WHAT IS A FLEXIBLE SPENDING ACCOUNT?
A Flexible Spending Account (FSA) is an IRS tax-favored account you can use to pay for your pharmacy, dental, vision and approved Over-the-Counter expenses not covered by your insurance or any other plan (see rules and limitations in HRA and FSA Reference Guide). An FSA can also reimburse eligible health claims if you have exhausted your County-funded Health Reimbursement Account (HRA).
Flexible Spending Accounts feature:
- IRS approved reimbursement of eligible expenses tax-free
- Savings on income and Social Security taxes
Under current federal tax law, unless the person qualifies as a dependent as defined by the IRS, expenses for that dependent cannot be claimed. Therefore, expenses for domestic partners, dependents of a domestic partner as well as Over Age Dependents age 26-30 cannot be reimbursed under a spending account.
USE IT OR LOSE IT RULE
FSA accounts are subject to the IRS “lose it or use it rule.” Unreimbursed amounts left in the Account cannot be returned to you. Claims must be incurred prior to 12/31/14 and submitted to WageWorks by 03/31/15. Under IRS regulations, unclaimed amounts are forfeited. For this reason we encourage you to be conservative in your estimates and only consider expenses you know you will incur in 2014.
WHAT TYPES OF FSAs ARE AVAILABLE?
There are two types of FSA accounts, a Medical Expense FSA and a Dependent Day Care FSA:
Medical expenses not covered by your insurance plan may be eligible for reimbursement using your FSA Medical Expense Account, including but not limited to:
- Pharmacy copays
- Some over-the-counter drugs
- Eyeglasses and contacts
- Dental expenses
Dependent care expenses, whether for a child or an elder, include any expenses that allow you to work, such as:
- daycare services (child under 13 or adult)
- in-home care
- nursery and pre-school
- summer day camps
Refer to the Flexible Benefits (FSA) & Health Reimbursement (HRA) reference guide for plan details and rules
*NOTICE: Employees enrolled in a County CDH health plan: If you enroll in the FSA Medical Expense Account, all medical expenses for copays, co-insurance and deductibles will automatically be deducted from your Health Reimbursement Account (HRA) first. After the HRA account is exhausted, remaining CDH expenses can be reimbursed from your FSA. Pharmacy copays can also be reimbursed from your HRA once you have exhausted your FSA.
WHICH EXPENSES ARE NOT REIMBURSABLE?
The following is a partial listing of services or expenses that are not reimbursable under a Medical Expense FSA. For more information, call WageWorks.
- Insurance premiums, including premiums for health insurance through another source
- Cosmetic surgery not deemed medically necessary to alleviate, mitigate or prevent a medical condition
- Health or fitness club membership fees
- Health care expenses for a domestic partner or dependents of a domestic partner
- Health care expenses for an Over Age Dependent age (26 - 30)
WHICH EXPENSES REQUIRE PROOF OF MEDICAL NECESSITY?
Some prescription drugs or health care treatments require proof of medical necessity for reimbursement from your FSA. Below is a partial list of such expenses. Contact WageWorks for additional information.
- Massage therapy
- Drugs that may be used for non-cosmetic reasons, (i.e., Retin A, or that promote hair growth)
- Drugs or treatment programs for smoking cessation that have been prescribed for a specific life threatening medical condition, (i.e., emphysema)
- Drugs or treatment programs for weight loss that have been prescribed for a specific life threatening medical condition, (i.e., diabetes or heart disease).
WHAT ARE THE PLAN YEAR CONTRIBUTION LIMITS?
The maximum annual amount for a Medical Expense FSA is $2,500. The maximum annual amount for a Dependent Care FSA remains $5,000.
FSA Medical Expense Contribution: The minimum bi-weekly contribution amount is $10 per pay period; $260 annually. The maximum biweekly contribution amount is $96.15 per pay period, $2,500 annually. If you and your spouse both work for the County, each can have a Medical Expense Account and can elect the maximum deduction.
FSA Dependent Care Contribution: The minimum bi-weekly contribution amount is $10 per pay period; $260 annually. The maximum bi-weekly contribution amount is $196.20 per pay period; $5,000 annually.
VISIT wageworks.com TO COMPLETE A TAX-SAVINGS ANALYSIS
MEDICAL EXPENSE AND DEPENDENT CARE ACCOUNT CLAIM PROCESSING
WageWorks Health Care card
Can be used for IRS approved expenses at the time of service/sale.
- Instant payment when used at IIAS certified merchants
- Instant payment of pharmacy, vision and dental expenses
- Dental and vision expenses will require substantiation.
Note: Member must submit a Claim Form and itemized bill/receipt for Over-the-Counter medicines, vision and dental expenses.
PayMeBack claim forms with itemized receipts can be submitted manually by mail or fax if WageWorks Health Care card is not used. See process below.
Claim forms with itemized receipts must be submitted by mail, fax or online at www.wageworks.com.
HOW TO GET REIMBURSED FOR ELIGIBLE EXPENSES BY CLAIM FORM
1. Receive eligible services and incur the expense.
2. File online, mail or fax a correctly completed FSA HealthCare Account PaMeBack Claim Form along with one of the following:
a. An Explanation of Benefits (EOB) or
b. Itemized bill/receipt from your health, pharmacy, dental or vision insurance provider that shows:
i. The specific type of service you received
ii. The date and cost of the service
iii. Any uninsured portion of the cost
3. If services could be deemed cosmetic in nature, a written statement from your healthcare provider indicating the service was medically necessary accompanied by the receipt, invoice or bill for the service.
WageWorks will mail you, or direct deposit to your designated bank account, a reimbursement of qualified expenses during the next daily reimbursement period following receipt of your correctly completed Reimbursement Request.
Be conservative in your estimates as you cannot submit covered medical expenses to your medical FSA until your HRA balance is exhausted, especially if you have a large HRA balance that you have built up with rollovers from year to year of CDH participation.