What is a Flexible Spending Account?
Flexible Spending Accounts (FSAs) let you pay for eligible expenses with tax-free money. You contribute to an FSA with pre-tax money from your paycheck. This, in turn, lowers your taxable income.

A Health Care FSA helps you pay for eligible out-of-pocket medical, dental, vision and hearing expenses. Out-of-pocket expenses are those that your medical plan does not cover. These include deductibles, coinsurance and co-pays and certain Over-The-Counter (OTC) items.

A Dependent Care FSA helps you pay for eligible child or adult day care expenses. These expenses are so that you can work. If you’re married, your spouse must also work. If your spouse doesn’t work, he or she must be looking for work, attending school full-time or be unable to care for him or herself. Dependent care expenses include day care, before- and after-school programs, nursery school or preschool, summer day camp and adult day care. The cost of care must be for your child under age 13, or for a spouse or dependent who is not able to take care of him or herself. The person receiving the care must live with you at least half of the year.

What is the benefit of enrolling in an FSA?
Your contributions to an FSA are deducted from your pay on a pre-tax basis. Therefore, you could pay less in Federal and Social Security payroll taxes and in some cases, state income taxes.

How much money can I expect to save in taxes with an FSA?
When you contribute to an FSA, that money is deducted from your pay on a pre-tax basis. You may want to speak to a tax advisor to understand how an FSA will impact your personal tax situation. 

How does an FSA work?
Managing your FSA is as easy as 1-2-3.

1. Estimate how much you will spend on eligible health care expenses, dependent care expenses or both during the plan year. This is what you pay out-of-pocket.
2. Decide how much you wish to set aside into your Health Care FSA, your Dependent Care FSA or both up to the Internal Revenue Service (IRS) limits. Your employer will deduct that amount from your paycheck in equal amounts each pay period. These deductions are done pre-tax. Note: These are two separate FSAs. The Health Care FSA cannot pay for dependent care expenses. The Dependent Care FSA cannot pay for health care expenses. 
3. As you incur eligible expenses throughout the year, you have two ways to use your funds. You can use your PayFlex Card^® to pay at the point of service. If you do not have your card with you or  choose not to use it, you can pay with another form of payment. You can then submit a claim for reimbursement.

Is there a maximum that I can contribute to a Health Care FSA?
Yes. In 2018, the Health Care FSA annual maximum contribution amount is $2,650. This limit is on a per-participant basis. This means, if both you and your spouse  are eligible to participate in an employer-sponsored Health Care FSA, you may each contribute up to the individual limit of $2,650 if your spouse’s employer’s plan also offers the IRS maximum of $2,650. Your spouse’s plan may have a lower limit, so have him or her check with  Human Resources/Benefits Department or the employer’s summary plan description (SPD) to confirm the contribution amount allowed for a Health Care FSA.
 
Can I change my election during the plan year?
Your FSA election remains in effect for the plan year. This is an IRS rule. The only way to change your FSA election during the plan year is if you have a status change event. Some examples of a status change event are marriage and birth or death of a dependent. Please contact your Human Resources if you wish to change your election based on a status change event. 
 
How do I change my election?
Your FSA election remains in effect for the plan year. This is an IRS rule. The only way to change your FSA election during the plan year is if you have a status change event. If you have a status change, the change you wish to make to your FSA must be consistent with the status change event. Here is a list of status change events. Note: Your plan determines which of these are allowed. Please refer to your plan documents.

• Change in legal marital status (marriage, divorce, legal separation, annulment, death of a spouse)
• Change in number of tax dependents (birth, adoption, death)
• Change in employment status that affects benefit eligibility
• Dependent becomes or is no longer eligible under the plan (reaches limiting age, gains or loses student status)
• Change in residence that affects eligibility

A Dependent Care FSA has additional status change events. If you change care providers you may make an election change. A change in provider also includes going from having a care provider to not having one (for example, when one parent stops working). If your care provider increases their cost and the provider is not a relative, you may make an election change.
If you have had a status change event, please contact your Human Resources within 30 calendar days of the status change event.

How do I get reimbursed?
As you incur eligible expenses throughout the plan year, you have two ways to use your funds. You can use your PayFlex Card® at the point of service for your eligible health care expenses. If you do not have or use the card, you can submit a claim for reimbursement.

What does the term “incurred expense” mean?
The IRS considers an expense to be “incurred” at the time you receive the care, not when you are billed or pay for the expense. The expense must be incurred within the FSA plan year and while you have coverage.
Here are some examples.

• Your FSA coverage is effective January 1 through December 31 of this year. Eligible expenses that you incur during this period can be reimbursed.
• You received Health Care services in December of last year. You paid for those services in February of this year. This expense cannot be reimbursed. In this example, you incurred the expense before the start of this FSA plan year.
• You had eligible dental work done this year, in January. However, you prepaid for the work last December. Though you paid for the work last year, you incurred the expense this year. This expense can be reimbursed from your FSA this plan year.
• You paid for summer day camp in March. Camp begins July 15 and ends July 22. You can be reimbursed for the cost of camp after July 22.

What happens if I have funds left in my account at the end of the plan year?
If you have more than $10 left in your Health Care or Limited Health Care FSA at the end of the year, you can carry over your funds up to $500 and avoid losing money at the end of the year. Review your current and prior years’ expenses. This will help you estimate what you may spend in the next year. The carryover does not apply to Dependent Care FSAs. Review the Carryover FAQs below beginning on page 4 for more information.

