Flexible Spending Account (FSA) Information

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Flexible Spending Account (FSA) Information

2 simplify | motivate | execute© 2010 ConnectYourCare All Rights Reserved.

Who We Are

ConnectYourCare is your healthcare account administrator. • Online account access• Health education tools• Healthcare payment card• Easy access to funds


Online CDH Portal

24 x 7 real-time access to:• Obtain real-time account

balances• Check transaction history on

accounts – contributions and disbursements

• Submit online request for reimbursement, check claim status, and view reimbursement schedule

• Add/update personal and direct deposit information

• Access a variety of health education and wellness tools


Health Education Tools

A variety of WebMD tools are available in the online portal.• WebMD Hospital AdvisorSM— Hospital information and rankings for specific

procedures• WebMD Medication AdvisorSM— Information on less expensive prescription

options• WebMD Treatment Cost AdvisorSM— Cost estimates on 350 of the most common

medical conditions, tests, and procedures• WebMD Health TopicsSM— A to Z medical encyclopedia listing of over 1,500

ailments with information, treatment options, prevention, and more• WebMD HealthQuotientSM— State-of-the-art

assessment tool that scores participants’ health status, calculates risk levels, and provides recommendations for health improvement and behavior change

• Symptom Checker — Information about what medical symptoms could indicate and helpful facts before a doctor’s visit


Accessing Account Funds

Healthcare Payment Card• Use it at healthcare locations where

Visa is accepted• Use it for qualified healthcare items• Automatically records purchase online• Money comes directly out of your

account• No need to pay upfront and wait for

reimbursement • Cannot be used at ATMs• Multiple ConnectYourCare accounts

are accessible with the same card (if offered by your employer)


Reimbursement Requests

• Pay out of pocket for a qualified expense

• Enter your claim online• View claim status online at

any time• Receive reimbursement • Set up direct deposit for even

quicker reimbursements


Saving Receipts

• Name of the patient• Date the service was provided • Name of the service provider • Description of the service • Amount/cost of the item or service

provided

Always save your itemized receipts!


Best-in-class service to participant through multiple channels• Robust Online Portal (24 x 7)

– Real-time account balances– Transaction history

• Interactive Voice Response (24 x 7)– Account information– User name reminder or password reset

• E-mail– Interactive communication method– Limited to basic operations, not used for personal health information

(PHI)• Live Customer Assistance

– Detailed questions or personal assistance– Trained in adjudication and call assistance

Customer Service Available at All Times


What is an FSA?

Contributions• You decide how much to contribute to your account –

your employer sets the limit• Contributions are tax free and processed through payroll

Using Your Account • Use the funds for your qualified medical expenses or those of your

spouse or your dependents• Total funds for the year are available when your plan becomes effective

(even if you have not contributed that amount yet)

Funds Forfeiture• Unused amounts at year-end are NOT rolled over to the next plan year


Examples of Qualified Medical Expenses

• Acupuncture• Alcoholism treatment• Ambulance• Automobile modifications for

physically handicapped• Birth control pills• Braille books & magazines • Chiropractic care• Christian Science practitioner• Contact lenses & related materials• Crutches• Dental treatment• Dentures• Diagnostic services• Drug addiction treatment• Eye examination • Eye glasses• Fertility treatment

• Flu shot• Guide dog or other animal

aide• Hearing aids• Hospital services• Immunization• Insulin• Laboratory fees• Laser eye surgery• Medical testing device• Nursing services• Organ transplant• Orthodontia• Over-the-counter

medications• Physical exam• Physical therapy• Prescription drugs

• Psychiatric care• Smoking cessation program• Surgery• Transportation for medical

care• Weight loss program to treat

obesity• Wheelchair


Examples of Qualified OTC Expenses

Eligible Items• Acne medications• Anesthetic mouth gels & rinses• Anti-itch creams• Antiseptics• Bandages and dressings• Contact lens solutions • Eye drops• Eye patches• Prenatal vitamins• Reading glasses• Smoking cessation products• Sunburn creams/sun block• Wart and corn removers

Eligible only with a prescription*• Allergy prevention/treatments• Antacids and acid reducers• Cold and flu medicines• Cold sore remedies• Decongestants• Oral pain relievers • Orthopedic shoe inserts• Pain and fever relievers• Sinus medications• Snoring cessation aids• Vitamins, herbal and fiber supplements• Weight loss and dietary supplements

Some over-the-counter treatments are eligible for purchase with FSA funds. Other items require a prescription. This list is subject to change. Please see www.connectyourcare.com/otc for updated information.

