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Flexible Spending Account

Medical FSA lets you pay for many of your out-of-pocket medical expenses with tax-free dollars. Dependent Care FSA lets you use pre-tax dollars toward qualified dependent care with tax-free dollars.

 

Plan Type: Medical & Dependent Care FSA 
Phone: 800.300.5248
Web: hrbenefitsdirect.com
Eligibility: Active employees working 30 or more hours per week
Effective Date: 1st of the month after 30 days of continuous employment

Medical FSA 

Lets you pay for many of your out-of-pocket medical expenses with tax-free dollars. These expenses include insurance copayments and deductibles, and qualified prescription drugs, insulin and medical devices. You decide how much of your pre-tax wages you want taken out of your paycheck and put into an FSA. EPI will front load effective 1/1 of the plan year. You don’t have to pay taxes on this money. There is no carry-over of FSA funds. This means that FSA funds you don’t spend by the end of the plan year can’t be used for expenses in the next year. However, this plan does permit you to use unused FSA funds for expenses incurred during a grace period of up to 2.5 months after the end of the FSA plan year.

Dependent Care FSA 

Lets you use pre-tax dollars toward qualified dependent care. If you elect to contribute to the Dependent Care FSA, you may be reimbursed for qualified expenses for: The cost of child or adult dependent care The cost for an individual to provide care either in or out of your house Nursery schools and preschools (excluding kindergarten) In order for dependent care services to be eligible, they must be for the care of a tax-dependent child under the age of 13 who lives with you, or a tax-dependent parent, spouse or child who lives with you and incapable of caring for him or herself. The care must be needed so that you and your spouse (if applicable) can work. Care must be given during normal working hours – Saturday night babysitting does not qualify. EPI will not front load, therefore you will only be able to access funds after deducted from your pay.

Grace Period

If you do not exhaust all of your FSA funds by 12/31, you have until March 15th of the following calendar year to incur claims.

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Debit CardsAll participants will receive debit cards for the Medical FSA only

Claims SubstantiationSubstantiation may be required for all claims. If substantiation for medical services is not filed in a timely manner, your Debit Card will be suspended until verification is approved.

 

How to File a Medical  FSA Claim Form

  1. To be reimbursed with funds from your FSA, you must file an FSA Claim Form(available on the Documents Tab

 Attach an Explanation of Benefits (EOB) to this FSA Claim Form. An EOB is mailed to you after we have processed a medical, dental or prescription drug claim. In some cases, you may use an itemized bill or a cash receipt* from a service provider instead of an EOB. For example, if you purchase a hearing aid (not covered by the medical plans) you may attach the receipt from your hearing aid dealer to the FSA Claim Form. *An itemized bill or cash receipt must include the following: a. Name and address of the provider b. Detailed statement of services rendered, with dates of services For prescribed over-the-counter medicines that are reimbursable from your medical FSA, you must attach the prescription and the receipt which should include the date, name of the retailer, and a list of products purchased.

  1. Please group all documents in order of the individual’s name, and then by date of service. Mail the completed FSA Claim Form with attachments (EOBs and/or itemized bills) to the address below.
  2. Keep copies of all claims submitted. Documentation mailed with this claim form will not be returned.
  3. You must submit all FSA claims by the last day of the specified run-off period of the following year for expenses incurred during the plan year. Check with your company’s Human Resources department for the exact date your run-off period ends. Any money remaining in your account after the end of the plan year will be forfeited under Internal Revenue Service (IRS) guidelines.

Mailing address:

PSA Unit BlueCross BlueShield of South Carolina
P.O. Box 100237
Columbia, SC 29202

Fax: (803) 264-6423
Phone: toll-free 1-800-300-5248

 

How to File a Dependent Care FSA Claim Form

  1. Attach a copy of your itemized bill from the provider with the following information: a. Name and address of the provider b. Social Security Number or federal tax identification number of the provider c. Detailed statement of services rendered, with dates of services
  2. Mail the completed FSA Claim Form, along with a copy of the provider’s itemized bill, to the address listed below.
  3. Keep copies of all claims submitted. We will not return documentation mailed with this claim form.
  4. You must submit all FSA claims by the last day of the specified run-off period of the following year for expenses incurred during the plan year. Check with your company’s Human Resources department for the exact date your run-off period ends. Any money remaining in your account after the end of the plan year will be forfeited under Internal Revenue Service (IRS) guidelines.

