Flexible Spending Account Overview

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1 Flexible Spending Account Overview What is a Flexible Spending Account? A flexible spending account (FSA) allows you to set aside money on a pre-tax basis. You can then use the money to pay for qualified out-of-pocket expenses, such as: Medical Dental Vision Dependent Care You can use your FSA to be reimbursed for expenses incurred by yourself, your spouse, your children, or your qualifying relative. Employees usually save an average of 25% to 50% on their expenses, depending on their tax bracket. Having a FSA helps you reduce your taxes, and increase your take-home pay. How Does an FSA Work? Prior to a new plan year, employees elect how much they would like to have taken out of their pay check. The elected amount will be available on the very first day of your coverage period. Your contributions will be taken out of your paycheck in equal amounts, throughout the coverage period. Contributions You are eligible to elect up to $2550 for your Medical FSA contribution. FSA contributions are deducted before federal taxes, social security taxes, and most state taxes. 1 P a g e

2 Eligible Health FSA Expense Your Health Care Flexible Spending Account (FSA) dollars can be used for a variety of out-of-pocket health care expenses. The following is based on a list of eligible expenses used by federal employees. BABY/CHILD TO AGE 13: Mattresses* PRACTITIONERS: Lactation Consultant* Medic Alert Bracelet or Necklace Allergist Lead-Based Pain Removal Nebulizers Chiropractor Special Formula* Orthopedic Shoes* Christian Science Practitioner Tuition: Special School/Teachers for Oxygen* Dermatologist Disability or Leaning Disability* Well Baby/Well Child Care Post-Mastectomy Clothing Homeopath DENTAL: Prosthetics Naturopath* Dentures and Bridges Syringes Optometrist Dental X-Rays Wigs* Osteopath Exams and Teeth Cleanings MEDICAL PROCEDURES/SERVICES: Physician Extractions and Fillings Acupuncture Psychiatrist or Psychologist Oral Surgery Alcohol and Drug/Substance Abuse THERAPY: (inpatient treatment and outpatient care) Orthodontia Ambulance Alcohol and Drug Addiction Periodontal Services Fertility Enhancement and Treatment Counseling (not martial or career) EYES: Hair Loss Treatment* Exercise Programs* Eye Exams Hospital Services Hypnosis Eye Glasses and Contact Lenses Immunization Massage* Laser Eye Surgeries Invitro Fertilization Occupational Radial Keratotomy Physical Examination (not employmentrelated) Physical HEARING: Reconstructive Surgery (due to a Smoke Cessation Program* congenital defect, accident or medical treatment.) Hearing Aids and Batteries Service Animals Speech Hearing Exams Sterilizations/Sterilization Reversal Weight Loss Programs* LAB EXAMS/TESTS Transplants (including organ donor) Blood Tests and Metabolism Tests Transportation* Body Scans MEDICATIONS: Cardiograms Insulin X-Rays Prescription Drugs MEDICAL EQUIPEMENT/SUPPLIES: OBSTETRICS: Air Purifications Equipment* Breast Pump and Lactation Supplies Arches and Orthotic Inserts Doulas* Contraceptive Devices Lamaze Classes Crutches, Walkers, Wheel Chairs OB/GYN Exams Exercise Equipment* OB/GYN Prepaid Maternity Fees (reimbursable after birth) Hospital Beds* Pre-and Postnatal Treatments Note: This list is not meant to be all-inclusive, as other expenses not specifically mentioned may also qualify. Also, expenses marked with an asterisk (*) are potentially eligible expenses that require a Note of Medical Necessity form, from your health care provider to quality for reimbursement. For additional information, check your Summary Plan Document or contact your Plan Administrator. 2 P a g e

