Corporate Health Exchange Frequently Asked Questions

Corporate Health Exchange Frequently Asked Questions

FAQs Quick Start Menu If you have a specific question, see if it s here in the list below and click on the link to be taken directly to the answer you re looking for. Otherwise, feel free to browse and scan the FAQs at your own pace. The Corporate Health Exchange 3 1. What is the Patient Protection and Affordable Care Act (PPACA)? 3 2. What is a Corporate Health Exchange? 3 3. Is the Aon Hewitt Corporate Health Exchange sponsored by the government? 3 4. What are the benefits of the Aon Hewitt Corporate Health Exchange? 3 5. Why is Payless moving our benefits to the Aon Hewitt Corporate Health Exchange? 4 6. Where can I get more information? 4 Annual Enrollment 6 7. When is Annual Enrollment? 6 8. What will I need to do? 6 9. Who s eligible for benefits? 6 My Options 7 10. What are my options for medical coverage? 7 11. Is one plan level better than another? 7 12. What s the difference between a traditional PPO and a high-deductible? 7 13. Can each family member choose a different plan level or insurance carrier? 8 14. Which insurance carriers will I be able to choose from? 8 15. Will I be able to use the same providers as I do today? 8 16. How should I choose an insurance carrier if my dependents and I live in different states? 8 17. How do I decide which option is right for me? 8 18. How can I find the plan that s most like the one I have today? 9 19. Will pre-existing conditions be covered? 9 20. What s included in the preventive care that s covered at 100% by all plans for 2014? 9 21. How will my prescription drugs be covered? 10 22. What are my options for dental coverage? 11 23. What do I need to know about dental networks? 11 24. What are my options for vision coverage? 11 Paying for Coverage 12 25. Will I have to pay more for medical coverage? 12 26. When will I find out actual costs? 12 1

27. Do I get to keep the Payless credit if I don t enroll in coverage? 12 28. What will I have to pay when I need medical care? 12 29. What s a deductible and how does it work? 13 30. What s an out-of-pocket maximum and how does it work? 13 31. What is a Health Savings Account (HSA)? 14 32. How is an HSA different from a Health Care Flexible Spending Account (FSA)? 14 33. Can I enroll in both the HSA and Health Care FSA? 15 34. Why would I want to use both an HSA and an FSA? 15 35. What are the tax advantages of an HSA? 15 36. Can I use my spouse s FSA for medical expenses if I m contributing to an HSA? 15 2

The Corporate Health Exchange 1. What is the Patient Protection and Affordable Care Act (PPACA)? The ACA, for short, is the name of the final, amended version of the health care reform law that went into effect in March 2010. The goal of the ACA is to make health insurance available to everyone, regardless of medical history or ability to pay. As part of the ACA, most Americans will be required to have health insurance starting January 1, 2014. This is called the individual mandate. If you don t have coverage, you ll pay a penalty of $95 per adult when you file your 2014 taxes.* That may not sound like a lot of money, but it goes up to $325 per adult in 2015, then to $695 per adult in 2016. * For 2014, the penalty is $95 per adult and $47.50 per child (up to $285 per family), or 1% of your family income, whichever is more. 2. What is a Corporate Health Exchange? A Corporate Health Exchange is a new way for you to get health care coverage and comply with the individual mandate (see above). It is an online insurance marketplace where buyers like you can shop for coverage from multiple insurance carriers who are competing for your business. A Corporate Health Exchange merges the best of both worlds: group rates with more individual choice and price competitiveness that comes from free-market competition. The Aon Hewitt Corporate Health Exchange is America s first national large employer multiinsurance carrier Corporate Health Exchange. Its online system is easy to navigate and, just like other online stores, you ll be able to see all your options and sort by the features that are most important to you. By the time you complete your enrollment, you should feel confident that you ve selected the right mix of plan level and insurance carrier at a price you can afford. 3. Is the Aon Hewitt Corporate Health Exchange sponsored by the government? No. This is a private Corporate Health Exchange. It is unrelated to the government-run state and federal health insurance exchanges, or marketplaces, mandated by the ACA legislation. It does, however, provide benefits consistent with the law and guarantees coverage, regardless of preexisting conditions. You ll likely receive more information about the government-run health insurance marketplaces from your home state soon. 4. What are the benefits of the Aon Hewitt Corporate Health Exchange? The Aon Hewitt Corporate Health Exchange offers you: More choices. Traditionally, you got to choose from the health plans offered by your company. Through the Corporate Health Exchange, you ll be able to choose from several plan levels, a variety of insurance carriers, and a range of costs. Competitive pricing. The insurance carriers are competing for your business. So it s in their best interest to offer their best prices. Plus, Payless ShoeSource will provide a credit to use toward the cost of your coverage. You ll be able to see the credit amount from Payless and your price options for coverage on the Payless Health Exchange website when you enroll. 3