 

Mailing address:

FSA Administration

BlueCross BlueShield of South Carolina

P.O. Box 100237

Columbia, SC 29202

 

Secure fax: (803) 264-6423

Phone: Toll free 1-800-300-5248

QuestionAnswer
What is a Flexible Spending Account (FSA)?Flexible Spending Accounts (FSAs) were created by federal legislation and are designed to help you save money by paying for qualified medical or dependent care expenses on a tax-free basis. An FSA enables you to set aside pre-tax funds from each paycheck. You may use these funds to pay for dependent care expenses, or medical expenses not paid by your health benefits.
What medical expenses can I pay with FSA funds?Funds in a medical FSA can be used to pay qualified health care expenses that are not covered by your health plan or other insurance. Qualified health care expenses are fully defined in Section 213(d) of the Internal Revenue Code. They may include, but are not limited to wellness or prescription drug copayments, eyeglasses, prescription contacts, dental expenses and LASIK surgery.You have access to a Flexible Spending Account Site where you can order FSA eligible items online. You can access the FSA Store via your Health Toolkit or by clicking on this link: https://fsastore.com/?a_aid=59f736860da51&a_bid=14273c4b&utm_source=BlueCross+BlueShield+of+South+Carolina&utm_medium=TPA+Portal+WEX+1Direct+Banner&utm_campaign=TPA+Partner
What expenses are not covered?Insurance premium payments are not eligible. Cosmetic expenses such as teeth whitening, liposuction, spider vein removal and many over the counter purchases are not eligible. Weight loss medication or acne medicine is not covered unless a letter of medical necessity is provided from the prescribing physician. These are common examples, not a complete list, of items not eligible for payment with FSA funds.
How does an FSA help me save money?Because you set aside FSA funds from your wages before state, federal or FICA taxes are deducted, you actually lower your taxable income.
Can I claim medical expenses on my annual tax return?You cannot claim any expenses reimbursed through an FSA on your tax returns. To itemize medical expenses on your tax return, you must meet the standard deduction set by the IRS on eligible expenses, which is unlikely. Therefore, an FSA may be a better option for you to save money.
What about the “use it or lose it” rule?Because federal legislation does not allow the FSA funds to be carried over to the following plan year, you forfeit any funds remaining in the account at the end of each plan year. However with careful planning, you should not lose any money. Check with your employer to find out the deadline for submitting claims after the plan year ends.
How much can I be reimbursed from my amount at any given time?With a medical FSA, you can claim up to your total annual election at any time during the plan year. If you elect $1,200 for the year, but have only deposited $200, you will be reimbursed the full $1,200 if you have with proper documentation for eligible expenses. With a dependent care account, you only can be reimbursed up to the amount that is available in your account at that time.
How do I submit a claim?Hardcopy Claim Submission: For all expenses, you must submit a copy of your Explanation of Benefits (EOB) or itemized receipts, along with an FSA Claim Form. Receipts must include the date of service, amount paid, and name of the item purchased or service received. Claim forms are available on your health plan’s Web site as well as on the FSA documents tab of this benefit portal.