What is a run out period?
A run out period is the time you have to submit claims before the funds in your account are forfeited. Your employer’s claim run out period is 120 calendar days after your plan year ends. For example, your FSA plan year is January 1 through December 31. You would have until April 30 of the next year to submit claims. Note: You must have incurred these claims during the plan year.  

What happens if I leave my company?
When your employment ends, you may continue to submit health care claims incurred during the time you had coverage. Your Health Care FSA may provide coverage through the last day of the month in which your employment ends. If not, then your coverage ends on the last day of your employment. In addition, you may be eligible to elect Consolidated Omnibus Budget Reconciliation Act (COBRA) coverage. Your employer will let you know how and by when to submit claims.  

For your Dependent Care FSA, you may generally continue to submit claims up to the balance in your account up through the claim run out period.

If my spouse and I each have an FSA, can we claim each other's expenses?
For health care expenses, you cannot claim the same expense under both accounts. In other words, you cannot “double-dip.” If you claim your spouse’s expenses on your FSA then your spouse cannot claim those same expenses on his or her FSA. If your spouse claims your expenses under his or her FSA, then you cannot also claim them under your FSA.

For dependent care expenses, you and your spouse can each have a Dependent Care FSA. However, between the two of you, you are limited to a maximum reimbursement of $5,000 in day care costs which may be reduced based on earned income and tax filing status. 

Health Care Flexible Spending Account (FSA) Carryover FAQs

These FAQs are general in nature and apply because your employer adopted the IRS carryover. For illustrative purposes, we used the maximum allowable carryover amount of $500 and a plan year that runs from January 1 to December 31.

What is the carryover?
The carryover feature allows a limited amount (not greater than $500) of unused health care FSA funds to be carried over to the next plan year. The carryover is a modification to the “use-it-or-lose-it” rule.

Do I automatically have the carryover feature in my plan?
Yes, however you must be an active employee in the FSA on the last day of the plan year.
 
How much of my health care FSA funds can I carry over?
The minimum amount is $10 and the maximum you can carry over is $500 in unused funds.
 
Does the amount that I carry over change the amount I can contribute to a Health Care FSA or Limited Purpose FSA (LPFSA)?
No. You can still contribute up to the IRS limit each plan year. For example, if you have a carryover amount at the end of the plan year, it will be added to the amount you elect to contribute to a Health Care FSA or Limited Purpose FSA for the next plan year.
 
Will my Health Care FSA or Limited Purpose FSA funds carry over each year?
Yes. The carryover applies to unused funds in your FSA. You must be an active employee in the FSA on the last day of the plan year.
 
What if I have less than $10 or more than $500 in unused funds at the end of the plan year?
If you have more than $500, or less than $10, in unused funds in your Health Care FSA or Limited Purpose FSA at the end of the plan year, you can only carry over from $10 up to $500. You’ll forfeit any unused funds above $500 and below $10. Keep in mind that you have until April 30 to submit claims from the prior plan year. This is the run out period for claims.

For example, you have a $500 carryover. You have $750 of unused funds on December 31 and you submit a claim for $250 in eligible expenses. This leaves $500 in unused funds that you carry over to the next plan year. However, if you have $750 of unused funds on December 31 and you don’t have any eligible expenses to submit by the end of your run out period, you can still only carry over $500. You would lose $250.

If I carry over funds to the next plan year, will the eligible expenses that I submit for the prior plan year still be paid?
Because your plan has a run out period (January 1 through April 30), you have some additional time after the end of your plan year to submit prior plan year claims. These claims must be for eligible expenses that you had during the prior plan year. Your carryover funds can be used to pay for the claims you submitted prior to the end of your run out period.

What if I have a Health Care FSA today and want to enroll in a Health Savings Account (HSA) in the new plan year?
Under HSA regulations, you can’t have both a General Purpose Health Care FSA and an HSA. If you have a Health Care FSA and are thinking about enrolling in an HSA for the next plan year, your plan will allow you to carry over your General Purpose Health Care FSA dollars into a Limited Purpose FSA (LPFSA). You can have an LPFSA with an HSA. The LPFSA will be limited to use for eligible dental and vision expenses until you meet your Advantage+ health plan annual deductible (or the IRS minimum deductible amount, if lower). After that, the LPFSA will pay all eligible medical expenses for the rest of the plan year, just like a General Purpose Health Care FSA.
 
Can I waive the carryover feature?
No. The carryover is automatic for any eligible FSA balance. You must be an active employee in the FSA on the last day of the plan year to have the carryover.
 
Does the carryover apply to my Dependent Care FSA?
No. The carryover doesn’t apply to a Dependent Care FSA.

I have a Health Care FSA. If I am contributing throughout the year, how much will my FSA cover for a claim in the beginning of the year?
With a Health Care FSA your full election amount is available on the day your coverage starts (January 1 or, if you enroll later in the plan year, your coverage effective date). This means that you can use your entire election on day one of the plan year. This is true even though you have not yet made all of your contributions for the year. For example, you elect to contribute $1,200 for the year. In January you have contributed $100. ($100 x 12 months = $1,200) In January you receive eligible health care services. This costs you $1,000. You have not made any other claims to the FSA. The FSA will pay the full amount of the claim for eligible expenses. You do not have to wait until you have contributed this amount to your FSA.

Why do I have to show that an expense was medically necessary?
There are some products or services that are not always used for medical care. Two examples are massage therapy and weight loss programs. If you use the item or service to treat a medical condition, you will need to show that. This is “evidence of medical necessity.” You can submit a prescription or letter from your health care provider. You can also download a Letter of Medical Necessity form. Your health care provider can fill it out and sign it. Once logged in, click on Documents & Forms. The form is in Administrative Forms.

