Flexible Spending Accounts 

Health Care Flexible Spending Account Reimbursement 

You can use your Health Care Flexible Spending Account to pay for a wide range of health care expenses, provided that: 

  • the claim is for an eligible health care expense that is not paid or reimbursed by any medical, dental, vision care, or hearing care insurance or other coverage; and
  • your claim is supported by appropriate documentation, including your paid receipt.      
Your claim for reimbursement may include eligible health care expenses for your spouse and dependents who qualify as dependents under current Internal Revenue Service (IRS) rules. 

USING YOUR ACCOUNT
You can use your Health Care Flexible Spending Account to pay for eligible health care expenses incurred: 

  • during a given calendar year; and
  • during the first 2-1/2 months (up to March 15) of the following year. 

For example, assume that: 

  • you elect to deposit $600 in your Health Care Flexible Spending Account for the 2017 calendar year; and
  • during 2017, you incur $400 of eligible expenses. 

In the above example, the $200 remaining from your 2017 election can be used to reimburse the eligible health care expenses that you incur between January 1, 2018 and March 15, 2018. 

CLAIM FILING DEADLINE
The deadline for filing Flexible Spending Account Plan claims is March 31. This means that you have until March 31 of each year to submit your claims for eligible health care expenses incurred: 

  • during the previous calendar year; and
  • the first 2-1/2 months (up to March 15) of the following year.

For example, assume that you elect to deposit $1,000 in your Health Care Flexible Spending Account for the 2017 calendar year. Also assume that: 

  • you incur $700 of eligible expenses during 2017; and
  • you incur $300 of eligible expenses between January 1, 2018 and March 15, 2018.

In the above example, you have until March 31, 2018 to submit your claim for the eligible expenses you incurred between January 1, 2017 and March 15, 2018. 

FORFEITURE
Any unclaimed amount that is remaining in your Health Care Flexible Spending Account as of March 31 of a given year will be forfeited. For example, assume that: 

  • you elect to deposit $700 in your account for the 2017 calendar year; and
  • you file claims for $500 in eligible health care expenses that you incur between January 1, 2018 and March 15, 2018.

In the above example, the $200 remaining in your account as of March 31, 2018 would be forfeited. 

The above “use it or lose it” forfeiture rule is required by IRS regulations. Any amounts that are forfeited by participants will be used to reduce the plan’s administrative expenses. 

QUALIFIED RESERVIST DISTRIBUTIONS
Qualified reservist distributions are permitted from the Health Care Flexible Spending Account. 

To be eligible for a qualified reservist distribution, you must (1) be a member of a reserve component (i.e., Army National Guard, Army Reserve, Navy Reserve, Marine Corps Reserve, Air National Guard, Air Force Reserve, Coast Guard Reserve, or the Reserve Corps of the Public Health Service), and (2) be ordered or called to active duty for either a period of at least 180 days or for an indefinite period of time. 

The amount of the distribution will equal the balance of your Health Care Flexible Spending Account. The distribution may be made at any time from the date you are called or ordered to active duty through the last date in which reimbursements could otherwise be made for the plan year in which you are ordered or called to duty. 

For example, assume that you are called to active duty on August 1, 2017 and have a Health Care Flexible Spending Account balance of $1,000. Rather than forfeit the $1,000 at the end of the year, a distribution of the $1,000 is permitted at any time between August 1, 2017 and March 31, 2018 (the last day in which reimbursements can be made for the 2017 plan year).

AMOUNT OF REIMBURSEMENT
At any time during the year, you can file a claim for health care reimbursement up to the full amount of your annual election for that year. 

For example, suppose that you elect to deposit a total of $500 in your Health Care Flexible Spending Account during a given calendar year. Also assume that you or a member of your family has an illness in February of the same year. You can submit a claim for reimbursement of up to $500 of eligible medical expenses at any time during the year. 

FSA CARD
The Health Care Flexible Spending Account has an FSA Card feature that makes using your account easy and convenient. This card will reflect the amount of your annual Health Care Flexible Spending Account deposit election for a given calendar year.

How the Card Works
Your FSA Card works like a bank debit card. You can use your card to pay for an eligible health care expense at any participating doctor, pharmacy, or other participating provider location. 

For example, assume that you have a $30 copayment due on a prescription drug purchase. When a participating pharmacist swipes your card, that $30 is automatically deducted from your Health Care Flexible Spending Account. 

Using Your Card
It is important to remember that you can use your FSA Card to pay for eligible health care expenses only. You cannot use it for dependent care expenses, or at non-health related locations such as gas stations, convenience stores, or restaurants. In addition:

  • you must make an election and agreement to use your card properly before it is activated;
  • you must save your receipts or other statements as proof of payment for eligible health care expenses;
  • you can use your card only at participating providers;
  • you must pay back any amount that is charged to your card for an ineligible expense;
  • your card account balance does not “carry over” from year to year; and
  • your card will be turned off when your employment or coverage terminates. 