3 The IRS does NOT allow the following expenses to be reimbursed under the Health Care FSA s, as they are not prescribed by a physician for a specific ailment. Ineligible Expenses Appearance Improvements Future Medical Care Retin-A Baby-Sitting/Child Care Genetic Testing Rogaine Chemical Peels Household Help Safety Glasses COBRA Premiums Illegal Operations Student Health Fee Contact Lens or Eye Glasses Long-Term Care Sunglass Clips Insurance Cosmetics Marriage or Career Counseling Sunscreen (SPF less than 30) Cosmetic Surgery/Procedures Maternity Cloths Tanning Salons/Equipment Controlled Substances Medicare Premiums Swimming Lessons Diapers Over-The-Counter Drugs Teeth Whitening DNA Collection/Storage Personal Trainers Veterinary Fees Electrolysis/Hair Removal Personal Use Items Weight-Loss Programs Face Lifts Pre-Payment for Services Funeral Expenses Note: This list is not meant to be all-inclusive Please Note: The IRS does not allow Over-the Counter (OTC) medicines or drugs to be purchased with Health Care FSA funds unless accompanied by a prescription and the prescription is filled by a pharmacist. If you have an OTC prescription, you can use your benefits card for these purchases. Ineligible Over-the-Counter Medicines and Drugs (unless prescribed in accordance with state laws) Acid Controllers Denture Medicated Nasal Sprays, drops & Inhalers Acne Medications Denture Pain Relief Medicated Respiratory treatments & Vapor Products Allergy & Sinus Digestive Aids Motion Sickness Antibiotic Products Ear Care Oral Remedies or Treatments Ant parasitic Treatments Eye Care Pain Relievers (Includes Aspirin) Antiseptics & Wound Cleansers Feminine Antifungal & Anti-Itch Skin Treatments Anti-Diarrheal Fiber Laxatives (bulk forming) Sleep Aids & Sedatives Anti-Gas First Aid Burn Remedies Smoking Deterrents Anti-itch & Insect Bite Foot Care Treatment Stomach Remedies Baby Rash Ointments & Creams Hemorrhoid Preps Unmedicated Nasal Sprays, Drops or Inhalers Baby Teething Pain Homeopathic Remedies Unmedicated Vapor Products. Cold Sore Remedies Incontinence Protection & Treatment Products Cough, Cold & Flu Laxatives (non-fiber) 3 P a g e

4 OTC items that are not medicines or drugs remain eligible for purchase with FSA plans. You can use your benefits car for these items. Eligible Over-The-Counter Items (Product categories are listed in bold face; common examples are listed in regular face.) CONTRACEPTIVES: FAMILY PLANNING: Splints & casts, hydro collators, Unmedicated Condoms Pregnancy and Ovulations Kits Nebulizers, Electrotherapy Birth Control Products Products, Catheters, Unmedicated DENTURE ADHESIVES, REPAIR, AND CLEANSERS: FIRST AID DRESSING AND SUPPLIES: Wound Care, Wheel Chairs Poligrip, Benzodent, Plate Weld, Bandages, 3M Nexcare, INCONTINENCE PRODUCTS: and Efferdent DIABETES TESTING AND AIDS: Non-sport Tapes Attends, Depend, GoodNites for Ascencia One Touch, Diabetic Tussin FOOT CARE TREATMENT: Juvenile incontinence prevail Insulin Syringes; Glucose Unmedicated corn and callus Pads PRENATAL VITAMINS: Products DIAGNOSTIC PRODUCTS: Treatments (e.g., callus cushions), Stuart Prenatal, Nature s Bounty Thermometers, Blood Pressure Monitors, Devices, Therapeutic insoles Prenatal Vitamins Cholesterol Testing GLUCOSAMINE &/OR CHONDROITIN: EAR CARE: Osteo-Bi-Flex, Cosamin D, READING GLASSES AND MAINTENANCE Unmedicated Ear Drops, Syringes, Flex-a-min, Nutritional Supplements ACCESSORIES: Ear Wax Removal HEARING AID/MEDICAL BATTERIES: Readers Glasses ELASTICS/ATHLETIC TREATMENTS: Reading Glasses Repair Kit ACE, Futro Elastic Bandages, HOME HEALTH CARE (LIMITED SEGMENTS): Braces/Supports, Hot/Cold Ostomy, walking aids, decubiti s/ therapy, Orthopedic Supports, Rib Belts Pressure relief, enteral/parenteral EYE CARE: Feeding supplies, patient lifting Contact Lens Care Aids, Orthopedic braces/supports, Contact Lens Solutions Dual Purpose Expenses Documentation is required for reimbursement of these items and services. The diagnosis of the medical condition and/or a recommendation by the medical professional for the purchase of the item, will be requested. Air Conditioner Genetic Testing Orthopedic Shoes or Inserts Air Purifier Glucosamine Prescription Weight Loss Drugs Behavioral Modification Language Training (for disability) Treadmill Programs Chondroitin Massage Therapy Varicose Veins Dietary Supplements Nutritional Supplements Weight Loss Programs 4 P a g e

