Flexible Spending Accounts. Cornell University

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1 Flexible Spending Accounts Cornell University Plan Year: January 1 December 31, 2014

2 What will be covered? Who is PayFlex? Flexible Spending Accounts PayFlex Card Getting reimbursed cornell.payflexdirect.com PayFlex Mobile Your connection to PayFlex 2

3 About PayFlex PayFlex is your CURRENT administrator for Flexible Spending Accounts. PayFlex processes your claims and provides you with customer service support designated for Cornell University! More than 25 years of experience in administering Flexible Spending Accounts. PayFlex is owned by Aetna! cornell.payflexdirect.com is your resource to: View your account information Submit claims for reimbursement View claim and card transaction history And more! 3

4 What is an FSA? An FSA is a Flexible Spending Account. There are two types of FSAs: Health Care account Dependent Care account Let s you pay for eligible expenses with pre-tax dollars You contribute to an FSA with pre-tax money from your paycheck You do not pay Federal & State income or Social Security taxes on this money Why should you enroll in an FSA? You could save up to 30% in what you pay for taxes. Annual Salary Health Care FSA Annual Contribution Dependent Care FSA Annual Contribution Savings $30,000 $1,500 $0 $310 $50,000 $1,750 $4,000 $1,188 $70,000 $2,000 $4,500 $1,343 At cornell.payflexdirect.com, find out how much you can save by using the Savings Calculator and Dependent Care Tax Wizard! 4

5 Health Care FSA Annual minimum contribution Annual maximum contribution $0 $2, Helps you pay for eligible medical, dental, prescription, vision and/or hearing expenses that are not covered by insurance. The individuals allowed to use your health care FSA contribution generally includes: Your spouse Your child to age 26 (up until December 31 st of the year they turn 26) Your dependent who is permanently and totally disabled. Your entire contribution is available at the beginning of the plan year. 5

6 Health Care expenses Eligible expenses: Medical & dental deductibles, co-pays and co-insurance Prescriptions Over-the-counter items (OTC) As of 1/1/ OTC drugs & medicines require Rx Hospital expenses Selected durable medical equipment Orthopedic devices LASIK surgery, eye glasses, contact lenses Saline/clean solutions Hearing aids and batteries Bridges, dentures, crowns, orthodontic care Chiropractic expenses/co-pays Insulin, syringes for insulin Ineligible expenses: Anti-bacterial soaps Dandruff or dry skin treatments Teeth bleaching or mouthwash Suntan/sunscreen lotion Cosmetic surgery Dietary & herbal supplements Child birth classes A letter of medical necessity may allow some of these expenses to be eligible View a detailed listing of eligible expenses at cornell.payflexdirect.com 6

7 Dependent Care FSA Annual minimum contribution Annual maximum contribution $0 $5,000 Helps you pay for child or adult care costs. You and your spouse, if married must be actively working, seeking employment, or full-time student, in order to get reimbursed. The cost of care must be for your child under age 13 or for a spouse or dependent who is not able to take care of him or herself. You can only be reimbursed up to the amount that is available in your account. If married and both individuals are enrolled in a dependent care FSA, the combined IRS maximum contribution remains at $5,000. For example: Each individual could elect $2,500 for their dependent care FSA. 7

8 Dependent Care expenses Eligible expenses: Licensed day care provider In-home provider as long as the provider is not your child under age 19, or someone you claim as a tax dependent Summer camps (not overnight) Tuition through preschool Before and after school care (under age 13) Ineligible expenses: Tuition expenses for kindergarten and beyond Overnight camps Child care expenses for a child 13 or older (unless disabled) Child care expenses for night-time babysitting Child care expenses while you are on an extended leave of absence Care provided by an older dependent or sibling View a detailed listing of eligible expenses at cornell.payflexdirect.com 8

9 Things to remember You can enroll in an FSA during the annual enrollment period. You can also enroll when you first become eligible. Once you enroll, you may only change your election if you have a change in status (i.e., birth, death, marriage, divorce, change in day care provider). You and/or your spouse do not need to be covered by your employer s health plan to participate in an FSA. Expenses must be for services received, not for services to be provided in the future. Your employer offers the grace period, which allows you additional time to spend your money. (2 ½ months) Your employer also offers a run-out period, which allows you additional time to submit claims for reimbursement. (120 days) FSAs have a use-it-or-lose-it rule. If you have funds left in your FSA at the end of the plan year you will lose them. Plan Year Grace Period last day to spend FSA dollars Run-out period last day to submit claims 1/1/ /31/2014 March 15, 2015 April 30,