You will receive additional information about the FSA Card following your election to participate in the Health Care Flexible Spending Account. You can also contact ADP Benefit Services at 1-800-654-6695 for additional information about the card and how it works. 

If you are asked to select “debit” or “credit” when using your FSA Card, always select “credit.” If you select “debit,” your payment will not be authorized.

ELIGIBLE HEALTH CARE EXPENSES
You can use your Health Care Flexible Spending Account to pay for eligible expenses only. Eligible health care expenses include expenses that are not paid or reimbursed by any medical, dental, vision care, or hearing care insurance or other coverage.

In general, the expenses which qualify for Health Care Spending Account reimbursement are those permitted by Section 213 of the Internal Revenue Code. 

Some examples of eligible health care expenses include:

  • Medical and dental plan deductibles, copayment, and coinsurance expenses
  • Orthodontic expenses
  • Vision or hearing care services (routine examinations, hearing aids, eyeglasses, contact lenses)
  • Keratotomy cornea surgery for the correction of nearsightedness (e.g., Lasik)
  • Medicine and drugs that are not covered by your prescription drug or other insurance (except for insulin and immunization, non-prescription over-the-counter drugs purchased on or after January 1, 2011 are not eligible expenses)
  • Breast pumps and other supplies that assist lactation
  • Smoking cessation or weight loss programs, if prescribed by a physician
  • Routine physical examinations
  • Wheelchairs for the disabled
  • Special education devices for the blind
  • Special communication equipment for the deaf, including visual display equipment for television
  • Special instructions for the deaf (under certain circumstances)
  • Acquisition, training and maintenance of a dog for the deaf or blind
  • Special home reconstruction for the handicapped (such as plumbing fixtures)
  • Inclinator for up and down stairs movement for handicapped (subject to certain limitations)
  • Transportation to receive health care
  • Oxygen equipment (for emphysema and lung-related conditions)
  • Health institution fees for physical and mental illness
  • Psychiatric therapy and psychologist treatments
  • Care for a mentally challenged child
  • Therapeutic care for drug and alcohol addiction 

INELIGIBLE EXPENSES
Some examples of expenses that are not eligible for health care reimbursement include: 

  • Medical, dental, or HMO premiums
  • Meals
  • Expenses for cosmetic surgery
  • Teeth whitening
  • Electrolysis
  • Imported drugs
  • Over-the counter items generally not used for medical care (except for insulin and immunization, any non-prescription over-the-counter items purchased on or after January 1, 2011 are not eligible for reimbursement)
  • Health club memberships
  • Long term care premiums
  • Marriage or family counseling
  • Missed appointment fees
  • Student health fee
  • Any other expense that is not specifically listed in IRS Publication 502 
If you are not sure whether a health care expense qualifies for reimbursement, you can view the list of eligible and ineligible expenses on the Flexible Spending website at www.flexdirect.adp.com or by calling ADP at 1-800-654-6695. Further details on eligible health care expenses can also be found in IRS Publication 502, Medical and Dental Expenses. You can obtain a copy of this publication by contacting your local IRS office. 

TAX DEDUCTION
If you use your Health Care Flexible Spending Account to pay for a given health care expense, you cannot claim the same expense as a deduction on your income tax return. In addition, any reimbursement paid for an ineligible expense will be subject to income taxes. 

PRIVACY OF HEALTH INFORMATION
HIPAA Privacy Rights: The Health Insurance Portability and Accountability Act of 1996 (HIPAA) prohibits the unauthorized use or dissemination of your medical records by the Company, plan administrators, insurance companies, or health care providers.

Under the HIPAA regulations, your personal medical records may be used for health purposes only. This means that: 

  • Your medical records may not be used by the Company for employment, personnel, or other non-health related reasons without your written consent;
  • Your medical records may not be disclosed without your written consent (except to the extent required by physicians and other health care providers to provide treatment);
  • You have the right to inspect your own health care information, and request changes if you believe the information is inaccurate; and
  • You have the right to restrict the use and disclosure of your own health care information. 

Privacy of Genetic Information: The Genetic Information Nondiscrimination Act of 2008 (GINA) prohibits the unauthorized use or dissemination of genetic information (including results from or information about genetic tests or services) by the Company, plan administrators, insurance companies, or health care providers. 

Under GINA, your genetic information may be disclosed only if you consent to this disclosure in writing 

You can contact Human Resources for a more complete description of your HIPAA and GINA health information privacy rights. You can also contact Human Resources if you have any questions concerning these rights. 

Privacy Procedures: To further protect the security of employees’ personal information and simplify account management, the Flexible Spending Account Plan also follows these procedures:

  • Online Forms – Participants do not need to enter their name, address or any other personal data. The online tool will automatically create a unique document for each participant in which all personal data is embedded within an encrypted barcode.
  • New FlexID Number – A random ID number will be provided to all participants. This number will be used on all FSA forms, removing the use of a Social Security Number and its associated risks.