Can I pay my spouse's health insurance premiums through my Health Care FSA?
No. Premiums are not an eligible expense for the Health Care FSA. You can view a standard list of eligible expenses online. Once logged in, go to Help & Support. For additional information on eligible expenses, please refer to IRS Resources within Resource Center. Here you will find links to IRS Publication 502 and IRS Publication 969.

How does the FSA reimburse orthodontia?
The IRS recognizes that orthodontia is different from other types of eligible health care expenses. For reimbursement of orthodontia expenses, what you will need to submit depends on the payment option that you choose. Please remember to submit the orthodontia expenses to your dental plan prior to submitting to PayFlex.

1. Coupon Payment Option – This option works best when the orthodontist provided you either a coupon book or a monthly reminder statement of expenses. You must submit the coupon or itemized statement with a completed claim form. You will do this as the service is provided.

2. Monthly Payment Option – The Auto Pay option allows you to set up recurring monthly reimbursements. To do this you must submit a copy of the contract or agreement* that you have with the orthodontist along with the completed claim form and the box on the claim form checked indicating you wish to establish automatic monthly reimbursements. Once we process the first claim, we will automatically reimburse you each month. You do not have to submit a claim form for each visit. We use the agreement to set the monthly amount that you will receive from the FSA for the length of the agreement. Note: You must be enrolled in the FSA and have funds available. You will receive the monthly payments on or about the due date stated in your agreement.

* You can get a payment contract or agreement from your orthodontist. That agreement must include the patient’s name; date that the service began; the length of service; cost of the initial banding work; and the amount you must pay each month.
 
Note: If you use the Auto Pay option, you cannot also use the PayFlex Card^® for these expenses.

3. Total Payment Option –You may have the option to pay the full amount when the treatment begins. If you did pay the full amount, you can receive reimbursement for the amount you paid out-of-pocket. We will reimburse you up to your FSA election amount, minus any previous FSA payments. Note: If you have sent in other claims, make sure to check your FSA balance. You can do this online. This will let you know how much you have available to cover your orthodontia treatment.

If you use the Total Payment option, you must include a copy of your paid receipt. You also need to include an itemized statement. This must include the provider’s name; the patient’s name; date that the service began; the amount you paid; and the amount your dental plan will pay.
 
Note: If you paid the entire amount all at once, you can only submit that expense one time for the plan year in which you paid it. If the orthodontia treatment will span multiple FSA plan years, and your provider will allow you to split up your orthodontia payments into separate plan years, the amount you pay in each FSA plan year is the eligible expense for that FSA plan year.
 
For example: Your treatment plan is 36 months and the braces are installed in May 2017. The total cost is $4,800. The treatment plan will span 2017, 2018 and 2019. Your provider agrees to three payments: $2,000 in May 2017, $1,400 in January 2018 and $1,400 in January 2019. The amount you pay in each FSA plan year is the amount eligible for reimbursement in each of those years, under the Total Payment Option. Your provider would need to give you a paid receipt for the amount you pay each year.

I have a Dependent Care FSA. If I am contributing throughout the year, how much will my FSA cover for a claim in the beginning of the year?
A Dependent Care FSA reimburses only eligible incurred expenses up to the amount you have contributed, minus any previous payments. It does not pay like a Health Care FSA, which pays your full election amount on day one. A Dependent Care FSA reimburses up to the balance in the account.

I have a Dependent Care expense that I want to submit for reimbursement. However, I don’t have enough in the account right now to cover the full amount. How should I submit this claim?
You can file your claim for the actual amount. However, the FSA will only reimburse you up to the balance in your account. The remaining amount will not be reimbursed to you until your scheduled contributions are available. Once the additional funds are available, the FSA will reimburse you for the remaining amount.

I pay tuition for my child’s kindergarten. Is this an eligible Dependent Care expense?
The cost of tuition is not an eligible expense. This includes kindergarten, as well as first grade and higher. If your child is in before- and after-school care those may be eligible expenses if the before- and after-school care is so you can work.

I just had a baby and will be home for six weeks. I'm taking my older child to day care during this time. Will these day care expenses be eligible?
This is not an eligible expense. The Dependent Care must be so you can work. Since you are not working during this period, the day care expense is not reimbursable.

I pay my neighbor to watch my 13-year-old after school. Is this an eligible expense?
No. Care must be for a qualifying person. A qualifying person includes your dependent child who is younger than age 13. Unless your child is not able to care for him or herself, this is not an eligible expense.   
 
My 16-year-old daughter cares for my 8-year-old son after school. Will my Dependent Care FSA reimburse me for the amount I pay my daughter?
No. This is not an eligible expense. If the care provider is your child, he or she cannot be your tax dependent. He or she must also be 19 or older by the end of the year. Refer to IRS Publication 503 for more information.  

When can I submit a claim for my Dependent Care expenses?
You would submit claims after the completed dates of service. For example, you pre-pay your care provider every Friday for the next week. You must wait until the end of the next week to submit your claim.

What type of documentation do I need to include with my Dependent Care claim?   
When you submit a claim, we need the detail for that expense. Include only one of the following for reimbursement:

• You can submit a Dependent Care FSA Claim Form that your care provider has signed. The form must include dates of service; name of dependent; cost of care; and the care provider’s name. With your care provider’s signature, this claim form is an itemized statement of the expense:

OR

• If your care provider does not sign the claim form, he or she must provide an itemized statement. You would then include that statement with the completed claim form. The itemized statement must include the dates of service; name of dependent; cost of care; and the care provider’s name.

