contribution to my employer’s health coverage?
      The answer depends on how you pay for your employer’s health plan. If you pay those premiums with pre-tax money, then the answer is no. You cannot use your HSA funds to pay for premiums that you pay pre-tax.

      If you pay the premiums with after-tax money, then you can use the HSA funds for this expense. Once you reach age 65, this is an eligible expense for the HSA.

      I am enrolled in Medicare. Can I use my HSA funds for my Medicare premiums?
      You can use your HSA funds for most Medicare premiums. You cannot use your HSA funds for a Medicare supplemental policy. Note: This applies if you are age 65 or older.

      What happens if I terminate employment?
      If you change employers or leave the work force, the HSA stays with you. It does not stay with your former employer. The account information will remain the same. This means that you will have the same PayFlex account and card. However, you may have to pay some new account fees. If applicable, these fees will be sent to you in writing from PayFlex.  

      What happens to my HSA upon my death?
      First, your estate can use the funds to pay any unpaid medical bills you may have at the time of your death. Your beneficiary will receive the remaining HSA funds. If that is your spouse, the HSA will remain an HSA. However, it will be in your spouse’s name. Your spouse will not have to pay any taxes on these funds.

      If the beneficiary is not your spouse, then the funds do not stay in an HSA. Your beneficiary will receive the funds as a withdrawal from your HSA. This means that the funds will be subject to income taxes. The funds will not be subject to the 20% penalty tax. Note: If you have a spouse and the beneficiary is not your spouse, some states require your spouse’s consent for you to have that beneficiary. You should speak to an attorney or tax consultant for more information.

      Is my HSA FDIC insured?
      When you open an HSA, the funds are in a “cash” account. This is similar to any other bank account. As with other bank accounts, those funds are FDIC insured. 

      Once your cash account reaches a certain balance, you may invest your HSA funds. If you do invest any of your HSA funds, those funds would be in an “investment” account. Any funds in an investment account are not FDIC insured. 

      What are my investment options?
      You must first have a balance of $1,000 in your HSA cash account. At that point, you will be able to register for an investment account. If you choose to move funds into an investment account, we make available a number of mutual funds. You can view these funds in the Financial Center once logged in. Once there, click on the Investments link on the left side of the screen. 

      If I no longer have a qualified HDHP, can I still use my HSA to pay for health care expenses?
      Yes. When you have a qualified HDHP you can contribute to the HSA. When you no longer have the HDHP you cannot contribute to the HSA. However, you can continue to use your HSA funds to pay for out-of-pocket Health Care qualified medical expenses.

      I have an HSA with another bank. Can I also enroll in a PayFlex HSA?
      Yes. You can have more than one HSA. The amount that you contribute to all HSAs is still limited to the annual contribution limit for the year. 

      You may also close your old HSA and transfer the funds to your new HSA. You may be paying fees on your old HSA. If so, you may want to consider that in regards to having more than one HSA.

      When am I eligible for a Health Savings Account (HSA)?
      First, you must have a qualified High Deductible Health Plan (HDHP) to have an HSA.The date that you are eligible for the HSA is based on the effective date of your HDHP.

      • If your HDHP starts on the first day of the month then you are eligible for the HSA that same day.  For example, the HDHP starts on January 1.  You are eligible for the HSA on January 1. 
      • If your HDHP starts on any day after the first day of the month, you are eligible for the HSA on the first day of the next month.  Let’s look at an example.  Your HDHP is starts on January 15.  You are eligible for the HSA on February 1.

      Once you sign up for the HSA, you must go through a Customer Identification Process (CIP).  With the CIP, we verify your name, Social Security number, address and date of birth.  If we need more information from you, that could delay the opening of your HSA.  Once your HSA opens, that is the effective date.  So, your effective date may be later than the date you are eligible.

      When can I start to use my HSA?
      You can start to use your HSA once it is open and funded.Your effective date determines which expenses you can pay with the HSA funds.You can use your HSA funds for expenses that you incur on or after the HSA effective date.You can’t use the HSA for expenses that you incurred before the HSA opened.

  • A Grace Period
    • Note: This information is general in nature for informational purposes only. Please refer to your employer’s plan for specific information about your plan.

      What is a grace period?
      A grace period is available for Health care and Dependent Care Flexible Spending Accounts (FSAs). A grace period extends the time that you can incur eligible expenses for the plan year. It can extend the plan year for up to two and a half months. For you to have a grace period, your employer would have to offer it as part of the plan.

      Let’s look at an example. You have an FSA. The plan year is January 1 through December 31. This means that you typically have to incur expenses during this time for the FSA to reimburse you. However, if your FSA has a grace period, then you would have until March 15 of the next year to incur expenses. This period of January 1 through March 15 of the next year is the grace period. If you still have funds in the FSA, the FSA will reimburse you for claims that you incur during this grace period. If you still have funds left in the FSA at the end of the grace period, they will be forfeited.   For more information, see run out period below.

      Do I automatically have a grace period?
      You do not automatically have a grace period on your FSA. Your employer would have to offer it as part of the plan. Please check with your employer’s plan description. That will tell you if you have a grace period. 

      How does PayFlex pay my grace period expenses?
      When you incur a claim during the grace period, we will first look to your prior year FSA. If you have funds available we will use those funds to pay the claim. Once you have no funds left in the prior year FSA, we will pay the claim from your current year FSA. If you did not enroll in the FSA this year, then we would pay the claim, up to the balance in your prior year FSA.  