How do I access my Medical FSA online?Visit hrbenefitsdirect.com. Username: SSN (ex: 123456789) Default Credentials: Password: Date of birth MM/DD/YYYY (ex: 05111970)
Can I still sign up for Medical FSA if my spouse or I contribute to a HSA?Unfortunately, you cannot have a medical FSA when you or your spouse contribute to a HSA. However, you can have a Limited Purpose FSA and use those funds for vision and dental expenses.
Whom do I contact for more information?If you have not spent all the amounts in your Health Flexible Spending Account or Dependent Care Flexible Spending Account by the end of the Plan Year, you may continue to incur claims for expenses during the "Grace Period." The "Grace Period" extends 2 1/2 months after the end of the Plan Year, during which time you can continue to incur claims and use up all amounts remaining in your Health Flexible Spending Account or Dependent Care Flexible Spending Account. Any monies left at the end of the Plan Year and the Grace Period will be forfeited, except for amounts contributed to your Health Savings Account. Obviously, qualifying expenses that you incur late in the Plan Year or during the Grace Period for which you seek reimbursement after the end of such Plan Year and Grace Period will be paid first before any amount is forfeited. For the Health Flexible Spending Account, you must submit claims no later than 90 days after the end of the Grace Period. For the Dependent Care Flexible Spending Account, you must submit claims no later than 90 days after the end of the Grace Period. Because it is possible that you might forfeit amounts in the Plan if you do not fully use the contributions that have been made, it is important that you decide how much to place in each account carefully and conservatively. Remember, you must decide which benefits you want to contribute to and how much to place in each account before the Plan Year begins. You want to be as certain as you can that the amount you decide to place in each account will be used up entirely.
What happens if I don't spend all Plan contributions during the Plan Year?If you terminate employment during the Plan Year, your right to benefits will be determined in the following manner: (a) You will remain covered by insurance, but only for the period for which premiums have been paid prior to your termination of employment. (b) You will still be able to request reimbursement for qualifying dependent care expenses from the balance remaining in your dependent care account at the time of termination of employment. However, no further salary redirection contributions will be made on your behalf after you terminate. You must submit claims within 90 days after termination. (c) Your Health Savings Account amounts will remain yours even after your termination of employment. (d) For health benefit coverage and Health Flexible Spending Account coverage on termination of employment, please see the Article entitled "Continuation Coverage Rights Under COBRA." Upon your termination of employment, your participation in the Health Flexible Spending Account will cease, and no further salary redirection contributions will be contributed on your behalf. However, you will be able to submit claims for health care expenses that were incurred before the end of the period for which payments to the Health Flexible Spending Account have already been made. Your further participation will be governed by "Continuation Coverage Rights Under COBRA."