Help when you need it. There are great tools and resources to help you every step of the way. The Make It Yours website is available now at www.makeityoursource.com/payless. When you enroll, you ll have access to state-of-the-art online tools and personalized support from the Payless Benefits Center, and the insurance carriers will be available to answer specific questions. Once you re in the plan, you can take advantage of all the resources offered through the insurance carriers. You ll also have access to health advocacy representatives who can explain how benefits work and help resolve issues. 5. Why is Payless moving our benefits to the Aon Hewitt Corporate Health Exchange? U.S. employers health care costs have grown almost 50% in the last five years and, without aggressive action, will increase more than 60% over the next five years. Our experience at Payless has been no less dramatic, and isn t sustainable for the future. There are a couple of reasons why the Corporate Health Exchange is an attractive solution: Participating in the Corporate Health Exchange transfers the burden back to the insurance carriers Our plans will be fully insured, which means we pay a set amount (premium) to the insurance carriers. If Payless claims are more than this amount, the insurance carriers will be responsible for the additional cost. We ll still help eligible associates pay for coverage through a credit, which shows our commitment to associates, while making our ongoing spending much more predictable. The exchange approach will also help slow the upward trend of health care costs. By making insurance carriers compete directly for your business, instead of competing for our business as a company, they have more incentive to offer their best possible price. Buying coverage through the Corporate Health Exchange also gives you more choice, since Payless no longer has to choose options based on what s most affordable and best suited to the general needs of our population. Now you ll have more control over the coverage you choose. 6. Where can I get more information? There are lots of resources available to help before, during, and after you enroll, including: Before you enroll Go to the Make It Yours website at www.makeityoursource.com/payless to learn how the Corporate Health Exchange works and more about your coverage options. You can watch videos and browse through a Reference Guide to see the plan levels and insurance carrier options. You can always contact the insurance carriers directly with specific questions. The insurance carriers contact information is available on the Make It Yours website. When you enroll During Annual Enrollment, November 7 to November 27, 2013, log on to the Payless Health Exchange website at https://payless.benefitsnow.com where you can compare your options, use helpful tools (such as DecisionDirect, which can give you a personalized medical plan suggestion), and enroll. When you log on to the Payless Health Exchange during Annual Enrollment, that s also where you ll be able to see the credit amount from Payless and prices based on plan level and insurance carrier. 4

If you need additional assistance, customer service representatives at the Payless Benefits Center are available Monday through Friday, from 9 a.m. to 6 p.m. ET, to answer questions about the Corporate Health Exchange, your benefit options, and the enrollment process. Just call 1.855.564.6152. The insurance carriers can also answer specific questions about the plans they offer. Throughout the year For questions about your coverage, always start by contacting your insurance carrier directly. They know their plans best and have the final authority on all claims, billing disputes, etc. If you need help with more complex issues, such as claims and billing disputes, call a health advocacy representatives available through the Payless Benefits Center at 1.855.564.6152. For more tips on making the most of your benefits, visit the Make It Yours website at www.makeityoursource.com/payless. 5