How does the Dependent Care FSA work?
With a Dependent Care FSA, expenses must be work-related. This means that you need the care so that you can work.

• If you are married, you and your spouse must both be working. If just one of you is working, the other spouse must be actively looking for work; be a full-time student; or be unable to care for him or herself. Note: Unpaid or minimally paid volunteer work does not qualify as employment.
• The expenses must be for a qualifying person. A qualifying person is your dependent child who is younger than age 13 or a spouse or tax dependent who is not physically or mentally able to care for him or herself.
• You must receive these services from an eligible care provider. This can include providers such as a licensed child care facility, an adult day care center and possibly a summer day camp. Check your specific plan for further details.
• The care provider cannot be your tax dependent, your child who is under age 19 at the end of the year, a person who was your spouse any time during the year or the parent of the qualifying person. The expenses must be for services you received during the plan year and while the qualifying person regularly spent at least 8 hours each day in your home. They cannot be for future services. For example, you prepay your child’s summer day camp. You cannot receive reimbursement until after your child attends/completes the camp.
• The annual reimbursement is limited to the lesser of your earned income for the year or the cost of care, up to $5,000. If you are married, this limit is based on the income of the lower paid spouse and whether you file separate tax returns.

You must file Form 2441, Child and Dependent Care Expenses, with your tax return.

What expenses are eligible under a Dependent Care FSA?
You can view a standard list of eligible expenses online. After logging in, go to Help & Support. You can find more information at www.irs.gov. Please refer to IRS Publication 503, Child and Dependent Care Expenses.

If I participate in the Dependent Care FSA, do I need to report this on my income tax return?
Yes. When you have a Dependent Care FSA, you must include this information as part of your tax return. You will do this on IRS Form 2441: Child and Dependent Care Expenses. (See Instructions for IRS Form 2441 for more information.) If you have questions, please speak with your tax advisor. In addition, the amount will be shown on your W-2 statement.

How much can I contribute to a Dependent Care FSA?
Typically, the most that you can contribute to a Dependent Care FSA is $5,000. This is per household per year. This means that if you and your spouse each have a Dependent Care FSA, you are limited to $5,000 between you. Keep in mind, this amount may be less based on earned income and tax filing status.

What does "work-related" mean?
Work-related means that you pay for dependent care so that you can work and earn an income. If you are married, your spouse must also work. If just one of you is working, then the other spouse must be actively looking for work; be a full-time student; or be unable to care for him or herself. Note: Unpaid or minimally paid volunteer work does not qualify. For the IRS definition of work-related expenses, please refer to IRS Publication 503. Please consult your tax advisor for specific information.

If I have the Dependent Care FSA, can I also take the Child and Dependent Care Tax Credit?
Generally, if you have a Dependent Care FSA you cannot also take the full tax credit. Please consult your tax advisor for specific information based on several variables such as tax filing status, number of dependents, earned income, tax bracket, etc. to learn which option is most beneficial for your unique situation.

After you incur an eligible expense, you can:

• Submit a claim online. You can upload, mail or fax your documentation to us. Once logged in, go to your Account Actions on the dashboard.
• Submit a claim using the PayFlex Mobile® app. You can download it for free* from your mobile app store. You’ll use the same username and password that you use for this website.
• Complete a paper claim form and mail or fax with your documentation. Select Documents & Forms. Click on Administrative Forms to get started.

*Standard text messaging and other rates from your wireless carrier still apply.

What type of documentation do I need to send with my claim?
It depends on your expense type.

• If the claim first goes through your medical or dental plan, you will receive an Explanation of Benefits (EOB) from the plan. This is the best form of documentation.
• If the claim is not run through your medical or dental plan (for example, an Over-The-Counter (OTC) expense), you can use the itemized receipt or statement. The receipt must show the date the purchase or service was incurred; the amount for which you are financially responsible; a description of the item or service; and the name of the merchant or provider. Note: If the claim is for an OTC medicine, you must also include a written prescriptionyour provider.
• If you are sending in a prescription drug receipt, it must contain the pharmacy name; patient name; drug name (if listed); date the prescription was filled; and amount you paid.
• If the claim is for dependent care, the dependent care provider must sign the claim form or provide you with an itemized receipt.  If the provider signs the completed claim form, no additional documentation is needed.

Note: If you don’t send an EOB, itemized receipt or statement with your claim, we’ll deny it. We can’t accept a cancelled check, credit card receipt, or billing statement that shows “previous balance,” “balance forward,” “estimated,” “filed,” or “pending insurance.”

The PayFlex Mobile app is available for iPhone^® and iPad^® mobile digital devices as well as Android^TM smartphones. You can download the app from your mobile phone’s app store.

Is there a fee to download the PayFlex Mobile app?
No. The PayFlex Mobile app is free*. You just need to have a PayFlex account to use the app. 

*Standard text messaging and other rates from your wireless carrier still apply.

How do I get a username and password for the PayFlex Mobile app?
You’ll use the same username and password as the PayFlex member website. If you haven’t set up your online account, you can get started today.

I have a Flexible Spending Account (FSA). What can I do on the PayFlex Mobile app?
You can:

• View your account balance, deposits and payments
• Submit claims for reimbursement
• View your PayFlex Card purchases and submit documentation (if applicable)
• View common eligible expenses
• View account alerts and PayFlex contact information

I have a Health Reimbursement Account (HRA). What can I do on the PayFlex Mobile app?
You can:

• View your account balance, deposits and payments
• Submit claims for reimbursement
• View common eligible expenses
• View your PayFlex Card purchases and submit documentation (if applicable)
• View account alerts and PayFlex contact information

How do I submit a claim using the app?
If you have a PayFlex FSA or HRA, you can use the app to submit a claim to pay yourself back for an expense you paid out of pocket. Here’s how to do it.