 

 

QuestionAnswer
What is Dependent Care FSA?An account funded by employee salary reductions for reimbursement of eligible dependent care expenses. You can withhold $5,000 (IRS limit) from your payroll per year. If you are married and filing a joint return or if you are a single parent.
What expenses may be paid with my dependent care FSA?A dependent care FSA can be used to reimburse your qualified childcare or adult care expenses. These include expenses paid for the care of eligible dependents while you work. Eligible dependents include children under age 13 who reside with you for more than half of the year, disabled spouses or parents for whom you contribute more than 50 percent of their expenses. To qualify for a dependent care FSA if you are married, both you and your spouse must work or your spouse must be disabled or a full-time student.
When will my funds be available for use?You will have access to your contributions that have been deducted from your payroll each pay period and accumulated in your account.
Can I pay for services in advance?Under IRS guidelines, you can only be reimbursed for dependent care that has already taken place. Also, you can only be reimbursed for the amount you have already contributed to your dependent care FSA. Unlike the health care FSA, the full amount of your dependent care election is not available January 1.
What expenses are eligible under my dependent care FSA?Nursery Schools, Day care centers (including adult day care facilities), In-home private care providers, Before and After-school care (if not included with tuition)
What happens when my claim amount is more than the amount I’ve contributed to the account?If you submit a request and your balance is less than the amount of the request, you will only be reimbursed for the amount of money available in your account. The remainder will be reimbursed once the money is deposited into your FSA.
How do I access my Dependent Care FSA online?Visit hrbenefitsdirect.com. Username: SSN (ex: 123456789) Default Credentials:Password: Date of birth MM/DD/YYYY (ex: 05111970)
What happens if I don't spend all Plan contributions during the Plan Year?If you have not spent all the amounts in your Health Flexible Spending Account or Dependent Care Flexible Spending Account by the end of the Plan Year, you may continue to incur claims for expenses during the "Grace Period." The "Grace Period" extends 2 1/2 months after the end of the Plan Year, during which time you can continue to incur claims and use up all amounts remaining in your Health Flexible Spending Account or Dependent Care Flexible Spending Account. Any monies left at the end of the Plan Year and the Grace Period will be forfeited, except for amounts contributed to your Health Savings Account. Obviously, qualifying expenses that you incur late in the Plan Year or during the Grace Period for which you seek reimbursement after the end of such Plan Year and Grace Period will be paid first before any amount is forfeited. For the Health Flexible Spending Account, you must submit claims no later than 90 days after the end of the Grace Period. For the Dependent Care Flexible Spending Account, you must submit claims no later than 90 days after the end of the Grace Period. Because it is possible that you might forfeit amounts in the Plan if you do not fully use the contributions that have been made, it is important that you decide how much to place in each account carefully and conservatively. Remember, you must decide which benefits you want to contribute to and how much to place in each account before the Plan Year begins. You want to be as certain as you can that the amount you decide to place in each account will be used up entirely.
What happens if I terminate employment?If you terminate employment during the Plan Year, your right to benefits will be determined in the following manner: (a) You will remain covered by insurance, but only for the period for which premiums have been paid prior to your termination of employment. (d) For health benefit coverage and Health Flexible Spending Account coverage on termination of employment, please see the Article entitled "Continuation Coverage Rights Under COBRA." Upon your termination of employment, your participation in the Health Flexible Spending Account will cease, and no further salary redirection contributions will be contributed on your behalf. However, you will be able to submit claims for health care expenses that were incurred before the end of the period for which payments to the Health Flexible Spending Account have already been made. Your further participation will be governed by "Continuation Coverage Rights Under COBRA." If you terminate employment during the Plan Year, your right to benefits will be determined in the following manner: (a) You will remain covered by insurance, but only for the period for which premiums have been paid prior to your termination of employment. (d) For health benefit coverage and Health Flexible Spending Account coverage on termination of employment, please see the Article entitled "Continuation Coverage Rights Under COBRA." Upon your termination of employment, your participation in the Health Flexible Spending Account will cease, and no further salary redirection contributions will be contributed on your behalf. However, you will be able to submit claims for health care expenses that were incurred before the end of the period for which payments to the Health Flexible Spending Account have already been made. Your further participation will be governed by "Continuation Coverage Rights Under COBRA."

 