      How does a grace period differ from a run out period?
      A run out period is the time you have to file claims before the plan year is closed. It is usually 90 days after your plan year ends. For example, your FSA plan year is January 1 through December 31. You would have until March 31 of the next year to file claims. Note: You must have incurred these claims during the plan year.

      The grace period extends the plan year. When you incur expenses during the grace period you can receive reimbursement from the prior year FSA. If we use the example above, you have an FSA with a plan year of January 1 through December 31. With the grace period, you can incur expenses through March 15 of the next year. Your run out period may still end March 31.  See your employer’s plan documents for information specific to your plan.

      What if I still have money in my account after the end of the grace period?
      If you have any funds left in your account at the end of the year, they will be forfeited. This is the IRS “use-it-or-lose-it” rule.  Review all of your expenses incurred during the plan year.  Make sure you have filed a claim for each before the run out period ends.  Any funds left in your FSA at the end of the run out period are forfeited.

      How does the grace period affect my enrollment for the new plan year?
      When your FSA has a grace period, you can still enroll in the FSA for the next year. When you incur a claim during the grace period, we will first look to your prior year FSA. If you have funds available we will use those funds to pay the claim. Once you have no funds left in the prior year FSA, we will pay the claim from your current year FSA.

      When planning for the next plan year, you need to take into account any funds that you may have left in the FSA during the grace period. This will help you to plan your FSA election for the next plan year.
  • COBRA & American Recovery & Reinvestment Act (ARRA)
    • Note: This information is general in nature for informational purposes only. Please refer to your employer’s plan for specific information about your plan.

      What is COBRA?
      COBRA is a federal program that provides certain former employees, retirees, spouses, former spouses, and dependent children the right to temporary continuation of health coverage at group rates. This coverage, however, is only available when coverage is lost due to certain qualified events.

      Who is entitled to benefits under COBRA?
      There are three elements to qualifying for COBRA benefits. COBRA establishes specific criteria for plans, qualified beneficiaries, and qualifying events:

      • Plan Coverage - Group health plans for employers with 20 or more employees are subject to COBRA. Both full and part-time employees are counted to determine whether a plan is subject to COBRA. Each part-time employee counts as a fraction of an employee, with the fraction equal to the number of hours that the part-time employee worked divided by the hours an employee must work to be considered full time.
      • Qualified Beneficiaries - A qualified beneficiary generally is an individual covered by a group health plan on the day before a qualifying event. This includes an individual who is either an employee, the employee's spouse, or an employee's dependent child. In some cases, a retired employee, retired employee’s spouse, or retired employee’s dependent child may be considered qualified beneficiaries.  In addition, any child born to or placed for adoption with a covered employee during the period of COBRA coverage is considered a qualified beneficiary. Agents, independent contractors, and directors who participate in the group health plan may also be qualified beneficiaries.
      • Qualifying Events - Qualifying events are certain events that would cause an individual to lose health coverage. The type of qualifying event will determine who the qualified beneficiaries are and the amount of time that a plan must offer the health coverage to them under COBRA. Longer periods of continuation coverage may be provided at the discretion of the plan.

      Qualifying Events for Employees:
       

      • Voluntary or involuntary termination of employment for reasons other than gross misconduct
      • Reduction in the number of hours of employment

      Qualifying Events for Spouses:

      • Voluntary or involuntary termination of the covered employee's employment for any reason other than gross misconduct
      • Reduction in the hours worked by the covered employee
      • Covered employee's becoming entitled to Medicare
      • Divorce or legal separation of the covered employee
      • Death of the covered employee

      Qualifying Events for Dependent Children:

      • Loss of dependent child status under the plan rules
      • Voluntary or involuntary termination of the covered employee's employment for any reason other than gross misconduct
      • Reduction in the hours worked by the covered employee
      • Covered employee's becoming entitled to Medicare
      • Divorce or legal separation of the covered employee
      • Death of the covered employee

      How does a person become eligible for COBRA continuation coverage?
      To be eligible for COBRA coverage, you must have been enrolled in your employer's health plan when you worked and the health plan must continue to be in effect for active employees. COBRA continuation coverage is available when a qualifying event occurs that would cause an individual to lose his or her health care coverage.

      What process must individuals follow to elect COBRA continuation coverage?
      Employers must notify plan administrators of a qualifying event within 30 days after an employee's death, termination, reduced hours of employment or entitlement to Medicare.

      How long after a qualifying event do I have to elect COBRA coverage?
      Qualified beneficiaries must be given an election period during which each qualified beneficiary may choose whether to elect COBRA coverage. Each qualified beneficiary may independently elect COBRA coverage. A covered employee or the covered employee's spouse may elect COBRA coverage on behalf of all other qualified beneficiaries. A parent or legal guardian may elect on behalf of a minor child. Qualified beneficiaries must be given at least 60 days for the election. This period is measured from the later of the coverage loss date or the date the COBRA election notice is provided by the employer or plan administrator. The election notice must be provided in person or by first class mail within 14 days after the plan administrator receives notice that a qualifying event has occurred.

      When does COBRA coverage begin?
      COBRA coverage begins on the date that health care coverage would otherwise have been lost due to a qualifying event.

      How long does COBRA coverage last?
      COBRA establishes required periods of coverage for continuation health benefits. A plan, however, may provide longer periods of coverage beyond those required by COBRA. COBRA beneficiaries generally are eligible for group coverage during a maximum of 18 months for qualifying events due to employment termination or reduction of hours of work. Certain qualifying events, or a second qualifying event during the initial period of coverage, may permit a beneficiary to receive a maximum of 36 months of coverage.