1. Log in to the app and select the Financial Center.
2. Select File Claim.
3. Select your employer and expense type.
4. In the Expense Start Date field, enter the date of service or purchase.
5. Enter the amount that you paid for the product or service. For a dependent care expense, enter the expense end date and your dependent’s name.
6. To attach a document, select the Add Photo image. You can take a photo of your receipt or Explanation of Benefits (EOB). Or you can pick from your photo library.
7. Select Review Claim.
8. After you review your claim, select Submit. If you need to make a change, select Cancel.
9. Select I Agree to submit your claim. Or select Go Back to make a change.

When I log in to the app, I see an alert for “claims requiring substantiation.” What does this mean?
When you see an alert for “claims requiring substantiation,” this means we need more information from you. We have to confirm that your PayFlex Card purchase was for an eligible expense. You can respond to the alert through the app. Just select the alert to get started. You’ll need to attach a picture of your Explanation of Benefits (EOB) or an itemized receipt for each card purchase listed. 

If you don’t send us the required documentation, we’ll have to suspend your PayFlex Card. While your card is suspended, you can’t use it for that account. However, you can still pay for eligible expenses out of pocket and submit a claim to pay yourself back.

An overpayment generally occurs when you pay for an expense with your PayFlex Card^® and we can’t confirm the transaction amount as an eligible expense. It can also mean documentation you submitted does not adequately support the amount you paid with the PayFlex Card. For example, you used your card to pay for a dental bill. The amount that you paid is more than what your dental plan shows as the amount you owe. In another example, you submit an itemized statement from the health care provider that shows insurance is either estimated, pending or filed but not paid. 
 
In both examples, your FSA has paid more than what your plan documentation states you should have paid. When this happens, your FSA will go into an overpayment status. Note: When your FSA is overpaid, we will suspend your PayFlex Card for that account. This means that you will not be able to use the card for other eligible expenses until the overpayment is resolved. For your card to be fully active again, we need one of three things.

• You can send us the documentation that verifies the transaction. (Verifying documentation is proof that an expense was for qualified health care and was your financial responsibility.)  
• You can send us documentation of another eligible expense that has not yet been reimbursed from your FSA or any other plan. The amount of the new claim must equal or exceed the overpayment amount. 
• You can send a check made out to PayFlex Systems USA, Inc. for the overpayment amount to the following address:

PayFlex Systems USA, Inc.
Flex Claims Department
P.O. Box 4000
Richmond, KY 40476-4000
 
If you send us a check, we’ll deposit that amount to your Health Care FSA. It will be available to reimburse you for other eligible health care expenses. 
 
You can view your card status online. After logging in, go to Account Settings and select PayFex Card.
 
How do I know if my account is in overpayment status?                                   
If your account is overpaid, you will see an alert on your account dashboard. You can also click on Alerts at the top of the page. If you signed up to receive the Explanation of Payment (EOP) by email, we will send you an email when a new EOP is available online. The EOP will explain the overpayment.  If you did not sign up to receive EOPs by email, we will mail the EOP to you. We store all documents online. You will be able to view the EOP online at any time from Documents & Forms. Note: If your account is overpaid, your PayFlex Card will be suspended for your Health Care FSA until the overpayment is resolved.  
 

• View your PayFlex EOP online
  You can view the EOP online. You can also download it. After logging in, go to Documents & Forms drop down and select My Documents. From the drop down menu, select Coupon with EOP Report. If your account is overpaid, you will see the EOP that we have sent to you.


• Sign up for electronic account notifications
  To receive emails about your account, you will need to sign up for electronic account notifications. After logging in, go to Account Settings. Click on the notifications link. Then, follow the online instructions.

What should I do if my account is in overpayment status?
If your account is overpaid, you must do one of the following:   

• If the claim that caused the overpayment has gone through your medical or dental plan, you should have received an EOB. Fax, mail or upload that EOB along with a copy of the letter notifying you of the overpayment. The EOB will show the date of service, a description of the service and the amount you have to pay for the claim. This will show us if that amount equals or exceeds the transaction amount. 
• If the EOB shows that you did overpay, you can substitute another eligible expense for the overpayment amount. Fax, mail or upload the EOB along with a completed claim form for the other expense. If you do not have an EOB, you can use a detailed receipt. The receipt must show the date of purchase or service; the amount for which you were financially responsible; a description of the item or service; and the name of the merchant or provider. Note: You must have incurred this expense in the same plan year. The amount of this expense would have to be equal to or greater than the overpayment amount. You also must not have already received reimbursement for this expense.
• If you do not have another expense to offset the overpayment, you will have to repay your Health Care FSA. You can mail a check for the amount of the overpayment. Make the check payable to PayFlex Systems USA, Inc. and mail to the address below.  Please do not send cash.

PayFlex Systems USA, Inc.
Flex Claims Department
P.O. Box 4000
Richmond, KY 40476-4000
 
I used my PayFlex Card to pay for my dental expenses. My dentist overcharged me. How should I fix this?
If your dentist overcharged you, you will have to work with your dentist to fix this. Your dentist will have to return the amount he or she overcharged you. The dentist should credit the amount back to your PayFlex Card. If the dentist will not credit your card, your account will remain in an overpayment status until other eligible expenses have been submitted, or you can send in a check made payable to PayFlex Systems USA, Inc. and mail to the address below to offset the overcharge. 
 
