FLEXIBLE SPENDING ACCOUNT (FSA) FAQs

What is a Flexible Benefit Plan?

• A benefit provided by your employer, which allows you to set aside a certain amount of income per pay period into an account before paying taxes on your paycheck. You may then, during the Plan Year, be directly reimbursed from your flexible spending account (FSA) for qualified expenses as outlined in your Plan’s communication materials.
• There may be different types of accounts available in your Flexible Spending Account: Healthcare Reimbursement, Dependent Care Reimbursement, Private Insurance, and Adoption Assistance.

How does my take-home pay increase by participating in a Flexible Benefit Plan?

• An increase usually occurs in take-home pay, because your money is being placed into your Flexible Spending Account before taxes. Your gross taxable salary is reduced. Participating in an FSA will reduce your federal, state, and FICA taxes.

Where can I get specific information about my Flexible Benefit Plan?

• Your employer should have given you a Flexible Benefit Plan Employee Guide when you first signed-up to participate in the Plan. If you did not receive this Guide, please ask your employer for another copy. It is very important that you refer to the Guide for specific questions about your Flexible Benefit Plan. In the Guide, you will find information about how often you will receive reimbursement checks, how much you are allowed to elect for the Plan Year and what type of expenses are eligible for reimbursement.

How do I file a claim?

• Complete a Claim Form with your name, company, employee ID number and a list of your incurred expenses. Attach your receipts and itemized documentation to support your claim and eligible expenses. Submit the Claim Form and itemized documentation to our office via fax, mail, or email.

Where can I get a Claim Form?

• Your employer should have given you a Flexible Benefit Plan Employee Guide when you first signed-up to participate in the plan. You can find a Claim Form in the back of your Guide or under the Participants section on our HOME page.

Where should I send my claims?

• Your claims should be submitted to our office with a completed Claim Form and all necessary receipts and itemized documentation for the expenses incurred. You can fax your claim to (757) 431-1155, email your claim to FlexDivision@flex-admin.com, or you can mail your claim to our office at the following address:

  Flexible Benefit Administrators, Inc.
  P.O. Box 8188
  Virginia Beach, Virginia 23450

  Please only use one submission method per claim to avoid duplication. For example, if you fax your claim, please do not also mail it. This may cause confusion and delay your reimbursement.

What documents are necessary to submit a prescription claim?

• Your receipt from the pharmacy should include the name of the patient, the name or Rx number of the drug and the date your prescription was ordered. Credit Card receipts and cash register slips are not considered valid receipts.

What documents are necessary to submit a medical claim?

• Your receipt for a medical claim should include the name of the patient, the nature of the medical care received, the amount charged and not paid by insurance, and the date of service. Please note that the date of service may not be the same as the date of payment.

Can I be reimbursed for a charge after service has been provided if I have not yet paid for the services?

• Yes, the charge must have been incurred, but it is not necessary that you have paid the bill.

What documents are necessary to submit a dependent care claim?

• Your receipt for Dependent Care should include the care provider’s name, the provider’s tax ID number or social security number, the dates of care and the amount charged.

What documents are necessary to submit an orthodontic claim?

• We reimburse orthodontic claims according to your contract with your orthodontist. You should submit a payment coupon with your claim.

How are orthodontic fees reimbursed?

• An orthodontic treatment period usually spans more than one Plan Year. In order to be reimbursed, the expense must have been incurred during the period of coverage, during the Plan Year. Expenses are treated as having been incurred when the participant is provided with the medical care that gives rise to the medical expenses, and not when the participant is billed or charged, or pays for the medical care.

How often will I receive a reimbursement check?

• Whenever you submit a claim to our office, we will process the claim according to your company’s reimbursement schedule. Please refer to your Flexible Benefit Plan Employee Guide for your company’s reimbursement schedule.

What happens to my Dependent Care Account if I terminate my employment?

• The deductions from your paycheck will cease when you terminate employment. You can submit claims for qualified Dependent Care expenses incurred before or after your termination date, as long as you still have funds left in your account. Claims for these expenses should be submitted to Flexible Benefit Administrators, Inc. within your employer’s run-out period (as stated in your Flexible Benefit Plan Employee Guide).