      Who pays for COBRA coverage?
      As an individual that has experienced a qualifying event (e.g. termination of employment or reduction in hours, etc.), it is your responsibility to pay for COBRA coverage even if you do not receive a monthly statement. 

      When are COBRA premiums due?
      The initial premium payment must be made within 45 days after the date of the COBRA election by the qualified beneficiary. Payment generally must cover the period of coverage from the date of COBRA election retroactive to the date of the loss of coverage due to the qualifying event. Premiums for successive periods of coverage are due on the date stated in the plan with a minimum 30-day grace period for payments. Payment is considered to be made on the date it is sent to the plan.

      What happens if I forget to pay my premium?
      If premiums are not paid by the first day of the period of coverage, the plan has the option to cancel coverage until payment is received and then reinstate coverage retroactively to the beginning of the period of coverage if payment is subsequently received prior to the end of the grace period.

      If I elect COBRA, how much do I pay?
      When you were an active employee, your employer may have paid all or part of your group health premiums. Under COBRA, as a former employee no longer receiving benefits, you will usually pay the entire premium amount, that is, the portion of the premium that you paid as an active employee and the amount of the contribution made by your employer. In addition, there may be a 2 percent administrative fee.
      Since it is likely that there will be a lapse of a month or more between the date of layoff and the time you make the COBRA election decision, you may have to pay health premiums retroactively-from the time of separation from the company. The first premium, for instance, will cover the entire time since your last day of employment with your former employer.

      How do I file a COBRA claim for benefits?
      Your health plan rules should include how to obtain benefits and written procedures for processing claims. View your Summary Plan Description for claims procedures. You should submit a claim for benefits in accordance with the plan's rules for filing claims.

      Can individuals qualify for longer periods of COBRA continuation coverage?
      Yes, disability can extend the 18 month period of continuation coverage for a qualifying event that is a termination of employment or reduction of hours. To qualify for additional months of COBRA continuation coverage, the qualified beneficiary must:

      • Have a ruling from the Social Security Administration that he or she became disabled within the first 60 days of COBRA continuation coverage
      • Send the plan a copy of the Social Security ruling letter within 60 days of receipt, but prior to expiration of the 18-month period of coverage

      If these requirements are met, the entire family qualifies for an additional 11 months of COBRA continuation coverage.  Plans can charge 150% of the premium cost for the extended period of coverage.

      Is a divorced spouse entitled to COBRA coverage from their former spouses’ group health plan?
      A covered employee’s spouse who would lose coverage due to a divorce may elect continuation coverage under the plan for a maximum of 36 months. A qualified beneficiary must notify the plan administrator of a qualifying event within 60 days after divorce or legal separation. After being notified of a divorce, the plan administrator must give notice to the qualified beneficiary of the right to elect COBRA continuation coverage.

      Under COBRA, what benefits must be covered?
      Qualified beneficiaries must be offered coverage identical to what is available to those individuals who are not receiving COBRA coverage under the plan (generally, the same coverage that the qualified beneficiary had immediately before qualifying for continuation coverage). A change in the benefits under the plan for the active employees will also apply to qualified beneficiaries. Qualified beneficiaries must be allowed to make the same choices given to non-COBRA beneficiaries under the plan, such as during periods of open enrollment by the plan.

      Can I receive COBRA benefits while on FMLA leave?
      The Family and Medical Leave Act, effective August 5, 1993, requires an employer to maintain coverage under any group health plan for an employee on FMLA leave under the same conditions coverage would have been provided if the employee had continued working. Coverage provided under the FMLA is not COBRA coverage, and FMLA leave is not a qualifying event under COBRA. A COBRA qualifying event may occur, however, when an employer's obligation to maintain health benefits under FMLA ceases, such as when an employee notifies an employer of his or her intent not to return to work.

      What changes did the Trade Act of 2002 and the TAA Health Coverage Improvement Act of 2009 make with regard to COBRA continuation coverage?
      The Trade Act of 2002 created a tax credit for certain individuals who become eligible for trade adjustment assistance and for certain retired employees who are receiving pension payments from the Pension Benefit Guaranty Corporation (PBGC). Under the tax provisions, eligible individuals can either take a tax credit or get advance payment of 65% of premiums paid for qualified health insurance, including continuation coverage.

      The Trade Adjustment Assistance Extension Act of 2011 increases the amount of the HCTC, expands those eligible to receive it, and extends COBRA coverage.  These changes are effective through January 1, 2014.  Starting in January 2012, the monthly HCTC credit increased to 72.5%  If you have questions about these provisions, you may call the Health Coverage Tax Credit Customer Contact Center toll-free at 1.866.628.4282. TTD/TTY callers may call toll-free at 1.866.626.4282.

      How do I find out about COBRA coverage and how do I elect to take it?
      Employers or health plan administrators must provide an initial general notice if you are entitled to COBRA benefits. You probably received the initial notice about COBRA coverage when you were hired.

      • When you are no longer eligible for health coverage, your plan administrator has to provide you with a specific notice regarding your rights to COBRA continuation benefits.
      • Employers must notify their plan administrators within 30 days after an employee's termination or after a reduction in hours that causes an employee to lose health benefits.
      • The plan administrator must provide notice to individual employees of their right to elect COBRA coverage within 14 days after the administrator has received notice from the employer.
      • You must respond to this notice and elect COBRA coverage by the 60th day after the written notice is sent or the day health care coverage ceased, whichever is later. Otherwise, you will lose all rights to COBRA benefits.
      • Spouses and dependent children covered under your health plan have an independent right to elect COBRA coverage upon your termination or reduction in hours.

