FSAs: a simple way to save

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FSAs: a simple way to save Flexible Spending Accounts (FSAs) empowering you to build health savings It s easy to save with an FSA

Why FSAs? A simple way to save Take advantage of significant tax savings by participating in a flexible spending account (FSA). You can elect to have a portion of your paycheck contributed pre-tax to pay for qualified medical expenses such as deductibles, co-payments, dental and vision, or to pay for qualified dependent care. Significant savings The scenarios below provide estimated savings if an FSA is used (assuming a 40% combined federal and state tax rate). $1000 $500 $500 out-of-pocket medical expenses out-of-pocket vision expenses out-of-pocket dental expenses $800 tax savings 2 $1000 $1000 $5000 out-of-pocket medical expenses vision and dental expenses child care expenses $2800 tax savings

FSA options Your employer may offer one or more types of FSAs, designed to maximize your savings and address your personal needs: Health care FSA Funds from a health care FSA can be used for qualified expenses including medical, dental, vision, deductibles, co-payments and coinsurance. For a full list of qualified expenses allowed by the IRS, see IRS Publication 502. With health care FSAs, the entire elected amount is available to you on the first day of the health plan year. You don t have to wait for your payroll contributions to accumulate before paying expenses with your FSA. Health care FSA limits The IRS has set the limit for health care FSA contributions to $2,500 per household (see publication 969). However, employers may decide to decrease this limit. Dependent care FSA or DCRA A dependent care FSA enables you to set aside pre-tax dollars to pay for qualified dependent care expenses. Funds can be used to pay for day care, preschool, elderly care or other dependent care. To qualify for a DCRA, the IRS requires that the dependent care is necessary for you or your spouse to work, look for work or attend school full-time. Limited-purpose FSA (LPFSA) Used in conjunction with a health savings account (HSA), an LPFSA allows you to contribute additional pre-tax dollars to use for dental and/or vision expenses. This allows you to maximize your pre-tax HSA contributions and contribute additional pretax dollars to an LPFSA. Post-deductible FSA (PDFSA) PDFSAs can be used for eligible medical expenses once a specified minimum deductible has been met. If you have an integrated HSA with HealthEquity, we automatically accumulate incurred claims towards your deductible. 3

How an FSA works 1 2 3 Sign Up During your employer s open enrollment at the beginning of each plan year, sign up to participate in an FSA. Select the option that best meets your needs and then determine the amount you would like to contribute from your pre-tax earnings. Typically anyone whose employer offers an FSA can participate, including employees not covered under the employer s health plan. Your employer may exclude certain types of employees, such as part-time, seasonal, or temporary. Ask your employer benefits team to verify eligibility. Self-employed individuals can t participate in an FSA. CONTRIBUTE Your employer will arrange to have the determined amount of your pre-tax earnings contributed to your FSA. Typically the amount withheld from your paycheck is equal each pay period. Use your funds When you incur a qualified expense, you can either pay with the HealthEquity Visa reimbursement account debit card provided by some plans or submit the expenses through the HealthEquity online tool for reimbursement. Remember to save all receipts; you ll need them for reimbursements and to validate your expenses with your employer or administrator. Use it or lose it! 4 FSA funds do not roll over from year to year. You must use all of your FSA dollars within the plan year or they will be forfeited. Some plans allow for a small grace period to use remaining funds. Ask your employer benefits team for clarification. This card is issued by The Bancorp Bank pursuant to a license from Visa U.S.A. Inc. The Bancorp Bank; Member FDIC. Copyright 2013 HealthEquity, Inc. All rights reserved. HealthEquity, the HealthEquity logo, and Building Health Savings are service marks of HealthEquity, Inc.

FSA insight other qualified users In addition to your own qualified expenses, you can use your FSA funds to pay for those of your spouse and dependents up to age 26. If your domestic partner meets IRS qualifications to be considered a tax dependent, you can use your FSA for him or her as well. DENTAL expenses FSA funds don t have to be used just for medical expenses. You can use them for qualifying dental expenses, including exams, x-rays, cleanings and dental work. You can even use your FSA to pay for orthodontic work. VISION expenses You can also use your FSA funds for vision expenses such as exams, eyeglasses, contacts and even corrective eye surgery. OVER-THE-COUNTER MEDICINE The IRS no longer allows FSA funds to be used for over-the-counter (OTC) medicines without a prescription. We encourage you to talk to your doctor and request him or her to write a prescription for OTC medicines or supplies that you frequently need to utilize. Then, you can use your FSA to pay for these items. archive your receipts online HealthEquity s easy-to-use online portal allows you to upload and store receipts. If your FSA is integrated with your health plan, you can even link your receipts to claims. Your receipts will remain stored in a safe, secure place, available for future reference and documentation. 5

Qualified expenses See the complete list of qualified and unqualified medical expenses in IRS Publication 502 Medical and Dental Expenses, and see the complete list of qualified dependent-care expenses for a DCRA in IRS Publication 503 Child and Dependent Care Expenses. Qualified medical expenses for a limited-purpose FSA are restricted to qualified out-of-pocket costs for dental and/or vision care. Other expenses eligible under a standard FSA aren t eligible under a limited-purpose FSA. Acupuncture Alcoholism (rehab, transportation for medically advised attendance at AA) Ambulance Amounts not covered under another health plan Annual physical examination Artificial limbs/teeth Birth control pills/prescription contraceptives Body scans Breast reconstruction surgery following masectomy for cancer Chiropractor Contact lenses Crutches Dental treatments Eyeglasses/eye surgery Hearing aids Long-term care expenses Medicines (prescribed, not imported from other countries) Nursing home medical care Nursing services Optometrist Orthodontia Oxygen Stop-smoking programs Surgery, other than unnecessary cosmetic surgery Telephone equipment and repair for hearing-impaired Therapy Transplants Weight-loss program (if prescribed by a physician for a specific disease) Wheelchairs Wigs (if prescribed) Non-qualified expenses The penalty for using FSA funds for non-qualified medical expenses is 20% if you are under age 65, plus the loss of tax-free treatment for the distribution. Keep all itemized receipts and copies of prescriptions for over-the-counter medications in case of an IRS audit. 6 Concierge services Dancing lessons Diaper service Elective cosmetic surgery Electrolysis or hair removal Funeral expenses Future medical care Hair transplants Health club dues Insurance premiums other than those explicitly included Medicines and drugs from other countries Nonprescription drugs, medicines, and supplements (unless prescribed) Nutritional supplements, unless recommended by a medical practitioner as treatment for a specific medical condition diagnosed by a physician Teeth whitening

Expert friends Helpful support for our members, available every hour of every day Marcy and her team of specialists based in Salt Lake City are available 24 hours a day, providing you with the tools and information you need to optimize your FSA. They can answer any questions you may have. 866.346.5800 Marcy, Member Services Salt Lake City, Utah 7

Scan it! NEW MOBILE APP now available itunes App Store Google Play Scan it! 15 West Scenic Pointe Drive, Suite 100 Draper, UT 84020 877.694.3942 info@healthequity.com www.healthequity.com FSAs_a_simple_way_to_win_EE_September_2013