FSA FAQs
General Information
Eligibility and Enrollment
Health FSAs
Dependent Care FSAs
Changing Your Election
“Use it or Lose It” Rule
Submitting Claims for Reimbursement
General Information
Why should I participate in the Flexible Benefits Plan?
One of the greatest advantages of the Plan is the tax savings generated
and the increase in your spendable income. The money contributed to
an FSA is not subject to taxes (Federal Income and FICA taxes and most
state and local income taxes). A Flexible Benefits Plan applies to
out-of-pocket expenses you cover with your spendable income, but allows
you to pay for these expenses with income before you are taxed.
Another advantage to participating in the Plan is the opportunity
it offers for you to budget for health care expenses by withholding
a small amount from each paycheck. Without that tool, you may be faced
with having to come up with large amounts of money at one time. This
is especially advantageous if you are scheduling a surgery, anticipating
maternity expenses, or if you do not have other coverage for dental
and vision expenses. Even those with coverage for medical, dental and
vision usually have deductibles, co-pays, and other out-of-pocket expenses
to cover.
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Information
Where do I call with questions about my Flexible Benefits
Plan?
If you have any questions about putting a Flexible Benefits Plan to
work for you, how to sign up, or how to determine your election amounts,
etc., please call a Customer Service Representative at 866-370-3040.
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Information
How do I know that you received my claim and whether or not
it was paid?
Generally, within 2-business days of submitting a claim by fax, you
can view your account to check on the status of the claim at www.benefitsolved.com.
Simply choose Login, FSA Participant and then follow the on-screen
instructions.
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Information
How do I know what my account balance is?
You can choose one of the following methods to check your account
balance:
- You can view your account at www.benefitsolved.com. Simply choose
Login, FSA Participant and then follow the on-screen instructions.
- Your account balance will be displayed on the reimbursement check
or direct deposit notification each time you submit a claim.
- You will receive a Balance Statement approximately 90 days before
the end of the Plan Year. This statement will provide you with a
summary of the remaining balance in the Health FSA and/or the Dependent
Care FSA as well as claims paid to date.
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Information
Eligibility and Enrollment
How do I enroll?
To enroll in either or both the Health and Dependent Care FSA, you
simply need to fill out the Enrollment Form/Direct Deposit Form before
beginning of each Plan Year.
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and Enrollment
Do I have to keep the same election each year?
No. Each year, you will have to re-enroll before the beginning of
the Plan Year. At this time, you will have the opportunity to evaluate
the need to participate in the Plan as well as budget for all health
care and/or dependent care expenses. You may decide to keep the same
election, change your election or in some cases waive participation.
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and Enrollment
Do I have to elect both the Health and Dependent Care FSAs?
No. You may choose to participate in one or both depending on your
individual needs.
Top | Eligibility
and Enrollment
Health FSAs
What is a Health Flexible Spending Account (FSA)
You may set aside pre-tax dollars to cover eligible medical expenses
that are not covered by any other type of insurance. The account helps
you budget for planned expenses such as deductibles, co-payments and
prescriptions. You may refer to the FSA Worksheet for a list of some
eligible and ineligible expenses.
Top | Health
FSAs
Are insurance premiums an eligible expense?
No, insurance premiums are not reimbursable from a Health FSA. However,
you may pay your required premium contributions (for coverage under
the Employer’s health plan) on a pre-tax basis outside of the
Health FSA.
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FSAs
Can I be reimbursed for medicines and drugs that do not require
a prescription?
Yes, over-the-counter drugs incurred for medical care are eligible
for reimbursement from your Health FSA.
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FSAs
What are some examples of OTC drugs that are eligible for
reimbursement from my Health FSA?
Allergy medicines, cough and cold medicines, first aid, and pain relievers
are a few examples of eligible items. For a more inclusive list, please
see the Over-the-Counter Drugs list available at www.benefitsolved.com.
Top | Health
FSAs
If I terminate employment or retire, can I receive the remaining
balance in my Health FSA?
No. However, you can continue to submit claims incurred prior to your
termination date before the end of the run-out period (defined in your
Summary Plan Description).
For example: Your plan has a 90-day run-out period following termination.
Your termination date is September 13 th. Your physician sees you on
September 12 th, but you do not receive the Explanation of Benefits
from your insurance carrier until October 31 st. You can still submit
this expense as it was incurred prior to your termination date, and
prior to the end of the 90-day run-out period following your date of
termination. Any expense incurred after September 13 is not eligible.