      I’ve heard that the COBRA Premium Reduction (Subsidy) ends on August 31, 2011, is this true?
      Not necessarily, some individuals will still be eligible to receive the subsidy beyond August 31, 2011. The American Recovery and Reinvestment Act (ARRA) provided a COBRA premium reduction for eligible individuals who were involuntarily terminated from employment through the end of May 2010. Due to the statutory sunset, the COBRA premium reduction under ARRA is not available for individuals who experience involuntary terminations after May 31, 2010. However, individuals who qualified on or before May 31, 2010 may continue to pay reduced premiums for up to 15 months, as long as they are not eligible for another group health plan or Medicare even if their COBRA coverage did not start until a later date due to the terms of a severance arrangement, or the use of banked hours or other similar provision that delayed the start of their COBRA coverage.  For example if an individual was involuntarily terminated on May 31, 2010 and due to the terms of a severance agreement their COBRA coverage did not start until December 1, 2010, they would still be eligible for the full 15 months of subsidy through February 29, 2012 as long as they are not eligible for another group health plan or Medicare.   Please contact your plan administrator if you have any questions about the ARRA COBRA subsidy.

  • Dependent Care Flexible Spending Account (FSA) Claim Tips
    • Note: This information is general in nature for informational purposes only. Please refer to your employer’s plan for specific information about your plan.
      I have a Dependent Care FSA.  If I am contributing throughout the year, how much will my FSA cover for a claim in the beginning of the year?
      A Dependent Care FSA reimburses only eligible incurred expenses up to the amount you have contributed, minus any previous payments. It does not pay like a Health Care FSA, which pays your full election amount on day one. A Dependent Care FSA reimburses up to the balance in the account. 

      I have a Dependent Care expense that I want to submit for reimbursement. However, I don’t have enough in the account right now to cover the full amount.  How should I submit this claim?
      You can file your claim for the actual amount. However, the FSA will only reimburse you up to the balance in your account. The remaining amount will not be reimbursed to you until your scheduled contributions are available.  Once the additional funds are available, the FSA will reimburse you for the remaining amount.

      I pay tuition for my child’s kindergarten. Is this an eligible Dependent Care expense?
      The cost of tuition is not an eligible expense. This includes kindergarten, as well as first grade and higher. If your child is in before- and after-school care those may be eligible expenses if the before- and after-school care is so you can work.

      I just had a baby and will be home for six weeks. I'm taking my older child to day care during this time. Will these day care expenses be eligible?
      This is not an eligible expense. The Dependent Care must be so you can work. Since you are not working during this period, the day care expense is not reimbursable.

      I pay my neighbor to watch my 13-year-old after school. Is this an eligible expense?
      No. Care must be for a qualifying person. A qualifying person includes your dependent child who is younger than age 13. Unless your child is not able to care for him or herself, this is not an eligible expense.  

      My 16-year-old daughter cares for my 8-year-old son after school. Will my Dependent Care FSA reimburse me for the amount I pay my daughter?
      No. This is not an eligible expense. If the care provider is your child, he or she cannot be your tax dependent. He or she must also be 19 or older by the end of the year. Refer to IRS Publication 503 for more information.  

      When can I submit a claim for my Dependent Care expenses?
      You would submit claims after the completed dates of service. For example, you pre-pay your care provider every Friday for the next week. You must wait until the end of the next week to submit your claim. 

      What type of documentation do I need to include with my Dependent Care claim?  
      When you submit a claim, we need the detail for that expense. Include only one of the following for reimbursement:
      • You can submit a Dependent Care FSA Claim Form that your care provider has signed. The form must include dates of service; name of dependent; cost of care; and the care provider’s name. With your care provider’s signature, this claim form is an itemized statement of the expense:
        OR
      • If your care provider does not sign the claim form, he or she must provide an itemized statement. You would then include that statement with the completed claim form. The itemized statement must include the dates of service; name of dependent; cost of care; and the care provider’s name.
  • All About Flexible Spending Account (FSAs)
    • Note: This information is general in nature for informational purposes only. Please refer to your employer’s plan for specific information about your plan.

      What is a Flexible Spending Account?
      Flexible Spending Accounts (FSAs) let you pay for eligible expenses with tax-free money. You contribute to an FSA with pre-tax money from your paycheck. This, in turn, lowers your taxable income.

      A Health Care FSA helps you pay for eligible out-of-pocket medical, dental, vision and hearing expenses. Out-of-pocket expenses are those that your insurance does not cover. These include deductibles, coinsurance and co-pays and certain over-the-counter (OTC) items.

      A Dependent Care FSA helps you pay for eligible child or adult day care expenses. These expenses are so that you and, if married, your spouse can work, look for work or attend school full-time. These include day care, before- and after-school programs, nursery school or preschool, summer day camp and adult day care. The cost of care must be for your child under age 13, or for a spouse or dependent who is not able to take care of him or herself and who lives with you at least ½ of the year.

      What is the benefit of enrolling in an FSA?
      Your contributions to an FSA are deducted from your pay on a pre-tax basis. Therefore, you pay less in Federal and Social Security payroll taxes. You use those funds in the FSA to help you pay for eligible Health Care and Dependent Care expenses. Then, you can use the tax savings to spend on things you really want—like new clothes, vacations, hobbies or even a gym membership.