Annual Enrollment 7. When is Annual Enrollment? Annual Enrollment for your 2014 benefits will take place from November 7 through November 27, 2013. Mark your calendar now because you must take action if you want coverage! 8. What will I need to do? Between November 7 and November 27, 2013, you must enroll if you want medical, dental, vision, and/or pre-tax saving account coverage for next year. Keep in mind, if you don t select a medical plan, you won t have prescription drug coverage next year. To enroll, go to the Payless Health Exchange website at https://payless.benefitsnow.com. Over the course of the enrollment process, you ll need to: Enroll the eligible dependents you want to cover in 2014. Choose the insurance carriers you want for your medical, dental, and/or vision benefits. Select the plan level you want (Bronze, Bronze Plus, Silver, Gold, or Platinum). Enroll in the rest of your benefits, make your pre-tax savings elections, print a confirmation statement, and then follow the link back to the Payless MyInfo portal to complete your life and disability elections. You can get detailed instructions to enroll and information about the tools available in the Reference Guide on the Make It Yours website at www.makeityoursource.com/payless. 9. Who s eligible for benefits? Full-time associates are eligible for Payless health care benefits. Full-time means that you work the average hours required to meet the Company s definition of full-time Eligible dependents include: Your spouse or same-sex or opposite-sex domestic partner Your eligible children under age 26; and Your eligible children of any age who became handicapped or totally disabled before age 26. 6

My Options 10. What are my options for medical coverage? You have several plan levels to choose from,* including: Bronze: a basic, high-deductible preferred provider organization (PPO) plan that offers access to a Health Savings Account (HSA) Bronze Plus: a buy-up to the Bronze option a high-deductible PPO plan that offers access to an HSA Silver: a PPO plan Gold: a PPO plan Platinum: a PPO plan that covers in-network care and limited benefits for out-of-network care (or, for some insurance carriers in CO, DC, GA, MD, OR, VA, and WA, an HMO plan that covers innetwork care only) Each plan level is available from different insurance carriers at different costs. Do you live in California? Your plans might be a little different, depending on the insurance carrier you choose. *If you live outside the service areas of all the insurance carriers participating in your area, an out-ofarea plan at the Silver or Gold level will be your only option. 11. Is one plan level better than another? No. Don t let the names of the plan levels fool you one option isn t necessarily better than another. They re designed to give you choices so that you can find the option that makes sense for your situation. Remember to take your total costs into consideration, which includes what you pay out of your paycheck (premiums) and what you pay out of your pocket when you receive care (deductibles, coinsurance, copays). For example, the Gold and Platinum plan levels will cost you more each paycheck, but less when you receive care. These plan levels have copays for some services and lower deductibles, coinsurance and out-of-pocket maximums compared to the Bronze and Bronze Plus plan levels. The Bronze and Bronze Plus plan levels come with lower paycheck deductions and higher deductible, coinsurance, and out-of-pocket maximums. If you don t need a lot of health care services, you ll spend less on your total health care costs because you re not paying premiums for coverage you don t need. 12. What s the difference between a traditional PPO and a high-deductible? A PPO is a type of medical plan that uses a network of physicians, hospitals, and other health care providers that have agreed to provide care at negotiated prices. You can also go to out-of-network providers, but you ll pay more. When you enroll in a traditional PPO, like a Gold plan, you have to meet a lower deductible before the plan starts paying a percentage of the costs, compared to a Bronze or Silver plan. For example, the Gold plan deductible is $600 for Associate Only coverage and $1,200 for Family coverage. In exchange for that lower deductible though, you will have higher paycheck deductions. 7

