|Health Care Plan Basics
Who is authorized to speak to Customer Service about My Account and What Information Are They Allowed to Access?
WageWorks takes its duty to protect your privacy seriously, and as a result we have a strict policy in place to safeguard your account and private information. While you can grant your spouse and dependents and those eligible to use your account limited access, you as the accountholder are the only one with full access and rights to your account and account settings. Please see the "Authorized / Unauthorized Caller Allowable Information Chart" for more information.
May a Domestic Partner's Medical Expenses Be Reimbursed Under a Health FSA?
According to the Internal Revenue Code Section 125, an FSA account can only be used to pay expenses of a qualifying child or qualifying relative (as such terms are defined in Internal Revenue Code Section 152). At this time, a domestic partner is not considered a spouse under federal law, so a domestic partner's medical expenses cannot be reimbursed under a health FSA unless the domestic partner is a "qualifying relative" of the participant. Please go to www.wageworks.com/forms/hcdependents.pdf to determine who is a qualifying child or qualifying relative under the Health FSA.
Submitting Mileage Claims
The IRS has changed mileage reimbursement rates for medical care effective based on the date the service is incurred. Mileage for travel to / from eligible health care –
Please include the following information with your mileage claim:
Submit the claim for mileage along with a Pay Me Back claim or with the Explanation of Benefits (EOB). Claims will need to match the mileage reimbursement to a service and its date.
Many online mapping services will detail your route and mileage from home to service provider. This is helpful (but not required) in submitting mileage reimbursement claims.
Your Flexible Spending Account: Real Examples-Real Savings
There are a lot a misconceptions about Flexible Spending Accounts, but one of the biggest is that only those with large families or chronic medical conditions can truly benefit from them.
While it is true that families and others with high medical expenses can save, so, too, can practically anyone else. In fact, if you have ever paid a copayment, bought a prescribed OTC medicine or wear glasses or contact lenses, you, too, can save significantly -- up to 40 percent -- on things you use every day.
An FSA, is like receiving free money. And, really, how many of us couldn't use a little free money?
But, don't only take our word for it. Below we've assembled a few real-world examples that detail how just about anyone can save with a Flexible Spending Account. Plus, you can also use the calculators online at www.wageworks.com to figure out your individual health and dependent care savings.
George is young, single and athletic and has never before considered an FSA. While George works out and runs to stay in shape, basketball is his sport and he plays whenever he can. He and few of his friends play in a league and during one of the games he injures his knee. Reluctantly, he goes to a doctor, and then a specialist, who tells him that he will eventually need surgery. While the surgery is covered by his insurance, his orthopedist, who specializes in sports injuries, is outside of his health care network. Fortunately, the injury occurred right before George's employer's Open Enrollment period. To help cover the additional costs, George signs up for an FSA. While researching, he also learns that he can use his account to save on many other health care items that he uses regularly and sets his yearly election amount accordingly. See the chart below to find out how much George will save.
*Savings based on a total tax rate of 40%. Your individual savings may vary based on your location and tax situation.
Janiya and Charles are both young professionals in their early thirties. They have a 3-year old son, Charles Jr., and are expecting two new additions at the beginning of next year. While Janiya works full time now, she plans on cutting back her schedule once the new babies arrive. With Charles Jr. in preschool, Janiya's soon-to-be reduced income, and all the additional costs associated with having and taking care of two new babies, the Samuels could really use the financial help that a health and dependent care FSA can provide. The two decide to really do their homework this Open Enrollment to maximize the FSA benefits offered by their employers. Using the FSA calculator, they estimate their out-of-pocket costs for prenatal care and hospitalization, doctor visits for themselves and their three children, as well as the costs for necessary over-the-counter items (OTC), such as thermometers, children's Tylenol, and band aids (Although because of the 2011 Health Care Reform Law, OTC drugs and medicines now require a doctor's prescription). They also decide to contribute the maximum to their dependent care FSA, which will help lower the cost of Charles Jr.'s preschool and the additional work-hours babysitting they need. See the chart below to find out how much the Samuels will save.
Sally and Ed are a middle age couple nearing retirement. Their youngest daughter just graduated from college, so with the kids out of the house, the two are looking forward to the reduced financial burden and increased freedom the next phase of their life will bring. While out celebrating at their favorite restaurant, Sally cracks a tooth at dinner. The next day, Sally visits the dentist and learns that she will need major oral surgery, which is only partially covered by their health insurance. When Sally and Ed first learned about the FSA benefit, their children were in college, so they didn't really think it was for them. But Sally has a friend at work that used her FSA for those invisible braces, so she decides to find out whether it could also help with her surgery. In researching, she learns that not only is the out-of-pocket expense associated with her surgery covered but so are many of the over-the-counter health care items, such as TUMS and Claritin that she and Ed use every day. (Although because of the 2011 Health Care Reform Law, OTC drugs and medicines now require a doctor's prescription). With Open Enrollment just around the corner, Sally and Ed decide to give an FSA a try. See the chart below to find out how much the Spinellis will save.