      How much money can I expect to save in taxes with an FSA?
      When you contribute to an FSA, that money is deducted from your pay on a pre-tax basis. This means that you pay less in Federal and Social Security payroll taxes. Generally, federal taxes range from 15% to 28% and Social Security taxes are 7.65% of your pay.

      How does an FSA work?
      Managing your FSA is as easy as 1-2-3.
      1. Estimate how much you will spend on eligible health care expenses, Dependent Care expenses or both during the plan year. This is what you pay out-of-pocket.
      2. Decide how much you wish to set aside into your Health Care FSA, your Dependent Care FSA or both up to the IRS limits. Your employer will deduct that amount from your paycheck in equal amounts each pay period. These deductions are pre-tax. Note: These are two separate FSAs. The Health Care FSA cannot pay for Dependent Care expenses. The Dependent Care FSA cannot pay for health care expenses.
      3. As you incur eligible expenses throughout the year, you have two ways to use your funds. If your employer offers the PayFlex Card®, you can use that to pay at the point of service. If you do not have or use the card, you can submit a claim form for reimbursement.

      Can I change my election during the plan year?
      Your FSA election remains in effect for the plan year. This is an IRS rule. The only way to change your FSA election during the plan year is if you have a status change event. Some examples of a status change are marriage and birth or death of a dependent. Please contact your Human Resource or Benefits Department if you wish to change your election based on a status change event.

      How do I change my election?
      Your FSA election remains in effect for the plan year. This is an IRS rule. The only way to change your FSA election during the plan year is if you have a status change event. If you have a status change, the change you wish to make to your FSA must be consistent with the status change event. Here is a list of status change events. Note: Your plan determines which of these are allowed under the plan. Please refer to your plan documents

      • Change in legal marital status (marriage, divorce, legal separation, annulment, death of a spouse)
      • Change in number of tax dependents (birth, adoption, death)
      • Change in employment status that affects benefit eligibility
      • Dependent becomes or is no longer eligible under the plan (reaches limiting age, gains or loses student status)
      • Change in residence that affects eligibility

      A Dependent Care FSA has additional status change events. If you change care providers you may make an elelction change. A change in provider also includes going from having a care provider to not having one (for example, when one parent stops working). If your care provider increases their cost and the provider is not a relative, you may make an election change.

      If you have had a status change event, please contact your Human Resources or Benefits Department within 30 days of the status change event.

      How do I get reimbursed?
      As you incur eligible expenses throughout the plan year, you have two ways to use your funds. If your employer offers the PayFlex Card®, you can use that to pay at the point of service for your health care expenses. If you do not have or use the card, you can submit a claim form for reimbursement.

      What does the term “incurred expense” mean?
      The IRS considers an expense to be “incurred” at the time you receive the care, not when you are billed or pay for the expense. The expense must be incurred within the FSA plan year and while you have coverage for you to receive reimbursement.

      Here are some examples.

      • Your FSA coverage is effective January 1 through December 31 of this year. Expenses that you incur during this period can be reimbursed.
      • You received Health Care services in December of last year. You paid for those services in February of this year. This expense cannot be reimbursed. In this example, you incurred the expense before the start of the FSA plan year.
      • You had dental work done this year, in January. However, you prepaid for the work last December. Though you paid for the work last year, you incurred the expense this year. This expense can be reimbursed from your FSA.
      • You paid for summer day camp in March. Camp begins July 15 and ends July 22. You can be reimbursed for the cost of camp after July 22.

      What happens if I have funds left in my account at the end of the plan year?
      If you have funds left in your account at the end of the year, they are forfeited following the run out period. This is the IRS “use-it-or-lose-it” rule. Your employer may offer a “grace period.” With the FSA grace period, expenses that you incur during an additional two months and 15 days (two and a half months) after the end of your plan year can be paid from your FSA funds.

      You can avoid losing money at the end of the year. Review your current and prior years’ expenses. This will help you estimate what you may spend in the next year. Make sure to be conservative while planning for predictable expenses.

      What is a run out period?
      A run out period is the time you have to file claims before your account is forfeited. It is usually 90 days after your plan year ends. For example, your FSA plan year is January 1 through December 31. You would have until March 31 of the next year to file claims. Note: You must have incurred these claims during the plan year. Check your employer’s plan documents for your specific run out period.

      What happens if I leave my company?
      When your employment ends, you may continue to submit health care claims incurred during the time you had coverage. Your Health Care FSA may provide coverage through the last day of the month in which your employment ends. If not, then your coverage ends on the last day of employment. In addition, you may be eligible to elect COBRA coverage. Your employer will let you know how and by when to submit claims.

      For your Dependent Care FSA, you may generally continue to submit claims up to the balance in your account. Another option that may be selected by your employer, allows you to only submit claims incurred before your employment ends.

      You should contact your Human Resources or Benefits Department for more information.

      If my spouse and I each have an FSA, can we claim each other's expenses?
      For health care expenses, you cannot claim the same expense for both accounts. In other words, you cannot “double-dip.” If you claim your spouse’s expenses on your FSA then your spouse cannot claim those same expenses on his or her FSA. If your spouse claims your expenses under his or her FSA, then you cannot also claim them under your FSA.

      For Dependent Care expenses, you and your spouse can each have a Dependent Care FSA. However, between the two of you, you are limited to a maximum reimbursement of $5,000 in day care costs which may be reduced based on earned income and tax filing status.