10 Getting started is easy with PayFlex Review your expenses from the prior plan year. Use our online planning & education tools. My resources education materials, planning tools, forms and IRS publications Eligible expense items general list of eligible health care and dependent care expenses Savings calculator estimate your health care and dependent care expenses Frequently asked questions helps you understand your FSA Once you know how much you want to contribute for the year, you can figure out how much will be deducted each pay period. 10

11 PayFlex Card Spending made simple. Select. Swipe. Save. What is the PayFlex Card? It is similar to a debit card. You use it to pay for eligible expenses. Generally all you need to do is swipe your card and save your receipt. Benefits of using the card Immediate payment from your account Increases your personal cash flow No claim filing Ease of use Where can I use the card? Physician and dentist offices, vision care providers, and hospitals Grocery stores, discount stores, web-based merchants Drug stores and retail pharmacies who have implemented an IRS-approved system Merchants must accept MasterCard in order for the card to work 11

12 PayFlex Card Spending made simple. Select. Swipe. Save. What can I purchase with the card? Eligible health care expenses such as co-pays, prescriptions, vision and hearing products and certain over-the-counter (OTC) items Things to remember Save all receipts and Explanation of Benefits in case documentation is requested by PayFlex or the IRS. New participants will receive a PayFlex Card via mail in a plain, white envelope during the first week of January. You can order additional cards online for a spouse or dependent at no cost. At cornell.payflexdirect.com, you can view your account balance, card transaction history and any outstanding card transactions requiring documentation. 12

13 Substantiating your card transactions According to IRS guidelines, PayFlex is required to verify that all purchases made with your PayFlex Card are eligible expenses. During the plan year, you may receive a Request for Documentation letter OR see an alert on cornell.payflexdirect.com that states you have a claim requiring substantiation. RRL Process takes place quarterly: February, May, August, & November If you receive a letter, you must respond to keep your PayFlex Card ACTIVE. If you see an alert on cornell.payflexdirect.com, click on Learn More and upload your documentation Common reasons when documentation may be required: The amount of the expense does not match your co-pay. The merchant description provided to PayFlex from the card swipe does not clarify the type of expense. This generally occurs with dental or hospital expenses. 13

14 How to keep your card active If you see an alert message or receive a Request for Documentation letter, you have three options for substantiating your card transactions. Option 1: Send us the documentation for the expense. Upload, fax or mail an Explanation of Benefits (EOB) or itemized receipt for the expense(s) listed in the letter or displayed online. Option 2: Send us another expense. Upload, fax or mail an EOB or receipt for another eligible expense. The amount must be equal to or greater than the amount in question. Option 3: Pay back your account for the amount in question. Send a personal check or money order to PayFlex to cover the amount. Note: If you do not respond, we will suspend your card. Once we receive and process your documentation or payment, your card will be active again. 14

15 Getting reimbursed If you choose not to use your PayFlex Card, you can: 1. Submit a claim online at cornell.payflexdirect.com with Pay Me or Pay Them Pay Me reimburse yourself for out-of-pocket expenses Pay Them pay your provider directly 2. Submit a claim through the PayFlex Mobile app 3. Complete a claim form and fax to PayFlex 4. Complete a claim form and mail to PayFlex Reimbursements will be paid out weekly on Tuesdays! Quick Tips: An Explanation of Benefits (EOB) or itemized receipt must be sent with your claim form Your EOB or receipt must include: the amount you owe name of merchant/service provider date of service service/item received name of patient Receive quick reimbursements by enrolling in direct deposit online. Download a claim form online in My Resources. View your claim history and payments online at cornell.payflexdirect.com. 15