PayFlex Systems USA, Inc.
Flex Claims Department
P.O. Box 4000
Richmond, KY 40476-4000

I received a bill for an estimated amount. Should I pay this amount?
No. When you receive a bill for an estimated amount, that means that the amount you will actually owe is unknown at that time. Therefore, you should wait until your medical or dental plan pays the claim and determines how much you owe. Your plan will send you an EOB showing the amount you owe. Once you know how much you have to pay for the claim, then you can use your PayFlex Card to make the payment.

Your PayFlex Card, your account debit card, can be used to pay for eligible health care products and services. This includes doctor and dentist visits, hospital stays, prescriptions and hearing and vision care. You may also use your card at some discount and grocery stores. These stores must have a system that can process a health care card. Note: The merchants and providers must accept MasterCard^® in order for your card to work.

What are the benefits of using the PayFlex Card?
There are four key benefits to the PayFlex Card. 

1. Immediate payment from your account – You can use your card at the point of service.
2. Increased personal cash flow – When you use your card you do not have to pay out-of-pocket. 
3. Reduced claim filing – You won’t have to submit a claim and wait for reimbursement. Note: Be sure to keep all of your itemized receipts. PayFlex may request them to verify the transaction was for eligible health care expenses.
4. Ease of use – Using your card allows you easy access to your funds. 

How does my PayFlex Card work for health care expenses?                        
You can use your PayFlex Card to pay for an eligible expense. Swipe your card. Select “credit” or “debit.” Your transaction will process like any other credit or debit card purchase. Note: The merchants and providers must accept MasterCard^® for your card to work. They also must be a health care location (such as a doctor’s office or pharmacy). If they are not a health care location, they must have a system that can process a health care card. If you are purchasing both eligible and non-eligible items, you can only use your card to pay for the eligible items. You will have to use another form of payment for the non-eligible items.    

When you first receive your card, it is good for five years.

Note for Health Care FSA: Each year that you enroll, the card will house the FSA plan year election amount. You can only use the card for expenses that you incur during that plan year. You should always keep all of your itemized receipts in case you need them to verify your card transactions.

Should I select “debit” or “credit” when using my PayFlex Card?              
You can use your card as "credit" or "debit." When you choose "debit", you will need to enter a Personal Identification Number (PIN). To create a PIN, please call 1-888-999-0121.

I just received my PayFlex Card. Do I have to use the card for all of my health care expenses?
No. You do not need to use your card for all health care expenses. You can always use another form of payment for your expenses and submit a claim for reimbursement.

Where can I use my PayFlex Card?
You can use your card at qualified merchants where MasterCard® is accepted, and where merchants can process health care cards. This includes doctor and dental offices, hospitals, pharmacies and hearing and vision care centers. You can also use your card at some discount and grocery stores.
 
Review the complete list of qualified merchants whom utilize an inventory control system to identify IRS eligible expenses. You can also review the list of non-qualified merchants, whom you can use, however we may request copies of your receipts to verify the purchase was for IRS eligible expenses.

Note: The merchants and providers must accept MasterCard^® for your card to work.  

What should I do if my PayFlex Card is not accepted?
There is more than one reason why you may not be able to use your card. 

• Some providers do not accept debit or credit cards.
• A merchant or provider may not accept MasterCard^®.
• The merchant may not be able to accept health care cards.
• Your account balance may not cover the expense.
• Your account may be suspended. When your account is suspended, it means we need more information for a prior transaction (generally an Explanation of Benefits or a detailed receipt).

If you are unable to use your card, you will have to use another form of payment. You can then file a claim for reimbursement.

Can I buy Over-The-Counter (OTC) items with the card?
You can use your funds to pay for eligible OTC items and supplies. These are items such as bandages or a home diagnostic test. You can also use the funds to pay for equipment, such as crutches or diabetic supplies..However, the rules are different for OTC medicines. To use your funds for OTC medicines, you first need a written prescription from your provider. A standard list of eligible expenses is available online. After logging in, go to Help & Support.

Can I use my PayFlex Card to purchase eligible items online?
Yes. You can use your card for the online purchase of eligible items. Please remember to keep any and all receipts.

Do I also need to submit a claim form when I use my PayFlex Card?
If you used your card, you do not need to submit a claim. However, there may be times when we need more information about the card transaction. We may ask you to send documentation to verify your expense is eligible.

How do I access my account information online?
After logging in, you'll see your account dashboard. This will show general account information and you can get to more details like transactions, claims, etc.

Why did I receive a Request for Documentation letter?
You recently used your PayFlex Card. You received a letter because we need more information on that card transaction. We need proof that the expense was for qualified medical care. The amount you paid may not match an exact copayment amount because it may have been for expenses that applied to a deductible or for coinsurance. When the amount is not a copayment amount, we need to verify how much you were supposed to pay out-of-pocket for the claim. Generally, that means we’ll need to receive a copy of the EOB from your medical or dental plan. Note: If you received this letter, your debit card may be suspended. You need to respond by the date stated in the letter to keep your card active. You cannot use your debit card while it is suspended. However, you may still request reimbursement by submitting a completed claim form.

In order for PayFlex to verify the debit card transaction, you can send one of the following items for the transaction in question.

• The best form of proof is an EOB. You will receive this for any claim that first goes through your medical or dental plan.
• If this is not for a claim that went through your medical or dental plan (for example, an OTC expense), you can use an itemized receipt. The receipt must show the date of purchase or service; the amount you paid; a description of the item or service; and the name of the merchant or provider. Note: If the claim is for an OTC medicine, you must also include a written prescription from your health care provider.
• If you are sending a prescription drug receipt, it must contain the pharmacy name; patient name; date of the prescription; and amount you paid.