  • Health Care Flexible Spending Account (FSA) Claim Tips for Orthodontia
    • Note: This information is general in nature for informational purposes only. Please refer to your employer’s plan for specific information about your plan.
       

      How does the FSA reimburse orthodontia?
      The IRS recognizes that orthodontia is different from any other type of health care. For reimbursement of orthodontia, what you will need to submit depends on what is allowable under your plan and the payment option that you choose. Please remember to submit to your dental insurance carrier prior to submitting to PayFlex.

      1. Coupon Payment Option – If your plan allows, this option works best when the orthodontist provided you either a coupon book or a monthly reminder statement of expenses. You must submit the coupon or itemized statement with a completed claim form. You will do this as the service is provided.
         
      2. Monthly Payment Option – If you plan allows, the Auto Pay option allows you to set up recurring monthly reimbursements. To do this you must submit a copy of the contract or agreement* that you have with the orthodontist along with the completed claim form and the box on the claim form checked indicating you wish to establish automatic monthly reimbursements. Once we process the first claim, we will automatically reimburse you each month. You do not have to submit a claim form for each visit. We use the agreement to set the monthly amount that you will receive from the FSA for the length of the agreement. Note: You must be enrolled in the FSA and have funds available. You will receive the monthly payments on or about the due date stated in your agreement.
      * You can get a payment contract or agreement from your orthodontist. That agreement must include the patient’s name; date that the service began; the length of service; cost of the initial banding work; and the amount you must pay each month.
      Note: If you use the Auto Pay option, you cannot also use the PayFlex Card® for these expenses.
      1. Total Payment Option – Based on your plan, you may have the option to pay the full amount when the treatment begins. If your plan allows and you did pay the full amount, you can receive reimbursement for the amount you paid out-of-pocket. We will reimburse you up to your FSA election amount, minus any previous FSA payments. Note: If you have sent in other claims, make sure to check your FSA balance. You can do this online. This will let you know how much you have available to cover your orthodontia treatment.
      With this option, you must include a copy of your paid receipt. You also need to include an itemized statement. This must include the provider’s name; the patient’s name; date that the service began; the amount you paid; and the amount insurance will pay.Note: You can only submit this once for reimbursement.
      I am not re-enrolling in the Health Care FSA. I have the Auto Pay option for orthodontia. How does the FSA reimburse orthodontia during the grace period?
      If your plan has a grace period, the Auto Pay option will continue to pay with funds that you have left in your FSA. This will happen for the first two months of the grace period. The third month will have no payment activity. Payment for Auto Pay option is only for a full month. The grace period is 2 ½ months. This means that the third month is not a full month for payment. If you did not re-enroll in the FSA, you will receive no more payments.
  • My PayFlex Card®
    • Note: This information is general in nature for informational purposes only. Please refer to your employer’s plan for specific information about your plan.

      What is a PayFlex Card?
      Your PayFlex Card is a debit card. You can use this card to pay for health care products and services. This includes doctor and dentist visits, hospital stays, prescriptions and hearing and vision care. You may also use your card at some discount and grocery stores. These stores must have a system that can process a health care card. Note: The merchants and providers must accept MasterCard® in order for your card to work.

      What are the benefits of using a PayFlex Card?
      There are four key benefits to the PayFlex Card. 

      1. Immediate payment from your account – You can use your card at the point of service.
      2. Increased personal cash flow – When you use your card you do not have to pay out of pocket. 
      3. Reduced claim filing – You won’t have to submit a claim and wait for reimbursement.  Note: Be sure to keep all of your itemized receipts.  You may be requested to submit them.
      4. Ease of use – Using your card allows you easy access to your funds. 

      How does my PayFlex Card work for health care expenses?
      You can use your PayFlex Card to pay for an eligible expense. Swipe your card.  Select “Credit.” (Though this is a debit card, you will not select “Debit.”) Your transaction will process like any other credit or debit card purchase. Note: The merchants and providers must accept MasterCard® for your card to work. They also must be a health care location (such as a doctor’s office or pharmacy). If they are not a health care location, they must have a system that can process a Health Care card. If you purchase eligible and non-eligible items, you can only use your card to pay for the eligible items. You will have to use another form of payment for the non-eligible items.   

      When you first receive your card, it is good for five years. Note for FSA: Each year that you enroll, the card will house the FSA plan year election amount. You can only use the card for expenses that you incur during that plan year. This includes a grace period if your employer offers one on the FSA. You should always keep all of your itemized receipts to substantiate card transactions.

      Should I select “debit” or “credit” when using my PayFlex Card?
      When you use your PayFlex card, select “credit.” Though this is a debit card, you will not select “Debit.”

      I just received my PayFlex Card. Do I have to use the card for all of my health care expenses?
      No. You do not need to use your card for all health care expenses. You can always use another form of payment for your expenses and submit a claim for reimbursement.

      Where can I use my PayFlex Card?
      You can use your card to pay for Health Care products and services. This includes doctor and dentist visits, hospital stays, prescriptions and hearing and vision care. You may also use your card at some discount and grocery stores. These stores must have a system that can process a Health Care card. Note: The merchants and providers must accept MasterCard® for your card to work.  

      What should I do if my PayFlex Card is not accepted?
      There is more than one reason why you may not be able to use your card. 

      • Some providers do not accept debit or credit cards.
      • A merchant or provider may not accept MasterCard®.
      • The merchant may not be able to accept health care cards.
      • Your account balance may not cover the expense.
      • Your account may be suspended. When your account is suspended we need more information regarding another card transaction.

