Page 11 - Non-NC OE Guide
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Flexible Spending Accounts
Available Through Health Equity Debit Card—NEW!
An FSA allows you to set aside before-tax dollars from your paycheck The Health Equity FSA debit card is an
to cover qualiied expenses you would normally pay out of your pocket easy way to keep cash in your pocket while
with after-tax dollars. You pay no federal income, state income, or Social using your FSA. Many payments made
with the card are approved automatically,
Security taxes on the money you place in your FSA. so no further paperwork is required. Both
healthcare and dependent care expenses
Funds you elect to contribute to the Healthcare FSA are available in may be paid with the debit card.
full on the irst day of the plan year. Our FSA program includes a $500
rollover provision. You can roll over up to $500 of unused FSA dollars If HealthEquity cannot determine the use
of your debit card is for an eligible expense,
into your account to use next year. The amount you roll over is in addition a request for substantiation will be sent
to your regular annual election. Funds you contribute to the Dependent which will require you to submit a copy of
Care FSA function like a debit card; you need to accumulate the funds the receipt which clearly indicates the nature
before you can use them. of the expense. The reason for this request
is to prove funds were used to pay eligible
medical, dental, and vision care expenses.
Healthcare FSA Failure to respond to substantiation requests
The Healthcare FSA lets you pay for certain IRS-approved medical care will result in the suspension of your debit
expenses not covered by your insurance plan with pre-tax dollars. For card.
example, cash you now spend on deductibles, copayments, or other Your FSA debit card eligible expenses
out-of-pocket medical expenses can instead be placed in the Healthcare include medical out-of-pocket expenses not
Reimbursement FSA pre-tax to pay for these expenses. You may also use covered by the HRA, dental, vision, pharmacy
copays, and over-the-counter materials and
Healthcare FSA funds to reimburse eligible expenses for your dependents medication with a written prescription from
who are not covered under the MG+BW medical plan. The maximum your doctor.
contribution to the healthcare reimbursement FSA is $2,500 per plan year. The FSA debit card can be used to pay your
portion of the deductible before the HRA
If you enroll in the MG+BW medical plan, the HRA will reimburse pays. The HRA will automatically begin to pay
eligible medical plan expenses which apply to you or a covered family your portion of the deductible once you have
member’s plan year deductible. You may use your healthcare FSA funds exceeded the $500 per individual or $1,000
to reimburse your share of the medical deductible which you must pay per family deductible. We suggest you wait to
before your MG+BW funded HRA begins to pay. pay your portion of the deductible until you
receive your Explanation of Beneits (EOB)
from UnitedHealthcare and you may use
Once you have paid the irst $500/$1,000 of your plan year deductible, your FSA debit card to pay your share of the
your available HRA funds will be used to reimburse the provider. You are deductible.
not required to submit claims for reimbursement from your HRA.
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Available Through Health Equity Debit Card—NEW!
An FSA allows you to set aside before-tax dollars from your paycheck The Health Equity FSA debit card is an
to cover qualiied expenses you would normally pay out of your pocket easy way to keep cash in your pocket while
with after-tax dollars. You pay no federal income, state income, or Social using your FSA. Many payments made
with the card are approved automatically,
Security taxes on the money you place in your FSA. so no further paperwork is required. Both
healthcare and dependent care expenses
Funds you elect to contribute to the Healthcare FSA are available in may be paid with the debit card.
full on the irst day of the plan year. Our FSA program includes a $500
rollover provision. You can roll over up to $500 of unused FSA dollars If HealthEquity cannot determine the use
of your debit card is for an eligible expense,
into your account to use next year. The amount you roll over is in addition a request for substantiation will be sent
to your regular annual election. Funds you contribute to the Dependent which will require you to submit a copy of
Care FSA function like a debit card; you need to accumulate the funds the receipt which clearly indicates the nature
before you can use them. of the expense. The reason for this request
is to prove funds were used to pay eligible
medical, dental, and vision care expenses.
Healthcare FSA Failure to respond to substantiation requests
The Healthcare FSA lets you pay for certain IRS-approved medical care will result in the suspension of your debit
expenses not covered by your insurance plan with pre-tax dollars. For card.
example, cash you now spend on deductibles, copayments, or other Your FSA debit card eligible expenses
out-of-pocket medical expenses can instead be placed in the Healthcare include medical out-of-pocket expenses not
Reimbursement FSA pre-tax to pay for these expenses. You may also use covered by the HRA, dental, vision, pharmacy
copays, and over-the-counter materials and
Healthcare FSA funds to reimburse eligible expenses for your dependents medication with a written prescription from
who are not covered under the MG+BW medical plan. The maximum your doctor.
contribution to the healthcare reimbursement FSA is $2,500 per plan year. The FSA debit card can be used to pay your
portion of the deductible before the HRA
If you enroll in the MG+BW medical plan, the HRA will reimburse pays. The HRA will automatically begin to pay
eligible medical plan expenses which apply to you or a covered family your portion of the deductible once you have
member’s plan year deductible. You may use your healthcare FSA funds exceeded the $500 per individual or $1,000
to reimburse your share of the medical deductible which you must pay per family deductible. We suggest you wait to
before your MG+BW funded HRA begins to pay. pay your portion of the deductible until you
receive your Explanation of Beneits (EOB)
from UnitedHealthcare and you may use
Once you have paid the irst $500/$1,000 of your plan year deductible, your FSA debit card to pay your share of the
your available HRA funds will be used to reimburse the provider. You are deductible.
not required to submit claims for reimbursement from your HRA.
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