A high-deductible PPO plan operates the same, but as the name suggests, you have a significantly higher deductible before your coverage kicks in. For example, the deductible in the Bronze plan is $2,750 for Associate Only coverage and $5,500 for Family coverage. To balance the cost of the high deductible, your paycheck deductions will be lower. You can use a Health Savings Account (HSA) to pay qualified health care expenses tax-free. Once you meet your high-deductible, you get the protection of a traditional PPO and pay a percentage of your ongoing expenses, up to the out-ofpocket maximum. (See question #30 for more details about the HSA.) 13. Can each family member choose a different plan level or insurance carrier? No. All family members must be enrolled in the same plan. 14. Which insurance carriers will I be able to choose from? Most of the largest insurance carriers are participating in the exchange. Keep in mind that providers may vary by region. For medical coverage, that includes Aetna, Health Net, Kaiser Permanente, and UnitedHealthcare. For dental coverage, you ll be able to choose from Aetna, Delta Dental of CA, Delta Dental of KS, MetLife, and UnitedHealthcare. For vision coverage, you ll be able to choose from MetLife, UnitedHealthcare, and VSP. 15. Will I be able to use the same providers as I do today? It depends. Each insurance carrier has its own network of preferred providers. If you want to keep seeing your current doctors, select an insurance carrier that includes your preferred providers (e.g., doctors, specialists, hospitals) in its network. Even if your current insurance carrier is participating in the Corporate Health Exchange, the provider network could be different, so always check the provider directories before making a decision. To see if your current provider will be in your new network, you can use the Doctors and Facilities tool that will be available when you enroll. You ll be able to check the provider networks for each insurance carrier you are considering. 16. How should I choose an insurance carrier if my dependents and I live in different states? In this situation, you should consider one of the national insurance carriers that offer national provider networks, so that your dependents have access to in-network providers in most locations. When you enroll, you can use the Doctors and Facilities tool to search for in-network providers by zip code. If you have any questions, you can call the Payless Benefits Center at 1.855.564.6152. Customer service representatives are available Monday through Friday, from 9 a.m. to 6 p.m. ET. The insurance carriers can also answer specific questions about their provider networks. 17. How do I decide which option is right for me? You ll have access to a number of resources to help you make smart decisions. You should start by visiting the Make It Yours website at www.makeityoursource.com/payless to access videos, details about your options, a Reference Guide with comparison charts, and more. 8

When you enroll, you ll be able to see the credit amount from Payless and your price options on the Payless Health Exchange website at https://payless.benefitsnow.com. You ll also be able to access tools that can help you make decisions, such as DecisionDirect, Health Plan Comparison Charts, Summaries of Benefits and Coverage, and more. If you need help, customer service representatives at the Payless Benefits Center will also be available Monday through Friday, from 9 a.m. to 6 p.m. ET, to answer questions about the Corporate Health Exchange, your benefit options, and the enrollment process. Just call 1.855.564.6152. The insurance carriers can also answer specific questions. 18. How can I find the plan that s most like the one I have today? That s a tricky question. The exact plan you have today will no longer be offered, but you may see similarities in your new options. You really should take a fresh look at all of your options and decide which plan level, insurance carrier, and costs will meet your needs best. When you enroll, you ll have lots of tools and resources available to help you make decisions. It will be easy to compare your options because you ll be able to sort them by the features that are most important to you. The insurance carriers can also answer specific questions. 19. Will pre-existing conditions be covered? Yes. When you enroll in medical coverage through the Corporate Health Exchange, coverage is guaranteed, regardless of whether you and your eligible dependents have pre-existing conditions. 20. What s included in the preventive care that s covered at 100% by all plans for 2014? The U.S. Preventive Services Task Force recommendations are used to determine which services are considered preventive services. The following is a partial listing of outpatient preventive care services that are 100% paid by the plan when you see an in-network provider, without needing to meet the deductible. Insurance carrier age and limitations apply, so check with your insurance carrier if you have any questions. Annual physical exam Pediatric exams Well-woman exam (includes Pap) Mammogram Bone density screening Cancer screenings Cardiovascular screenings Colorectal screening Prostate screening Digital rectal exam Immunizations (child) Immunizations (adult) Influenza vaccination (adult) 9