      If you are unable to use your card, you will have to use another form of payment. You can then file a claim for reimbursement.

      Can I buy over-the-counter (OTC) items with the card?
      You can use your funds to pay for OTC items and supplies.  These are items such as bandages or a home diagnostic test. You can also use the funds to pay for diabetic supplies and equipment such as crutches.  However, the rules are different for OTC medicines. To use your funds for OTC medicines, you need a written prescription.   A standard list of eligible expenses is available online.  After logging in, go to My Resources. Click on Planning Tools.

      Can I use my PayFlex Card to purchase eligible items online?
      Yes. You can use your card for online purchases of eligible items. Please remember to keep any and all receipts. 

      Do I also need to submit a claim form when I use my PayFlex Card?
      If you used your card, please do not submit a claim. However, there may be times when we need more information about the card transaction. We may need you to show documentation that an expense was for qualified medical care. Refer to “What should I do if my account is in overpayment status?”.

      How do I access my account information online?
      After logging in, from My Dashboard, select Financial Center from the top navigation bar. Then use the drop down menu to select which account you want to view. You can see account information and card transactions.

      Why did I receive a Request for Documentation letter?
      You recently used your PayFlex Card. You received a letter because we need more information on that card transaction. We need proof that the expense was for qualified medical care. The amount you paid may not match your copay amount. The amount you paid may have been for an estimated amount. We need to know how much you were supposed to pay out of pocket for the claim. Note: If you received this letter, your account may be suspended, if you do not respond by the date indicated. While your account is suspended, you cannot use your card for that account.  However, you may request reimbursement by submitting a completed claim.

      You can send one of the following items for the transaction in question.

      • The best form of proof is the Explanation of Benefits (EOB). You will receive this for any claim that first goes through your medical or dental plan.
      • If this is not for a claim that went through your medical plan (for example, an OTC expense), you can use an itemized receipt. The receipt must show the date of purchase or service; the amount you paid; a description of the item or service; and the name of the merchant or provider. Note: If the claim is for an OTC medicine, you must also include a written prescription from your health care provider.
      • If you are sending a prescription drug receipt, it must contain the pharmacy name; patient name; date of the prescription; and amount you paid.

      Please provide this information as soon as possible. You can upload the documentation online. If you are not able to do this, you can mail or fax it to us. The Request for Documentation letter gives you the instructions for getting that to us. Once we confirm that the amount you paid is an eligible expense, we will re-activate your card.

      Note: A cancelled check or credit card receipt alone is not acceptable documentation.

      What is an Inventory Information Approval System (IIAS)?
      An Inventory Information Approval System (IIAS) is a system that marks a product or service as an eligible health care expense. Stores that sell eligible and non-eligible items must have an IIAS to accept health care cards. These include drug stores, discount stores and grocery stores. These types of stores sell more than just health care items. For example, a drug store also sells newspapers, food items and cosmetics. When you purchase a number of items, the IIAS marks the items that you can pay for with your PayFlex Card. You would then pay for the other items with another form of payment. 

      What should I do if a store does not have an Inventory Information Approval System (IIAS)?
      If the store does not have an IIAS, you can still make your purchase. You will have to use another form of payment. You can then submit a claim for reimbursement.

      What happens if I do not have enough money in my account to pay for an expense?
      If you do not have enough funds in your account, you PayFlex Card will be denied. You could ask the merchant to charge your card just for the amount that you have available. Then you would pay the balance with another form of payment. Depending on the type of account, you may or may not be able to submit a claim for reimbursement.

      • HSA – Once you contribute more funds to your account, you can submit a claim for reimbursement.
      • Health Care FSA – With a Health Care FSA, the full amount of your annual election was available on the first day of the plan year. Even though you may still be contributing to the FSA, you will not be able to submit a claim for reimbursement.

      How do I report a lost or stolen card?
      As soon as you know your card is lost or stolen, please contact us at (888) 879-9280. Note: You should report the loss to us within 30 days. If you report it within 30 days, you will not have to pay for any fraudulent charges as outlined in your card holder agreement.

  • All About FSAs
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    • Is there a maximum that I can contribute to a healthcare FSA?
      Yes, effective your first plan year beginning on or after January 1, 213. the Healthcare Flexible Spending Account (FSA) annual maximum contribution amount will be $2,500.   The new limit is on a per-participating basis.  This means, if both you and your spouse are eligible to participate in an employer-sponsored healthcare FSA, you may each contribute up to the individual limit of $2,500 if your spouse's employer's plan also offers the IRS maximum of $2,500.  Please check with your Human Resources/Benefits Department or your employer's plan description to confirm the contribution amount allowed for a healthcare FSA.
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  • Managing My Settings
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    • How do I enroll in direct deposit?
      • Login to your HealthHub account and select Financial Center on the top navigation bar.
      • Click on Enroll in Direct Deposit on the left navigation bar and complete all required fields.

      You may also enroll in direct deposit by completing a paper form available in Resource Center.


      How do I change my username and password?
      Login to your HealthHub account and select My Settings on the left navigation bar to get started.
       

      What is eNotify™ and how do I enroll in it?
      eNotify™ is HealthHub’s electronic notification service that is used to provide updates on your account balance (Balance Reminder), notifies you when your claim has been received (Claim Received) and when it has been processed (Explanation of Benefits), and alerts you when additional documentation is needed for your PayFlex Card® transactions (Receipt Request Letter). You choose which notifications you want to receive as well as when and how you want to receive them.

