Flexible Savings Accounts Aetna Consumer Financial Solutions products are administered by PayFlex Systems USA, Inc. ( PayFlex ), an affiliate of Aetna Life Insurance Company ( Aetna ). PayFlex s robust account tools, accessible through your Aetna Navigator secure member website, make it easy for you to manage your tax-advantaged accounts. This material is for informational purposes only. MasterCard is a registered trademark of MasterCard International Incorporated. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about PayFlex, 2013 go PayFlex to www.payflexdirect.com. Systems USA, Inc. 1 69.25.306.1 (12/13)
What will be covered? Flexible Spending Accounts Dependent Care Spending Accounts Your portal via Aetna Navigator Getting reimbursed PayFlex Mobile Your connection to PayFlex 2
About PayFlex PayFlex is your administrator for Flexible Spending Accounts. PayFlex processes your claims and provides you with customer service support designated for the University of Rochester! More than 25 years of experience in administering Flexible Spending Accounts. PayFlex is now owned by Aetna! Aetna Navigator is your resource access your FSA member portal to: View your account information Submit claims for reimbursement View claim and card transaction history And more! 3
Medical Flexible Spending Account (FSA) Aetna Consumer Financial Solutions products are administered by PayFlex Systems USA, Inc. ( PayFlex ), an affiliate of Aetna Life Insurance Company ( Aetna ). PayFlex s robust account tools, accessible through your Aetna Navigator secure member website, make it easy for you to manage your tax-advantaged accounts.
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 You can find out how much you can save by using the Savings Calculator and Dependent Care Tax Wizard! 5
Health Care FSA Annual minimum contribution Annual maximum contribution $0 $2,500.00 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 children to age 26 Your dependent who is permanently and totally disabled. Your entire contribution is available at the beginning of the plan year. In 2013, the Health Care FSA maximum was capped at $2500 due to a change in Federal Regulations. The new limit is on a per-participant basis. 6
Health Care expenses Eligible expenses: Medical & dental deductibles, co-pays and co-insurance Prescriptions Over-the-counter items (OTC) As of 1/1/2011 - 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 on your FSA portal. 7
Things to remember You can enroll in an FSA during the annual enrollment period. You can also enroll when you first become benefit eligible. Once you enroll, you may only change your election if experience a qualifying event (i.e., birth, death, marriage, divorce, change in day care cost). 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. 8
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 (you can carry over up to $500 for an HC FSA) 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: $3,350 Family coverage max: $6,650 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? 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? You can carryover up to $500 from an HC FSA. 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.
Dependent Care Flexible Spending Account (DCFSA) Aetna Consumer Financial Solutions products are administered by PayFlex Systems USA, Inc. ( PayFlex ), an affiliate of Aetna Life Insurance Company ( Aetna ). PayFlex s robust account tools, accessible through your Aetna Navigator secure member website, make it easy for you to manage your tax-advantaged accounts.
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. 11
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 on your FSA portal. 12
Your Member Portal Aetna Consumer Financial Solutions products are administered by PayFlex Systems USA, Inc. ( PayFlex ), an affiliate of Aetna Life Insurance Company ( Aetna ). PayFlex s robust account tools, accessible through your Aetna Navigator secure member website, make it easy for you to manage your tax-advantaged accounts.
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. 14
Single Sign-On through Aetna Navigator 15
Getting reimbursed Access for FSA member portal via Aetna Navigator: 1. Submit a claim online 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 daily. 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 (if applicable) Receive quick reimbursements by enrolling in direct deposit online. Download a claim form online in My Resources. View your claim history and payments online. 16
File a Claim with Pay Me To fax or mail a claim, download & print a claim form via My Resources. Click on File a Claim under Quick Links. Select Pay Me to get started. 17
File a Claim with Pay Them Click on File a Claim under Quick Links. Select Pay Them to get started.
Your member portal: 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 Download and print forms Enroll in enotify to receive important account notifications View legislative updates and important HealthHub news View frequently asked questions
View your account details Click on the Financial Center. Select your account from the drop down menu. 20
PayFlex Mobile Keeping you connected for FREE! Available for iphone, BlackBerry and Android smartphones Getting Started with PayFlex Mobile 1. Register your account online 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 888.678.8242. 21
Stay informed with electronic notifications Click on the My Settings. Select Notifications / Email Address to get started. enotify via email Reimbursement Account Balance Reminder (monthly/quarterly) Claim Received Explanation of Payment enotify via web alerts Reimbursement Account Claim Received
Your connection to PayFlex Customer Service Phone: 888.678.8242 Hours: Submit a Claim Monday Friday, 8am - 8pm EST Saturday, 10am - 3pm EST Online: Log in > select File a Claim Fax: 888.238.3539 Mail: PayFlex Systems USA, Inc. P.O. Box 4000 Richmond, KY 40476-4000 23
Managing your FSA with PayFlex it s easy!
This material is for informational purposes only and is not an offer of coverage. It contains only a partial, general description of plan benefits or programs and does not constitute a contract. All spending accounts have limitations and exclusions. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Aetna plans, refer to PayFlexDirect.com. 2012 Aetna Inc. 25