UncategorizedFlexible Spending Account (FSA)
How It Works
A Healthcare FSA is used to pay for eligible medical expenses which are not covered by your insurance or other plan. These expenses can be incurred by you, your spouse, a qualifying child, or relative. Your full annual contribution amount is available at the beginning of the plan year, so you don’t have to wait for the money to accumulate. You can use your PayFlex debit card to pay for eligible expenses.
The PayFlex debit card is a convenient way to pay for eligible Healthcare expenses.
The card knows when the expense is eligible and whether you have funds available. When you use the card, save your Explanation of Benefits, itemized statements and detailed receipts. There may be times when PayFlex asks you to provide documentation to verify you used your card for an eligible expense. If you’re a new Healthcare FSA member, you’ll automatically receive one card in the mail before the beginning of the plan year. The card is not available for the Dependent Care FSA.
Note: Funds are not allowed to be used to help pay for or towards any Medical premiums incurred.
Dependent Care FSA
The Dependent Care FSA is a great way to pay for eligible dependent care expenses, such as before and after school care, day time baby-sitting fees, elder care services, and preschool costs. Eligible dependents include your qualifying child up to age 13, spouse and/or relative. Your full annual contribution is not available at the beginning of the plan year. You can only get reimbursed up to the amount that is available in your account.
Annual Contribution Limits For Healthcare FSA:
- Minimum Annual Contribution: $250
- Maximum Annual Contribution: $2,850
For Dependent Care FSA:
- Minimum Annual Contribution: $250
The maximum contribution depends on your tax filing status.
Determine Your Maximum Contribution Based On Your Tax Filing Status
- If you are married and filing separately, your maximum annual contribution is $2,500 for each person
- If you are single and head of household, your maximum annual contribution is $5,000
- If you are married and filing jointly, your maximum annual contribution is $5,000
- If either you or your spouse earn less than $5,000 a year, your maximum annual contribution is equal to the lower of the two incomes
- If your spouse is a full-time student or incapable of self-care, your maximum annual contribution is $3,000 a year for one dependent and $5,000 a year for two or more dependents
You have a 120-day run-out period (ending March 31 of the year following the current plan year) after your current plan year ends to submit reimbursement requests for all eligible FSA expenses incurred DURING your plan year. For example, if your plan year is 2022, then your run-out period would end on March 31, 2023.
Plan for your FSA savings
Worksheets will help you calculate the amount you expect to pay during the plan year for eligible, uninsured out-of-pocket medical and/or dependent care expenses.
How to register online
- Go to PAYFLEX.COM
- Click on Create Your Profile and follow the online instructions
- After successfully registering your account, My Dashboard will be displayed and you will be able to access your account information
- To receive electronic account notifications, select My Settings at the top of the page and
- Select the notifications link,
- Enter your email address and then re-enter to confirm, and
- Then select the notifications you wish to receive and click Submit.
Filing a claim with PayFlex
If you pay for an eligible expense with cash, check or personal credit card, you can file a claim online at PAYFLEX.COM or through the PayFlex Mobile® app to pay yourself back for your out-of-pocket expenses.
Or you can fill out a paper claim form and mail it to PayFlex at PO Box 981158 El Paso, TX 79998-1158 or fax it to PayFlex at 1-855-703-5305. This form can be found in the Resource Center at PAYFLEX.COM or you may call PayFlex at 844-PAYFLEX to request a form.
After you log in to PAYFLEX.COM, click on the Financial Center tab and select your account from the drop down. Click on File a Spending Account Claim to get started. When you submit a claim, you need to include supporting documentation that shows the following:
- Merchant or service provider name
- Name of patient (if applicable)
- Date of service
- Amount you were required to pay
- Description of item or service
Enroll in direct deposit
To receive your claim payments quickly, sign up for direct deposit through the PayFlex member website. Log in to PAYFLEX.COM. Click on the Financial Center tab. Select your account from the drop down menu and click on Enroll in Direct Deposit to get started.
FSA appeals process
If you have an FSA reimbursement claim denied, in full or in part, you have the right to appeal the decision by sending a written request within 30 days of the denial for review to:
PayFlex Systems USA, Inc.
PO Box 981158
El Paso, TX 79998-1158
or Fax to:
Your appeal must include:
- The name of your employer
- The date of the services for which your request was denied
- A copy of the denied request
- The denial letter you received
- Why you think your request should not have been denied and
- Any additional documents, information or comments you think may have a bearing on your appeal.
Your appeal and supporting documentation will be reviewed upon receipt. You will be notified of the results of this review within 30 business days from receipt of your appeal. In unusual cases, such as when appeals require additional documentation, the review may take longer than 30 business days. If your appeal is approved, additional processing time is required to modify your benefit elections.
Note: Appeals are approved only if the extenuating circumstances and supporting documentation are within your employer’s, insurance provider’s and the IRS’ regulations governing the plan.
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