1. BeneFLEX HR Resources & Benny Say:
FSA
Flexible Spending Account
The more you know about
Flexible Spending Accounts
The more you save!

2. Section 125 Plan Benefit paid for by the Company
HIPAA – Confidential/Private
Help you save money
We are here to help you get the most out of this benefit
Completely voluntary benefit for you and your whole family
You do not have to enroll in the company insurance to participate
Your 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) items
Mail order prescription invoices and online pharmacy
“Amount Due” on medical and dental statements incurred in the plan year
Doctor and emergency room co-payments
Health plan deductibles and coinsurance
Dental expenses
Orthodontics
Vision services and eyeglasses
LASIK 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 Elections
Nondrug Over-the-Counter Items
24/7 Account balance availability
Online at
IVR at (913)

6. Worksheet
Talk with your medical providers to help forecast your upcoming expenses.

7. Dependent Care FSA
The maximum election is $5,000 per year per household
Covers expenses for the following:
Daycare
Latchkey
Summer/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 copayments
Vision Expenses
Dental Expenses
Nondrug Over-the-Counter Items
Contact your HR department to determine the medical election amount available to you.

9. FSA Medical Expenses

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, 2011
FSA 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 categories
Acid Controllers
Allergy & Sinus
Antibiotic products
Anti-diarrheals
Anti-gas
Anti-itch & insect bite
Antiparasitic treatments
Baby rash ointments creams
Cold sore remedies
Cough, cold & flu
Digestive aids
Feminine anti-fungal/itch
Hemorrhoidal pres
Laxatives
Motion sickness
Pain relief
Respiratory treatments
Sleep aids & sedatives
Stomach 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 Use
In 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
Manual
Deadline Tuesday 3:00 p.m. CST
Complete Claim Form – fax or mail along with a copy of receipts to BeneFLEX
Checks issued on Thursday
Direct Deposit

16. To download a direct deposit form, go to www. beneflexhr
To download a direct deposit form, go to hover over Section 125, HRA & HSA, Click Printable Forms

17. To download a claim form, go to www. beneflexhr
To download a claim form, go to click on Section 125 & HRA, Click Printable Forms

18. Claim Form – Employee Information
Complete all employee information
Check the box if you have a new address

19. Claim Form – Dependent Care
Complete all requested information
The 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 Reimbursement
Canceled 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 rendered
Date of original service, not a billing date
Amount of charge
Federal 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 an OTC medicine, doctor’s prescription must be attached along with the receipts.
If claiming a “dual use” item, doctor’s letter 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 Reimbursement
The 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 rendered
Date service was provided, not a billing or due date
Amount of charge
Any insurance payment, if applicable
Canceled checks and credit card slips are not allowable receipts.

23. Claim Submission Guidelines Over-the-Counter Non Drugs
Over-the-Counter (OTC) non drugs – Partial listing online at
When and who sold the product (date, name & address)
Type of OTC was purchased - *Must show product or brand name
Amount of charge
*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 required
When and who sold the product (date, name & address)
Type of OTC was purchased - *Must show product or brand name
Amount 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 – Signature
According 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.

26. Know your Account Balance
Web Site –
Interactive Voice Response (IVR)
( )
Office Hours (7:00 a.m. to 6:00 p.m. CST)
( ) or  ( )
3rd Quarter Statement
Reimbursement Checks

27. To access your account information, hover over “Section 125, HRA & HSA” on the menu bar.
Then click on “FSA & HRA Employee Account Information”.

28. If you are a new user, click “New User” on the right and follow the steps to setup your account.

29. Questions
Please call BeneFLEX
at (800) or
(314)