      To enroll in eNotify™, login to your HealthHub account and select My Settings. Then click on Manage Notifications, enter your email address twice and select the notifications you wish to receive either via email or web alert. To save your changes, click Submit.

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    • How do I change my email address?
      Login to VSTO.healthhub.com and select My Settings on the left navigation bar to get started. Please note, the email address you provide will be used for all account communications.

      How do I change my username and password?
      Login to VSTO.healthhub.com and select My Settings on the left navigation bar to get started.

      How do I enroll in direct deposit?
      • Login to VSTO.healthhub.com and select Financial Center on the top navigation bar.
      • Click on Enroll in Direct Deposit on the left navigation bar and complete all required fields.
      You may also enroll in direct deposit by completing a paper form available in Resource Center.

      What is eNotify™  and how do I enroll in it?
      eNotify ™ is HealthHub’s electronic notification service that is used to provide updates on your account. You choose which notifications you want to receive as well as when and how you want to receive them.

      To sign up for account notifications, log in to atk.healthhub.com and select My Settings. Then click on the notifications link, enter your email address and select the notifications you wish to receive. To save your changes, click Submit.
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  • MyPayFlex application FAQ
  • Flexible Spending Account (FSA) in Overpayment Status
    • What does overpayment status mean?

      An overpayment generally occurs when you pay for an expense with your PayFlex Card® and the documentation does not support the amount you paid.  For example, you used your card to pay for a dental bill. The amount that you paid is more than what your dental plan shows as the amount you owe. In another example, you submit an itemized statement from the health care provider that shows insurance is either estimated, pending or filed but not paid. 

      In both examples, your FSA has paid more than what your plan states that you should have paid. When this happens, your FSA will go into an overpayment status. Note: When your FSA is overpaid, we will suspend your card for that account. This means that you will not be able to use the card for other eligible expenses. If you have other accounts on the card, the card will continue to work for those accounts. For your card to be fully active again, we need one of two things. You can send us the documentation that substantiates the transaction. (Substantiation is proof that an expense was for qualified care and was your financial responsibility.) You can send us a check for the overpayment amount to the following address:

      PayFlex Systems USA, Inc.
      Flex Claims Department
      P.O. Box 3039
      Omaha, NE 68103-3039

      You can view your card status online. After logging in, go to Quick Links. On the left side of the screen, click on Manage My Debit Cards.

      How do I know if my account is in overpayment status?
      If your account is overpaid, you will see an alert message when you log in to your account. It will appear under Alerts on My Dashboard. If you are enrolled in eNotify, we will e-mail an Explanation of Payment (EOP) to you. The EOP will explain the overpayment. (eNotify is PayFlex’s e-mail notification service.) If you do not have eNotify, we will mail the EOP to you. We store all documents online. You will be able to view the EOP online at any time. Note: If your account is overpaid, your card will be suspended for that account. 

      • View your PayFlex EOP online   
        You can view the EOP online. You can also download it. After logging in, go to My Dashboard. On the left side of the screen, select My Documents. From the drop down menu, select Coupon with EOP Report. If your account is overpaid, you will see the EOP that we have sent to you. 
      • Enroll in eNotify
        To receive e-mails about your account, you will need to enroll in eNotify.  After logging in, go to My Settings. Click on Manage Notifications. Then, follow the online instructions. 

      What should I do if my account is in overpayment status?
      If your account is overpaid, you must do one of the following:  

      • If the claim that caused the overpayment has gone through your medical or dental plan, you should have received an Explanation of Benefits (EOB). Fax, mail or upload that EOB along with a copy of the letter notifying you. The EOB will show the date of service, a description of the service and the amount you have to pay for the claim. This will show us if that amount equals or exceeds the transaction amount. 
      • If the EOB shows that you did overpay, you can substitute another eligible expense for the overpayment amount. Fax, mail or upload the EOB along with a completed claim form for that other expense. If you do not have an EOB, you can use a detailed receipt. The receipt must show the date of purchase or service; the amount for which you were financially responsible; a description of the item or service; and the name of the merchant or provider. Note: You must have incurred this expense in the same plan year. The amount of this expense would have to be equal to or greater than the overpayment amount. You also must not have already received reimbursement for this expense.
      • If you do not have another expense to offset the overpayment, you will have to repay the account. You can mail a check for the amount of the overpayment. Make the check payable to PayFlex Systems USA, Inc. and mail to the address below.  Please do not send cash.

      PayFlex Systems USA, Inc.
      Flex Claims Department
      P.O. Box 3039
      Omaha, NE 68103-3039

      I used my PayFlex Card to pay for my dental expenses. My dentist overcharged me. How should I fix this?
      If your dentist overcharged you, you will have to work with your dentist to fix this. Your dentist will have to return the amount he or she overcharged you.  The dentist should credit the amount back to your PayFlex Card.  If the dentist will not credit your card, your account will remain in an overpayment status until other eligible expenses have been submitted, or you can send in a check made payable to PayFlex Systems USA, Inc. and mail to the address below to offset the overcharge. 

      PayFlex Systems USA, Inc.
      Flex Claims Department
      P.O. Box 3039
      Omaha, NE 68103-3039

      I received a bill for an estimated amount. Should I pay this amount?
      When you receive a bill for an estimated amount, that means that the amount you will actually owe is unknown. Therefore, you should wait until your insurance plan pays the claim and determines how much you owe. Your plan will send you an EOB showing the amount you owe.  Once you know how much you have to pay for the claim, then you can use your PayFlex Card to make the payment.

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