Please provide this information as soon as possible. You can upload the documentation online. If you are not able to do this, you can mail or fax it to us. The Request for Documentation letter gives you the instructions for getting the information to us. Once we confirm that the amount you paid is an eligible expense, we will re-activate your card and you may begin using it again.

Note: A cancelled check or credit card receipt alone is not acceptable documentation.
 
I received a request for documentation for my card purchases. What do I need to do?
You have three options:

1. Send us the documentation for your card purchase.
   You can do this online, through the PayFlex Mobile® app, or by fax or mail. If you’re sending documentation online, you’ll need to send it to us in PDF format. Your documentation needs to include the following:
   • Date of purchase or service
   • Amount you were required to pay
   • Description of the product or service
   • Merchant or provider name
   • Patient name (if applicable)
   
   If your expense went through your medical or dental plan, you’ll need to send an Explanation of Benefits (EOB) from your plan. This is the best form of documentation.
   
   If your expense didn’t go through your medical or dental plan, you can send an itemized receipt or statement for the expense. It must show:
   • Date of purchase or service
   • Amount you were required to pay
   • Description of the product or service
   • Name of the merchant or provider
   
   Generally, we won’t ask you to send information for your prescriptions. But if we do, send your prescription drug receipt that includes the pharmacy name, patient name, prescription name, date the prescription was filled, and the amount you paid.
   
   Note: We can’t accept a cancelled check, credit card receipt, or billing statement that shows “previous balance,” “balance forward,” “estimated,” “filed,” or “pending insurance.”


2. Send us another expense.
   If you have another expense that you incurred in the same plan year and paid out of your pocket, you can use that expense to help cover the one in question. Just send us documentation for that expense. You can do this online, through the PayFlex Mobile® app, or by fax or mail.


3. Pay back your account.
   Just send us a personal check or money order with a copy of the letter. Make it payable to PayFlex.

You’ll want to provide the documentation or payment as soon as possible. We’ll let you know in the letter, the date you need to respond. If you don’t respond by that date, we’ll have to suspend your card. While your card is suspended, you can’t use it for that account. However, once we confirm that the amount you paid was for an eligible expense or receive your re-payment to cover the expense, we’ll re-activate your card.

I received a request for documentation for my card purchases. How quickly do I need to respond?
You’ll want to provide the documentation or payment as soon as possible. We’ll let you know in the letter, the date you need to respond. If you don’t respond by that date, we’ll have to suspend your card. While your card is suspended, you can’t use it for that account. However, once we confirm that the amount you paid was for an eligible expense or receive your re-payment to cover the expense, we’ll re-activate your card.

What is an Inventory Information Approval System (IIAS)?
An Inventory Information Approval System (IIAS) is a system that marks a product or service as an eligible health care expense. Stores that sell FSA eligible and non-eligible items must have an IIAS to accept health care cards. These include drug stores, discount stores and grocery stores. These types of stores sell more than just health care items. For example, a drug store also sells newspapers, food items and cosmetics. When you purchase a number of items, the IIAS marks the items that you can pay for with your PayFlex Card. You would then pay for the other items with another form of payment.  

What should I do if a store does not have an Inventory Information Approval System (IIAS)?
If the store does not have an IIAS, you can still make your purchase. You can use your debit card and we may request a copy of your receipt. This is so we can confirm the purchase was for an eligible expense. You may also use another form of payment and then submit a claim for reimbursement.

What happens if I do not have enough money in my account to pay for an expense?
If you do not have enough funds in your account, your PayFlex Card will be denied. You could ask the merchant to charge your card just for the amount that you have available. Then you would pay the balance with another form of payment. With a Health Care FSA, the full amount of your annual election is available on the first day of the plan year. Even though you may still be contributing to the FSA, your debit card will be denied if the amount of the transaction exceeds the available balance in your FSA. 
 
What should I do if my card is lost or stolen?
Contact us as soon as possible to report a lost or stolen card to help limit any potential loss or liability as outlined in your cardholder agreement. We can then cancel your card and send you a new one. 
 
If you’re still worried about identity theft after cancelling your card, you can use MasterCard’s Identity Theft Resolution Services at no cost. They can assist you with the process of restoring your identity. Identity Theft Resolution Services include:  

• 24/7 access to MasterCard’s certified resolution specialists
• Internet monitoring to proactively detect stolen personally identifiable information and compromised confidential data online 
• Assistance from a specialist with notification to all three major credit reporting agencies to place blocks on cardholders’ records and obtain free credit reports
• Assistance with completing paperwork to alert various parties of the potential fraud
• Education about how identity theft can occur and protective measures to avoid further occurrences

 
To learn more about the Identity Theft Resolution Services, call the MasterCard Assistance Center at 1-800-MC-ASSIST (1-800-622-7747).
 
 
Activating Your PayFlex Card®          
                                                                        
If you receive a PayFlex Card® with an activation label, this means you must activate your card before you can use it. 
 
How do I activate my new card?
If you receive a new card with an activation label, call Card Services at 1-877-261-9951. This is the same number you will see on the card activation label. Then enter your card number followed by the # sign. You will then enter the last four digits of your Social Security number (SSN). Once you finish these steps, your card will be activated. You can then use your card right away.   
 
When can I call to activate my card?
You can call to activate your card as soon as you receive it. Remember, you only have to activate your card if it has an activation label on it. To activate your card, call 1-877-261-9951. This is the same number you will see on the card activation label. You can call this number at any time.
 