QuestionAnswer
What is a prepaid debit card?A prepaid debit card is a special-purpose Visa® card that gives you an easy, automatic way to pay for qualified health care benefit expenses by electronically accessing the pretax amounts set aside in your flexible spending account (FSA). It works like a Visa card, but has the amount of your FSA contribution stored on it. You or an eligible dependent can use your card for qualified, eligible expenses at businesses that accept Visa cards. The amount of the qualified purchases will be deducted automatically from your account, and the pre-tax dollars will be electronically transferred to the provider/merchant for immediate payment.
Is this just like other Visa cards?No. The prepaid debit card is a special-purpose Visa card you can use only for qualified health care benefits expenses. There are no monthly bills and no interest. It cannot be used, for instance, at gas stations or restaurants. The merchant must be authorized to accept these IRS-approved transactions. You should check with the merchant before you make your purchase.
How many prepaid debit cards will I receive?You will receive two prepaid debit cards. If you would like additional cards, contact your plan administrator. There may be a fee.
What if my prepaid debit card is lost or stolen?You should call your plan administrator to report a lost or stolen card as soon as you realize it is missing. Your administrator will turn off your current card(s) and issue replacement card(s). Replacement cards are $5 each. This cost will be deducted directly from your FSA.
How do I activate my prepaid debit card?Call the toll-free number on the activation sticker on the front of your card. One phone call will activate both cards. Each card user should sign the card with his or her name.
Where can I use my prepaid debit card?IRS regulations allow you to use your cards in participating pharmacies, mail-order pharmacies, discount stores, department stores and supermarkets that can identify FSA-eligible items at checkout. Transactions at these merchants are fully substantiated and in most cases, no paper follow-up is needed. If pharmacies are not equipped to identify the eligible items at the cash register, but have certified that 90 percent of the merchandise they sell is FSA-eligible, you may use your card. Since these pharmacies cannot identify the eligible items at the point of sale, another form of substantiation or paper follow-up will be required. When you make a purchase, the expense is deducted from your account balance. You cannot use your cards at discount stores and supermarkets that do not participate. You can continue to use your cards to pay freestanding pharmacies and health care providers, such as hospitals, doctors and dentists.
If asked, should I select "debit" or "credit"?Since this is a prepaid debit card and no "prepaid" selection is available, you should select “credit.” You do not need a personal identification number (PIN) and you cannot get cash with this card.
How will my card work at participating discount stores and supermarkets?Bring prescriptions, vision products, eligible over-the-counter medicines and other purchases to the register. Present your card and swipe it for payment. If you have enough money in the account and are purchasing at least one FSA-eligible product, the card swipe transaction should be approved. The amount of the FSA-eligible purchases will be deducted from your account balance and no receipt follow up is required. The clerk will ask you to use another form of payment for the non-FSA-eligible items. If the card swipe transaction is declined, the clerk will ask for another form of payment for the total amount of the purchase. The receipt will identify the FSA-eligible items and may show a subtotal of the FSA-eligible purchases. In most cases, you will not receive requests to submit receipts as proof of purchase for FSA-eligible purchases made in participating discount stores or supermarkets.
Why do I need to save all itemized receipts for purchases made with my card?You should always save itemized receipts for FSA purchases made with your card. You may be asked to submit receipts to verify that your expenses comply with IRS guidelines. Each receipt must show the merchant’s or provider’s name, the service received or the item purchased, the date and the amount of the purchase.
What if I lose my receipts or I accidentally swipe the card for something not eligible?Usually the service provider can re-create an account history and provide a replacement receipt. If that’s not possible, you can send a check or money order to your plan administrator for the amount so it can be credited back to your FSA account.
Should I use my card to pay my provider at time of service?It depends. You should use your card if, at the time of checkout, your provider verifies exactly how much you owe. Your provider would do this by contacting your benefits administrator either by phone or online. In this case, you will not be asked to submit receipts because your transaction and your benefits plan will match exactly. Sometimes a provider requires payment and does not verify exactly how much you owe. If you use your card in this case, your card transaction may not match the amount your benefits administrator indicates you owe. You will then be asked to submit receipts, because your transaction and your benefits plan may not match exactly. If your provider does not verify your true amount owed and you overpay, it is your responsibility to have the provider credit your card for any overpayment or pay back the amount to your FSA.
Can I use my prepaid debit card if I receive a statement with a ‘patient due balance” for a medical service?Yes — as long as you have enough money in your account, the date of service is within the same plan year and the provider accepts Visa cards. If all these apply, simply write your prepaid debit card number on the statement and send it back to the provider or swipe your card at the provider’s office.
How do I know how much is in my account?Visit your plan administrator’s website to view your account activity and current balance. Or you can call your plan administrator at the phone number listed on your card to find out your current balance. You should always know your account balance before making a purchase.
How will I know whether I must submit receipts to verify a charge?You will receive a letter or notification from your plan administrator if you need to submit a receipt. You should save all receipts per the IRS regulations.
What if I fail to submit receipts to verify a charge?If you do not submit receipts within the requested time frame to verify a charge made with your prepaid debit card, then your card may be suspended. You will be required to repay the amount that was charged. Your plan administrator will reactivate your card after you submit a receipt or repay that amount.

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It is important that you take steps to educate yourself on all employee benefit plan options and rewards. It is your responsibility to complete your benefits election in Ultipro, no later than 30 days from eligibility.