5 Dependent Care FSA Dependent Care FSA can be used to receive reimbursement for eligible dependent care expenses. Dependent Care services must be incurred while the employee is at work. However, any services incurred during a temporary work absence (sick days, vacation), can be reimbursed. You can contribute up to $5,000 for the plan year, in Dependent Care FSA. If you are married and happen to file separate tax returns, the maximum contribution is $2,500. If your spouse elects Dependent Care through their employer, you can each only elect $2,500 for a maximum of $5,000. Unlike health care FSA, you can only get reimbursed for expenses that are in your current account balance. This means you must wait for your balance to build, to cover a large dollar amount, claim early in the year. Please note: If your spouse is a stay at home parent that takes care of your children, you are not eligible for a dependent care account. Eligible Dependent Care Expenses Examples of Eligible Dependent Care Expenses include: Before and After-School Care Elder Daycare for a qualifying individual Nanny (children under 13) Day-Camp (children under 13) In-home Daycare Sick-Child Facility Daycare Center Ineligible Dependent Care Expenses Examples of Ineligible Dependent Care Expenses Include: Babysitter for reasons other than helping to enable you to work Child Support Payments Childcare provided by a blood relative Cleaning and cooking services not provided by a caregiver Food, Clothing, Entertainment Late-Payment Fees Overnight Camps 5 P a g e

6 Wex Health/Benny Card All members who elect a FSA will received a Wex Health/Benny Card. The Wex Health/Benny Card will draw funds directly from your FSA, to pay for eligible medical expenses. By using your Wex Health/Benny Card, you eliminate having to wait for reimbursement of out-of-pocket medical expenses. The IRS regulations require all Wex Health/Benny transactions be substantiated. Most of the time, this will automatically occur electronically. However, there will be times where you are required to send in documentations after a Wex Health/Benny swipe. Please note: You cannot use your Wex Health/Benny Card to pay for any expenses that incurred in a previous plan year. Your Wex Health/Benny Card cannot be used for Dependent Care expenses. 6 P a g e

7 There are a few different ways you can be reimbursed for eligible Health and Dependent Care expenses. Online: You can log onto your personal online account, and click on the Flex Reimbursement Request option. Fax: You can fax your Flex Reimbursement Form to: You can your Flex Reimbursement Form to: Service@HealthEZ.com Mail: You can mail your Flex Reimbursement Form to: HealthEZ Attn: Eligibility Department 7201 West 78 th Street Suite 100 Bloomington, MN Flexible Spending Account: Reimbursements Run-out: The plan year for your Medical & Dependent Care FSA runs from November 1 st to October 31 st. At the end of each Plan Year, you will also have a Run-Out Period to submit any claims for any Eligible Expenses incurred during the Prior Plan Year. The Run-Out Period expires on January 31st. Carryover: If you have any funds left in your Health Care FSA at the end of the Run-Out Period, you may carryover up to $500 into the subsequent Plan Year. Dependent Care FSA: Run-out Period At the end of each Plan Year, you will have a Run-Out Period to submit any claims for any Eligible Expenses incurred during the Prior Plan Year. The Run-Out Period expires on January 31st. Termination of Employment Health Care FSA. If your employment is terminated during the Plan Year, you can: 1. You can close your account. If you do so, you will have until January 31st of the next plan year to submit claims for Eligible Expenses incurred before your termination of employment date; or 2. You can continue your contributions on an after-tax basis by elected COBRA coverage. In this case, you can still claim reimbursements from your account for expenses incurred after you terminate through the end of the Plan Year, provided you continue your FSA participation by making after-tax contributions. Dependent Care FSA. If your employment is terminated during the Plan Year, your contributions to your Dependent Care FSA will end. However, you can be reimbursed for Eligible Expenses incurred before your termination of employment date. You have until January 31st of the next plan year to submit claims. 7 P a g e