16 Making sense of FSAs and HSAs Flexible Spending Account (FSA) Health Savings Account (HSA) What is it? What are the tax advantages? Who owns the account and is it portable? Who contributes and what amounts are allowed pre-tax? An account that allows you to set money aside on a pre-tax basis to pay for eligible expenses for you, your spouse and eligible dependents. Contribution made on a tax-free basis Use it or lose it Payments are tax-free if used for qualified medical expenses Employer owns the account. FSAs are not portable. Employee Health Care FSA max: $2,500 Dependent Care FSA max: $5,000 An account that allows you and your employer, if applicable to contribute money on a pre-tax or post-tax basis. It is used to save and pay for qualified health care expenses. Contributions are made on a tax-free basis Funds roll over year to year and earn interest free of current taxation Payments are tax-free if used for qualified medical expenses Employee owns the account. If you change employers or leave the workforce, the HSA stays with you. Employee and/or Employer Single coverage max: $3,300 Family coverage max: $6,550 Eligible Expenses Eligible health care and dependent care expenses are listed online Eligible health care expenses are listed on online How do I access the funds? When can I access the funds? When must eligible expenses be incurred? Is documentation needed for reimbursement? PayFlex Card (For Health Care FSA only) Submit claims online or via mobile app Submit a paper claim via fax or mail 100% of HCFSA is available 1 st day of plan year. DCFSA funds are available when deducted from the paycheck. The date of service must be when you receive the service or purchase the product. It must be while you are covered under the plan and before the plan year ends. Itemized statement or Explanation of Benefits is required when submitting claims. Documentation may also be required by PayFlex to verify your card transactions. PayFlex Card Make a Payment feature (online) Make a Withdrawal feature (online) Funds are available when deducted from the paycheck or when an employee makes a post-tax contribution. The date of service must be after the account has been established to qualify for a tax-free distribution. No. Documentation is not needed for reimbursement. *However, IRS may need documentation at a later date Does the balance carry over? No. Any amount left in the account will be forfeited. Yes. Any unused funds will carry over. Can I earn interest on the funds in my account? No. Yes. The HSA is a FDIC insured interest bearing bank account. Investment options are available once the HSA balance is at least $1,000.

17 File a Claim with Pay Me To fax or mail a claim, download & print a claim form via My Resources. Log in to cornell.payflexdirect.com. Click on File a Claim under Quick Links. Select Pay Me to get started. 17

18 File a Claim with Pay Them Log in to cornell.payflexdirect.com. Click on File a Claim under Quick Links. Select Pay Them to get started.

19 cornell.payflexdirect.com View your account balance(s) Submit a claim for reimbursement Enroll in direct deposit View any upcoming payments for claims submitted View your claim history & card transactions View card status and order additional cards View any outstanding card transactions requiring documentation Download and print forms Enroll in enotify to receive important account notifications View legislative updates and important HealthHub news View frequently asked questions

20 Single Sign-On through Aetna Navigator ( Endowed Faculty & Staff) 20

21 View your account details Log in to cornell.payflexdirect.com. Click on the Financial Center. Select your account from the drop down menu. 21

22 PayFlex Mobile Keeping you connected for FREE! Available for iphone, BlackBerry and Android smartphones Getting Started with PayFlex Mobile 1. Register your account online at cornell.payflexdirect.com to create a username and password. 2. Go to your phone s app store and select PayFlex Mobile to download the app. 3. To use the app, login to your account using your PayFlex username and password. Features & Benefits Account Alerts Receive notifications related to account status and actions needed to keep your account active. Account Activity Access real-time account information including account balances, claims processed and transaction details. Claims Submission Submit claims for reimbursement and even substantiate a debit card transaction. Benefit Plan Details Store important health plan information and view a list of typical eligible expenses. Who to contact for assistance Downloading issues contact your phone carrier directly for assistance. All other issues contact PayFlex Customer Service at

23 Stay informed with electronic notifications Log in to cornell.payflexdirect.com. Click on the My Settings. Select Notifications / Address to get started. enotify via Reimbursement Account Balance Reminder (monthly/quarterly) Claim Received Explanation of Payment Debit Card Card Declined Card Documentation Processed Card Inactivated Receipt Request Letter enotify via web alerts Reimbursement Account Claim Received Debit Card Card Declined Card Documentation Processed

24 Your connection to PayFlex Customer Service Phone: Hours: Submit a Claim Monday Friday, 8am - 8pm EST Saturday, 10am - 3pm EST Online: Log in to cornell.payflexdirect.com > select File a Claim Fax: Mail: PayFlex Systems USA, Inc. P.O. Box 4000 Richmond, KY

25 Managing your FSA with PayFlex it s easy!