After I activate my card, when can I start using it to pay for eligible expenses?
You can use your card as soon as you activate it. Note: You must have funds in your account to use the card. The annual amount you elected will be available on your first day of coverage.  If you receive your card before this date, you must wait until that date before you can start using the card. You can view your account balance online from your account dashboard.
 
If I activate my card and then order a card for my spouse or dependent, do they need to activate their new card(s)?
No. If your card is already active, your spouse or dependent does not need to activate their new card(s). This means your spouse or dependent should be able to use their card(s) as soon as they receive it. Note:  If the card is already active, it will not have an activation label on it. If you try to activate an active card, you’ll hear this message: “Our records indicate this account has already been activated. Please contact the customer service phone number on the back of your card if you need further assistance.” 

If I receive a replacement card, do I need to activate it?
Yes. If you receive a new card with an activation label, you must activate the card before you can use it. To activate the card, call 1-877-261-9951. This is the same number you will see on the card activation label. You’ll get a replacement card when your current card expires or if you report your card as lost or stolen.
 
If I’m unsuccessful in activating my card, how many attempts can I make in a day? 
You should not have a problem activating your card. However, you can make two attempts to activate your card each day. If you’re unable to activate your card after the second try, you must wait until the next day to try again. 
 
What should I do if I have trouble activating my card or if I have more questions?
Please call Member Services. The number is on the back of your PayFlex Card. 

Personal Identification Number (PIN) for your PayFlex Card®                                

How do I get a PIN for my PayFlex Card®?
Call Card Services at 1-888-999-0121. You will be asked to enter your card number, the three-digit security code (located on the back of your card) and your five-digit zip code. Then you must enter a new four-digit PIN. This means you need to create your own PIN. To do this, enter four digits of your choice. To confirm your PIN, re-enter the four digits. Once you create your PIN, you can use it right away. 

Note: Please make sure to remember your PIN, as you will not receive a confirmation of your PIN. 
 
When will I have to use a PIN for my card transactions?
You can use your card as “debit” or “credit. Some merchants may now ask you to use your card as “debit”. This means you will need a PIN to complete the transaction. Please note that you are not required to select “debit”; you can still use your card as “credit.”
 
Why do I need a PIN now?
Some merchants may now ask you to use your card as “debit”. When you use your card as “debit,” you need a PIN to complete the transaction. Also, having a PIN decreases the risk of fraudulent use of your card if it is lost or stolen. Please note that you are not required to select “debit”; you can still use your card as “credit.”
 
How do I know when a PIN is required?
When you swipe your card, you will be prompted if a PIN is required. Please note that if you do not yet have a PIN, you can still use your card as “credit.” 
 
When using the card, should I select “debit” or “credit”?
If the merchant allows you to select “debit” or “credit”, either option will work. This means you may choose “credit” and sign the receipt. If you select “debit,” you will have to enter your PIN.  

What if I forget my PIN?
You can call 1-888-999-0121 to create a new PIN at any time.
 
Will my spouse or dependents need a different PIN for their debit card?
No. There is one PIN per cardholder account. Please make sure that any family member that has a separate debit card knows your PIN.

What happens if I order a new card for one of my dependents and he or she calls to create a PIN?
If your dependent calls to create a PIN, this new PIN will be the PIN for all cards on your account. If you had already set up a PIN, that PIN will not work anymore. When anyone creates a new PIN, it will override the PIN previously created.

What happens if I do not have a PIN and the merchant requires that I use one?
If you are asked to use a PIN, you can create one by calling Card Services. The toll-free number is 1-888-999-0121. If you do not yet have a PIN, you can still use your card as “credit.” If you are unable to use your card as “credit,” you can pay for the eligible expense with cash, check or personal credit card.  Then submit a claim for reimbursement.  

Now that my card will have a PIN, can I withdraw funds at an ATM?
No. The card will not work at an ATM.

Now that my card will have a PIN, can I get cash back when using the card at a merchant?
No. You can only use the card to pay for eligible expenses.

You can enroll in direct deposit online or with a paper form. Once you enroll, you can receive your reimbursements directly into your checking or savings account. After logging in, select Account Settings at the top of the page. Then select Bank accounts to get started.

To use paper enrollment, you can download the direct deposit form. After logging in, select Documents & Forms at the top of the page. Then select Administrative Forms. Complete the form. Mail it to us at the address on the form.

How do I change my email address?
You can change your email address at any time. After logging in, select Account Settings at the top of the page. This will take you to your profile where you can update your username and password. Note: This is the email address that we will use for all account communications.

How do I sign up for or change my account notifications?
After logging in, select Account Settings at the top of the page. Then select Account notifications to get started.

How do I stop paper checks?
If your plan allows, you can link a personal bank account to your PayFlex account. This stops paper checks and helps you get your money faster. After logging in, select Account Settings at the top of the page. Then select Bank accounts to get started.

Where can I find a list of eligible expenses?
After logging in, select Help & Support at the top of the page. You’ll see a link to the eligible expenses on that page.

Where can I view my account notices, statements and tax documents?
After logging in, select Documents & Forms at the top of the page. Then select My Documents.

How do I change my username and password?
After logging in, select Account Settings at the top of the page. This will take you to your profile where you can update your username and password.

How do I change my security questions?
After logging in, select Account Settings at the top of the page. This will take you to your profile where you can update your security questions.

Where can I view my account alerts?
After logging in, select Alerts & News at the top of the page. Then select Alerts from the drop down.

Where can I view PayFlex news?
After logging in, select Alerts & News at the top of the page. Then select News from the drop down.