Top | Health
FSAs
If I terminate employment or retire can I be reimbursed for
expenses incurred after my termination date?
No. In order to be considered an eligible expense, the expense must
be incurred prior to your termination date. However, you may be able
to continue your Health FSA coverage under COBRA.
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Dependent Care FSAs
What is a Dependent Care FSA?
You can use pre-tax dollars to cover eligible work-related dependent
care expenses for qualified dependents, or if you are married, while
you and your spouse work or your spouse attends school full-time.
Top | Dependent
Care FSAs
Who is a qualified dependent under the Dependent Care FSA?
- Dependent under the age of 13; or
- Dependent or spouse of employee who is mentally or physically disabled
and whom the employee claims as a dependent on his or her Federal
Income Tax return.
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Care FSAs
Can an adult be a qualified dependent?
Yes, an adult may qualify as a dependent provided that the employee
is providing more than half of that individuals support for the year,
and the dependent lives with the employee.
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Care FSAs
Do I have to use a daycare facility?
No. You can be reimbursed for expenses provided by an individual providing
care for your dependent in your home as long as the expenses are incurred
for you and your spouse (if married), to work, look for work or attend
school full-time.
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Care FSAs
Does my daycare provider have to be licensed?
No. However, you are required to submit his/her Tax Identification
Number or Social Security Number when filing your Federal Income Tax
return.
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Care FSAs
Does my daycare provider have to be 18?
No, but the individual must claim the money as income on their tax
return.
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Care FSAs
My child attends camp during the summer. Is this eligible?
Generally, no; however, if the camp is day camp and your dependent
attends to allow you and your spouse (if married), to work, look for
work or attend school full-time, then yes this would be an eligible
expense. Overnight camps are specifically excluded.
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Care FSAs
When can I be reimbursed for dependent daycare expenses?
Expenses are eligible for reimbursement when they have been incurred,
not when you are billed or when you pay for the services.
For example: Your daycare provider requires you to pay for the month
of September on September 1st. You can be reimbursed as the services
are incurred, not when you paid for the services. You can submit claims
after each week, every two weeks or on October 1st.
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Care FSAs
Changing Your Election
What if I discover that I elected too much for the Health
and/or Dependent Care FSA, can I change my election?
Generally no, unless you experience an IRS “Change in Status” and
your election change is consistent with the Change in Status event,
your election is irrevocable.
Top | Changing
Your Election
What is an IRS “Change in Status” that will allow
me to change my FSA election?
- Change in legal marital status (marriage, death of spouse, divorce,
legal separation, annulment)
- Change in number of tax dependents (birth, death of dependent,
adoption or placement for adoption)
- Change in dependent’s eligibility
- Change in employment status of employee, spouse or dependents
- Other changes that may permit an election change under the Dependent
Care FSA are:
- Change of dependent care provider
- Change of rate charged by unrelated dependent care provider
- Child attaining age 13
Election changes must be consistent with the event. If you experience
a Change in Status, please review your Summary Plan Description, as
it will provide you with important information on the deadline for
reporting this event.
Top | Changing
Your Election
If I elected too much in my Health FSA but not enough in my
Dependent Care FSA, can I move money from one account to the other?
No, Health and Dependent Care FSA elections are separate. You cannot
move contributions from one account to another. Also, it is very important
to note that the elections you make are for the entire year. Your elections
cannot be changed unless you experience an IRS Change in Status as
noted above.
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Your Election
“Use it or Lose It” Rule
What happens if I don’t use all the money elected in
my FSA?
The IRS has imposed a "use it or lose it,” rule. Any money
remaining in your FSA account at the end of the plan year cannot be
carried over and is forfeited. Please remember, you have a run-out
period following the end of the plan year to submit expenses that were
incurred during the plan year. It is important to estimate your expenses
carefully before making your elections. You should only contribute
to the FSA for expenses that you can accurately predict will be incurred
during the year.
Infinisource, Inc., will assist you in monitoring your Flexible Spending
Accounts by providing you with a statement at the beginning of the
fourth quarter of your plan year. You can minimize forfeitures by scheduling
routine exams, purchasing glasses or contact lenses, and scheduling
dental appointments, etc., at the end of the plan year to use up your
election amounts.
Top | "Use it
or Lose It" Rule
Submitting Claims for Reimbursement
How do I submit a claim for the Health or Dependent Care FSA?
You must complete an FSA Request for Reimbursement Form for each Health
or Dependent Care FSA claim you file. Remember to attach supporting
documentation for the claim. This information can be faxed to 800-379-5670.