What happens to my Healthcare Reimbursement Account if I terminate my employment?

• The deductions from your paycheck will cease when you terminate employment. You may be eligible to elect COBRA in order to continue contributing to your Healthcare Reimbursement Account, although your contributions will be post-tax dollars.
  
  
  1. If you have a negative account balance at the time of termination, you cannot continue your contributions through COBRA. You have already claimed more expenses than you have contributed to your account.
  2. If you have a positive account balance at the time of termination, and you have already incurred enough expenses to cover the balance, you do not have to continue your contributions through COBRA. You will have until your employer’s run-out period (as stated in your Flexible Benefit Plan Employee Guide) to submit your claims for expenses incurred before your termination date.
  3. If you have a positive account balance, and you have not yet incurred enough expenses to cover that balance, you may elect COBRA. This will give you more time to incur your expenses while you are participating in COBRA. You may be reimbursed for expenses incurred before the end of your COBRA participation date. Please ask your employer for more details about continuing your Healthcare Reimbursement Account through COBRA.

Can I change my Flexible Spending Account annual election after the Plan Year starts?

• Only if you have a Change In Status, such as marriage, divorce, child birth, death, etc. (Refer to the Change In Election section of your Flexible Benefit Plan Employee Guide).

Where can I get a Change-In-Status Form?

• Your employer should have extra copies of the Change-In-Status Form. Check with your employer’s Human Resources department or click here to download a form. You must get your Change-In-Status Form approved by your Human Resource Office before submitting it to Flexible Benefit Administrators, Inc.

Can I be reimbursed for vitamins or over-the-counter (OTC) medicines? What if my doctor recommends them?

• There are three categories of OTC purchases when relating to eligibility for reimbursement under a Health Flexible Spending Account. They are:
  
  
  1. As of January 1, 2011, over the counter mediations are no longer eligible for reimbursement without a prescription or letter of medical necessity.
  • Examples of non-affected items are blood pressure monitors, diabetic supplies, crutches, ace bandages, etc.
  2. Eligible: Over the counter medications with a prescription or letter of medical necessity are still eligible.
  • Examples of over the counter medications that this affects are: acid controllers, allergy and sinus medications, cold, cough and flu medications, digestive aids, sleep aids and stomach remedies.
  3. Dual Purpose Drugs and Items – Items that have both a medical and cosmetic or personal purpose require a medical practitioner’s letter of medical necessity for the treatment. Some examples are pills for lactose intolerance, weight-loss drugs, OTC hormone therapy, Glucosamine and prenatal vitamins. Please click here to download the Letter of Medical Necessity Form.
  4. Ineligible – Items that are considered dietary supplements, toiletries, cosmetics or personal use items cannot be reimbursed under any circumstances. Some examples are multivitamins, herbal/natural supplements, face creams/washes, toothbrushes and weight-loss foods.

How can I find out the balance of my FSA account?

• Flexible Benefit Administrators, Inc. allows you to check your balance 24-hours a day. Click on “Account Login” to access your account.
• Call the Toll-Free Help Line at 1-800-437-3539 to speak with a live Customer Service Representative during business hours, 8:30AM to 5:00PM, Monday through Friday EST.
• Email FlexDivision@flex-admin.com and get a response within one business day.
• A statement of your account will be attached to the check or direct deposit explanation of benefits when you get reimbursed for a claim.

What happens if there is money left in my account at the end of the Plan Year and I have not incurred any more eligible expenses?

• There is still a "use it or lose it rule". If you did not incur the expenses during the plan year, you will forfeit the funds left in your account. Any unused contributions cannot be paid to you or carried over into another plan year. Before signing-up to participate in the plan, carefully estimate your yearly healthcare expenses in order to decide your election amount.
• Remember: You will have a run-out period after your Plan Year ends, as decided by your employer and stated in your Flexible benefit Plan Employee Guide, to submit any claims or outstanding paperwork for expenses incurred during your Plan Year.

Didn’t answer your question? Please contact Flexible Benefit Administrators at (800) 437-3539 or email us by clicking here