* A “prescription” means a written or electronic order for a medicine or drug that meets the legal requirements of a prescription in the state in which the medical expense is incurred and that is issued by an individual who is legally authorized to issue a prescription in that state.


Examples of Not Qualified Expenses

• Cosmetic surgery• Cosmetics• Denture supplies• Deodorant• Exercise equipment• Fitness programs• Funeral expenses• Hair transplants• Household help• Illegal operations and

treatments

• Insurance premiums• Maternity clothes• Moisturizers and wrinkle creams• Teeth whitening, teeth whitening

products• Toothpaste, toothbrushes and

mouth wash• Sun tan lotions (w/o sun block)• Vitamins


What is a Dependent Care FSA or DCAP?

Contributions• You may contribute up to $5,000 to your account

($5,000 per calendar year if single or married filing jointly, $2,500 if married filing separately)

• Contributions are tax free

Using Your Account • Use the funds for child or dependent care while you are at work –

typical expenses include day care, before and after school care• Funds become available for use as you contribute them

Funds Forfeiture• Unused amounts at year-end are NOT rolled over to the next plan year


Eligibility Requirements

To be reimbursed through your DCAP for child and dependent care expenses, you must meet the following conditions:

• You must have incurred the expenses in order for you and your spouse, if married, to work or look for work, unless your spouse was either a full-time student or was physically or mentally incapable of self-care

• You cannot have made the care payments to someone you can claim as your dependent on your federal tax return or to your child who is under age 19

• You and your spouse must maintain a home that you live in for more than half the year with the qualifying child or dependent.


Qualified Dependent Care Expenses

Expenses for dependent care must be provided during working hours.

• Before school or after school care (other than tuition expenses)• Licensed day care centers• Nursery schools or pre-schools• Placement fees for dependent care providers, such as au pairs• Child care at a day camp, nursery school, or by a private sitter• Summer or holiday day camps • Late pick-up fees• Custodial care for dependent adults • Care of an incapacitated adult who lives with you at least 8 hours a

day


Not Qualified Dependent Care Expenses

• Expenses for children 13 and older• Educational expenses including private school tuition• Expenses for food, clothing, sports lessons, field trips and

entertainment• Overnight camp expenses• Registration fees• Transportation expenses• Late payment fees• Payment for services not yet provided (payment in advance)• Care for dependent while sick employee stays home


Substantiation Requirements

• IRS requires all charges to be verified as an eligible expense• Some expenses are verified automatically• All others require itemized receipts• Healthcare payment card will be suspended if itemized receipts are

not submitted


Automatic Substantiation

Some retailers automatically check your card purchases for eligibility

• Limits the need to submit receipts• IIAS compliant stores can provide auto

substantiation• Visit www.connectyourcare.com/stores

for a list of IIAS compliant stores• Doctors’ offices, hospitals and other

medical providers cannot provide auto-substantiation; receipts are required


Requirements for Submitting Receipts

• Each bar-coded claim form is unique

• Submit Claim Form with receipts via:– Fax–USPS mail

• View the image immediately to ensure receipt.

• Enter your direct deposit information online for faster reimbursement!


Tax Savings

FSAs and DCAPs can cover medical, dental or vision, and dependent care expenses that you would otherwise pay out of pocket, potentially saving you hundreds in taxes.


Frequently Asked Questions

How will I be able to access my account funds? • You will receive a healthcare payment card to access your FSA funds. You can also pay

for eligible expenses with any other form of payment and request reimbursement from your account.

When can I request reimbursement from my account?• You have access to the account when your plan becomes effective.

How will I know if I need to submit a receipt to ConnectYourCare for substantiation?

• If a receipt is needed, you will be notified by email or letter within a week of your payment card swipe. You can also check by logging into your account and visiting the Claim Center.

What if I don’t submit my receipts?• You must provide the receipts within the time requested, or the transaction will be

deemed ineligible, and you will be required to refund the amount of the transaction. If you fail to submit required receipts, your payment card will be deactivated. If you fail to reimburse the account, the amount of the ineligible expenses may be added to your W-2 or withheld from your pay.

Flexible Spending Account (FSA) Information

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