You may also submit your claim by mail:
Infinisource, Inc.
PO Box 488
Coldwater, MI 49036-0488
Top | Submitting
Claims for Reimbursement
May I submit expenses for my spouse and children for reimbursement
through my Health FSA?
Yes, you may be reimbursed for expenses incurred for you, your spouse
and any IRS dependents, regardless of where you are insured. It could
be that you are not covered through your employer’s health plan,
but have coverage through your spouse’s employer’s plan.
You may still submit your family out-of-pocket expenses to be reimbursed
under the Health FSA.
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Claims for Reimbursement
What supporting documentation must I file with each Health
FSA claim?
Explanation of Benefits (EOB): Each time you submit claims to your
health insurance carrier, you will receive this statement detailing
what the health plan will pay and what you must pay. For expenses that
are partially covered under another insurance plan, you must attach
a copy of both of the EOBs.
Itemized Bills: For expenses that are not submitted to another insurance
plan, you must attach a copy of an itemized billing containing the
following information:
- Name of patient
- Name and address of provider
- Description of service
- Date of service
- Amount of service
The documentation requirements are also listed on the FSA Request
for Reimbursement Form to assist you in properly filing your claim.
Following these guidelines will ensure you receive your reimbursement
without unnecessary delays.
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Claims for Reimbursement
What supporting documentation must I file with each Dependent
Care claim?
Request for Reimbursement Form: Complete the Dependent Care section
of the Request for Reimbursement Form and have your daycare provider
sign and date.
Receipt: The receipt must include the following information:
- Name and address of provider
- From/through dates of service
- Amount of charge
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Claims for Reimbursement
How long after the end of the Plan Year do I have to submit
claims?
Claims must be submitted prior to the end of the run-out period for
the Plan. The run-out period is defined in your Summary Plan Description.
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Claims for Reimbursement
Will I receive reimbursement for claims that are greater
than the current balance of my Health FSA?
Yes, the annual amount is available to you from the beginning of
the Plan Year.
Top | Submitting
Claims for Reimbursement
Will I receive reimbursement that is greater than the current
balance of my Dependent Care FSA?
No, you will only receive reimbursement for the amount that has been
contributed at the time you submit your claim.
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Claims for Reimbursement
Can I submit claims for dependent care expenses that are
greater than the current balance of my Dependent Care FSA?
Yes, however, you will only receive reimbursement for the amount
that you have contributed to your Dependent Care FSA. For example:
If you contribute $150 each month to your Dependent Care FSA, then
you will only receive $150 in reimbursement each month. The excess
amount of expenses will be pended and automatically paid to you as
contributions are posted to your account.
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Claims for Reimbursement
What happens if a claim exceeds the amount currently available
in my Dependent Care FSA?
The claim will be processed and approved. The amount that is currently
available will be disbursed and the remaining portion will be pending
until you make another contribution.
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Claims for Reimbursement
When can I expect to receive my reimbursement?
Claims are generally processed within 2-business days of receipt.
Reimbursements are then processed and released according to the disbursement
schedule and funding option of the employer. Generally, disbursement
schedules are daily. This means that reimbursements are processed each
day and include any claims that were processed the previous day. The
release of your reimbursement depends upon the funding option chosen
by the employer.
Your employer may have a funding arrangement that will:
- Allow the release of your reimbursement check immediately after
processing the reimbursement, or
- Allow the release of your reimbursement check within 2-business
days of processing the reimbursement.
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Claims for Reimbursement
How do I know why my claim was denied?
You will receive a letter indicating the reason for the denial along
with instructions for submitting the requested documentation.
Top | Submitting
Claims for Reimbursement
Why may the amount of my reimbursement differ from the amount of
my request?
There are a few reasons that you may see a different reimbursement
amount. A few of these are:
1. If the request was for more than the balance of your account.
For example:
Annual Election = $1,000.00
Total Amount Disbursed to Date = $700.00
Available Balance = $300.00
Total Amount of Request = $500.00
You will only be reimbursed $300.00, as this is your available balance.
2. If the request was for a dependent care claim, you may only be
reimbursed for the total amount that you have contributed. For example:
Annual Election = $5,000.00
Total Amount Contributed = $3,000.00
Total Amount of Request = $4250.00
You will only be reimbursed $3000.00, as this is the amount that you
have contributed to the account. The entire request of $4250.00 will
be processed and the remaining $1250.00 will be disbursed as contributions
are made.
Top | Submitting Claims for Reimbursement