Susan and John are newlyweds a few years out of college. Susan has a full-time career-track job and John works part-time while completing his graduate degree. While young and healthy and with relatively few medical expenses, both know they could still benefit from a health care FSA. The main reason they haven't yet enrolled is a concern over cash flow. After paying for rent and necessities they don't have a lot left over for much of anything else. So, if an FSA meant having to pay twice (once from their paycheck and again at the checkout counter) before being reimbursed then it is something they simply can't afford. This Open Enrollment, Susan has a new Flexible Benefits administrator that offers a health care debit card. In her research, Susan learns that her health care FSA is funded entirely at the beginning of the year and that purchases made with the card are debited directly from her account. If they need to, John and Sally can even use the account as an advance to pay for things they need, such as contact lenses and solution, before the money is deducted from Susan's paycheck. See the chart below to find out how much the Halls will save.
How is my Health Care account funded?
Once you make your annual election during open enrollment, your employer will fully fund your account at the beginning of the plan year with your total election amount. Your employer will then deduct the election amount from your paychecks in equal amounts throughout the year.
What if I have money left in my account at the end of the year?
Under current IRS regulations, "Use it or Lose it" rule, you forfeit any funds that are not claimed by the end of your coverage period. Click here for tips and links to tools that will help you consider all your potential expenses when deciding how much to contribute to your FSA.
Can I change my election if I use up all the funds in my account before the end of the year?
No. You can only change the amount you are contributing if you have a qualifying life event, such as marriage, divorce or the birth of a child.
Are over the counter (OTC) weight-loss items eligible?
Yes. However, because of the 2011 Health Care Reform Law, you will need to submit a doctor's statement with your reimbursement request verifying that the patient's diagnosis is obesity and that the OTC was prescribed to treat obesity. Keep in mind, an FSA will not pay for the cost of food supported by a weight-loss program that substitutes normal nutritional needs.
What is a Letter of Medical Need or Doctor's Statement?
The IRS requires that medical expenses reimbursed through an FSA must be primarily for the diagnosis, treatment or prevention of disease. For example, your doctor may prescribe a vitamin to treat your medical condition. Because vitamins are generally considered an ineligible expense, you will need a letter from your medical provider detailing the type of service rendered and the treatment necessary.
What if I leave the company or retire during the year and still have money in my account?
You will be reimbursed for any eligible expense incurred before the date you retire or leave the company. Under IRS regulations, any remaining funds in the account must be forfeited. Any expenses you incur after the end of your employment is not eligible for reimbursement.
What is the grace period?
The grace period allows you additional time to spend the dollars that are in your FSA. Your employer must elect grace period in order for you to participate. To find out if your employer offers the grace period log into your account or call customer service at 1-877-924-3967.
How will I know what items / services are covered under the FSA?
Click here for a standard list of eligible items and services.
Can the WageWorks® Health Care Card (Card) be used during the grace period?
Employers that offer a grace period for an FSA plan can also offer the grace period on the Card. The Card grace period feature will pay Card transactions made during the grace period from the participant's previous plan year balance, until those funds are exhausted, before making payments from the current new plan year account. Grace period on the Card is only available to participants that have an FSA enrollment for the new plan year.
How do I receive my reimbursements by direct deposit?
You may be able to sign up for direct deposit online. After logging in, select "profile" from your plan page and follow the instructions to change your payment option. In some instances, the direct deposit feature is managed by the employer. If you are unable to set up the feature online, please check with your employer for your options.
What is the deadline for submitting a reimbursement request?
You can submit a reimbursement request at any time during the same plan year when the expense was incurred. You can also log into your account at any time to see how long you have to spend or claim your funds. Or please contact customer service at 1-877-924-3967.
What is needed in an itemized receipt?
Five pieces of information are required to help ensure the approval of your claim. They are:
Please ensure that your documentation contains all the above information when submitting a claim. Review the Claim and Card Use Verification Checklist.
What is the deadline to enroll / change / cancel Pay My Provider?
To request a Pay My Provider transaction, you must have your request in place 10 days prior to the date that you want us to mail out the payment and the payment mail date is no more than 10 days to the service date.
Why did my claim pay towards my Health Care Card transaction instead of reimbursing me?
Most likely, you had a Card transaction that needed additional verification. If WageWorks requests a receipt via the Card Use Verification form and you did not submit a receipt or repayment, then 90 days from the date of the Card transaction, WageWorks will deduct the amount of that transaction from any future Pay Me Back claim that you submit. Click here for a full explanation of Card Verification and more information on how you can improve your Card experience. We have also prepared a Claim and Card Use Verification Checklist to help you when submitting claims or resolving Card transactions.
Where can I obtain additional reimbursement forms?
You may download claim forms online from here.
How can I check the status of my reimbursement?
You may check the status of your request by logging in to your account, or by calling customer service at 1-877-924-3967.
How do I receive my reimbursements by direct deposit?
You may be able to sign-up for direct deposit online. After logging in, select "edit my profile" from your plan page and follow the instructions to change your payment option. In some instances, the direct deposit feature is managed by the employer. If you are unable to set up the feature online, please check with your employer for your options.
How long does a direct deposit take to be posted to my bank account?
The standard turnaround time for deposit into your account is 72 hours after the claim has been processed.