1 BeneFLEX HR Resources & Benny Say: FSAFlexible Spending AccountWith Benny CardThe more you know aboutFlexible Spending AccountsThe more you save!
2 Section 125 Plan Benefit paid for by the Company HIPAA – Confidential/PrivateHelp you save moneyWe are here to help you get the most out of this benefitCompletely voluntary benefit for you and your whole familyYou do not have to enroll in the company insurance to participateYour election can be used for expenses incurred by you, your spouse, and dependents. They also do not need to be on your insurance plan to participate.
3 What is a Flexible Spending Account? An FSA is a benefit program that enables pre-tax dollars to be used to pay for eligible out-of-pocket health care expenses like:Prescription co-payments and nondrug over-the-counter (OTC) itemsMail order prescription invoices and online pharmacy“Amount Due” on medical and dental statements incurred in the plan yearDoctor and emergency room co-paymentsHealth plan deductibles and coinsuranceDental expensesOrthodonticsVision services and eyeglassesLASIK surgery
4 An Example:In this example, the employee participating in the FSA plan saves $100 a month - $1,200 a year pre-tax.
5 Use It or Lose It – THE FEAR IS GONE Good ElectionsNondrug Over-the-Counter items24/7 Account balance availabilityOnline atIVR at (913)
6 WorksheetTalk with your medical providers to help forecast your upcoming expenses.
7 Dependent Care FSAThe maximum election is $5,000 per year per householdCovers expenses for the following:DaycareLatchkeySummer/Sports Camp (No overnight)Adult Daycare
8 Medical FSA The maximum election is determined by your company Covers expenses for the following:Dr. visit and prescription copaymentsVision ExpensesDental ExpensesNondrug Over-the-Counter itemsContact your HR department to determine the medical election amount available to you.
10 Over-the-Counter Eligible Expenses The recently enacted Patient Protection and Affordable Care Act of 2010 has changed the rules for the purchase of over-the-counter (OTC) products using your Flexible Spending Account (FSA) pre-tax funds.The IRS currently allows OTC drugs and nondrug items to be reimbursed using your FSA dollars.
11 Over-the-Counter Eligible Expenses As of January 1, 2011FSA funds can no longer be used to purchase OTC medicine and drugs unless a medicine or drug is prescribed. A “prescription” means a written or electronic order for a medicine or drug that meets the legal requirements of a prescription in the state in which the medical expense is incurred and that is issued by an individual who is legally authorized to issue a prescription in that state.
12 Over-the-Counter Eligible Expenses The OTC items affected include items in the following categoriesAcid ControllersAllergy & SinusAntibiotic productsAnti-diarrhealsAnti-gasAnti-itch & insect biteAntiparasitic treatmentsBaby rash ointments creamsCold sore remediesCough, cold & fluDigestive aidsFeminine anti-fungal/itchHemorrhoidal presLaxativesMotion sicknessPain reliefRespiratory treatmentsSleep aids & sedativesStomach remedies
13 Over-the-Counter Eligible Items If you have a prescription for an OTC medicine or drug, you must pay out-of-pocket at point-of-sale and then submit a manual claim requesting reimbursement.You can continue to use your FSA funds to purchase OTC items that are not considered a medicine or drug (e.g. bandages, splints, contact lens solution, etc.) Please note that insulin remains an eligible expense with or without a prescription.Remember to consider these new OTC rules when estimating the dollar amount to put in your FSA for the next plan year.
14 Dual UseIn addition to OTC drug or medication requiring a doctor’s prescription.Items under the “dual use” require a doctor’s letter. Once BeneFLEX receives the letter, it is placed on file for the remainder of the year.
15 FSA Reimbursement Method ManualDeadline Tuesday 3:00 p.m. CSTComplete Claim Form – fax or mail along with a copy of receipts to BeneFLEXChecks issued on ThursdayDirect DepositBenny CardThe Benny Card works at any MasterCard terminal coded as medical, i.e. Doctor’s office, dentist, vision, pharmacy
16 To download a direct deposit form, go to www. beneflexhr To download a direct deposit form, go to click on Section 125 & HRA, Click Printable Forms
17 To download a claim form, go to www. beneflexhr To download a claim form, go to hover over Section 125, HRA & HRA, Click Printable Forms
18 Claim Form – Employee Information Complete all employee informationCheck the box if you have a new address
19 Claim Form – Dependent Care Complete all requested informationThe claim form can be used as the receipt if the provider signs the form and provides his or her Social Security Number or Tax ID
20 Claim Submission Guidelines Dependent Care Dependent Care ReimbursementCanceled checks are ok. If you include a copy of the front & back, the dates of service & either the facility federal ID number or the social security number of the individual providing service.All receipts must show the following information:Who rendered the services (name and address)What type of service was renderedDate of original service, not a billing dateAmount of chargeFederal ID number (facility) or social security number (individual)
21 Claim Form – Flexible Medical Account Claim must include a requested amount.Claim must be itemized or group by item.If claiming a “dual use” item or an OTC drug, doctor’s prescription must be attached along with receipts.
22 Claim Submission Guidelines Acceptable Receipts GUIDELINES FOR SUBMISSION OF CLAIMS: The Internal Revenue Code provides the following guidelines:Medical ReimbursementThe best receipt is an Explanation of Benefits from your insurance company.If other receipts are submitted, they must show the following information:Who rendered the service (name and address)What type of service was renderedDate service was provided, not a billing or due dateAmount of chargeAny insurance payment, if applicableCanceled checks and credit card slips are not allowable receipts.
23 Claim Submission Guidelines Over-the-Counter Over-the-Counter (OTC) drugs – Partial listing online atWhen and who sold the product (date, name & address)Type of OTC was purchased - *Must show product or brand nameAmount of chargeAny insurance payment, if applicable*If the receipt does not show the name of the product you can write the product name on the receipt.
24 Claim Submission Guidelines Over-the-Counter Drugs Over-the-Counter (OTC) drugs – Doctor’s prescription requiredWhen and who sold the product (date, name & address)Type of OTC was purchased - *Must show product or brand nameAmount of charge*If the receipt does not show the name of the product you can write the product name on the receipt.
25 Claim Form – SignatureAccording to the IRS guidelines, requested reimbursements cannot be claimed through any other plan, the claim form must be signed acknowledging the participant is aware and abiding by this IRS rule.If you use your Benny card, a manual claim is not required.
26 FSAs Are a Smart MoveBenny Makes Them EASY to Use!Introducing The Benny Debit MasterCard Card for All Your Qualified FSA ExpensesIt is a MasterCard – when asked “Debit” or “Credit” always select “Credit”.
27 Getting started is easy! You’ll receive TWO Cards in the mail, along with important information on using the Cards.ACTIVATE and SIGN your Cards. Each eligible user signs his or her own name.Now you’re ready to pay for eligible expenses directly from your FSA.NOTE: THE PHYSICAL CARD IS GOOD FOR FIVE YEARSIf a merchant or provider does not accept MasterCard, you can still submit a manual claim.
28 New Users – Watch for your Card There is a $10 fee for a third card or a replacement card.
29 How Does It Work? Simply Present Benny™. The Card gets SWIPED... At the time of payment for prescription or office visit…Simply Present Benny™.The Card gets SWIPED...And, payment is automatically deducted from your FSA account.Then, save your receipts in an envelope.
30 How does the card minimize paperwork? ALWAYS KEEP YOUR RECEIPTSCo-pay MatchBeneFLEX has obtained your co-pay information and loaded it into the systemCo-pay swipes are auto adjudicated in the systemLearning LogicThe card can learn eligible repeat swipesOrthodontic PaymentsInventory Information Approval System (IIAS)Grocery Stores, Discount StoresPharmacies
31 What is the IIAS? Have the cashier scan your entire purchase Swipe your Benny Card for the FSA eligible itemsParticipating merchant systems will allow the cost of the FSA-eligible items to be deducted from your FSA balanceThe clerk will request another form of payment for non-eligible items.No receipts will be needed to verify Card purchases from participating stores.
32 The Card works at major participating merchants, including…
33 Benny Also Works For: Mail order or online pharmacy purchases Write the Benny™ ID number on the order formWhen the provider sends you a bill instead of charging at the time of serviceSimply write your Benny ™ ID number on your statement and send it back to the provider