21. How will my prescription drugs be covered? In 2014, your prescription drug coverage will be provided by your medical insurance carrier through a pharmacy benefit manager, rather than a separate prescription drug company. Each insurance carrier has its own rules about how prescription drugs are covered. That s why you need to do your homework to determine how your medications will be covered before choosing an insurance carrier. If you or a family member regularly takes medication, it is strongly recommended that you call the medical insurance carrier before you enroll to better understand how your particular prescription drug(s) will be covered. See the Reference Guide posted on the Make It Yours website at www.makeityoursource.com/payless for a cheat sheet of questions to ask. Your coverage also depends on your plan level: If you enroll in the Bronze or Bronze Plus plan, you ll pay 100% of the cost of prescription drugs until you meet the deductible. After you meet the deductible, you pay 20% coinsurance until you reach the out-of-pocket maximum, and then you ll pay nothing. The Health Savings Account (HSA) is a great way to set aside pre-tax funds to pay your eligible out-of-pocket expenses such as your prescription drug costs. If you enroll in a Silver, Gold, or Platinum plan, you ll pay a flat fee for prescription drugs until you reach the out-of-pocket maximum, and then you ll pay nothing. In the Gold plan though, that s only true for generic prescription drugs you ll pay coinsurance for brand name drugs until you reach the out-of-pocket maximum, and then you ll pay nothing. 10

22. What are my options for dental coverage? For 2014, you have several plan levels to choose from, including: Bronze: A basic PPO plan that covers in- and out-of-network care, but does not cover major or orthodontia expenses Silver: A buy-up to the basic PPO plan that covers in- and out-of-network care, including coverage for major services and orthodontia expenses for children Gold: An enhanced PPO plan that covers in- and out-of-network care, including coverage for major services and orthodontia expenses for children Platinum: A DHMO plan that covers in-network care only, including orthodontia expenses for children and adults (not available in AK, ME, MT, ND, NH, SD, VT, WY, and some other limited areas) We did not set a subsidy or believe there was a platinum plan offering. Each plan level is available from different insurance carriers at different costs. 23. What do I need to know about dental networks? Just like the medical plans, each dental insurance carrier has its own provider networks that can vary by the plan level you choose. If it s important that you continue using the same dentist, you should check to see if your dentist is in the network before you choose a carrier. If you're considering Delta Dental, you need to take it one step further. If you choose a Bronze, Silver or Gold plan, there are actually two Delta Dental networks that dentists can be part of Premier only or PPO and Premier. Although the benefits are the same for both, the PPO network offers deeper discounts, which means bigger savings for you. So take a close look at the Delta Dental network, and if your dentist is part of the Premier network only, know you may have to pay more. If you choose a Platinum plan, the Delta Dental network goes by the name of DeltaCare. So you need to make sure your dentist is in the DeltaCare network --not just the Delta Dental network. 24. What are my options for vision coverage? For 2014, you have several plan levels to choose from, including: Bronze: Exam-only option that provides discounts for materials (e.g., lenses, frames, contacts) Silver: A PPO plan that covers in- and out-of-network care Gold: An enhanced PPO plan that covers in- and out-of-network care. Each plan level is available from different insurance carriers at different costs. 11

Paying for Coverage 25. Will I have to pay more for medical coverage? It depends on a few factors: The amount of your credit from Payless, which you ll be able see when you enroll on the Payless Health Exchange website. The plan level you choose. Certain plan levels like the Bronze or Bronze Plus are expected to cost about the same or less per paycheck than what you pay today, but you will have to meet a deductible (except for preventive care) before your coverage kicks in. Other plan levels like Gold and Platinum will likely cost more per paycheck because of the higher coverage they provide, but you ll pay less out of pocket when you use these plans. Keep in mind that one plan level isn t better than another. You ll be able to see the costs for each plan level on the Payless Health Exchange website when you enroll. The insurance carrier you choose. Certain insurance carriers may be able to provide a more competitive price, depending on where you live. Since the benefits provided under a plan level will be almost identical no matter which insurance carrier you choose, you ll be able to easily see which insurance carrier is able to offer you the best price for each plan level. The dependents you cover. You can enroll any combination of you, your spouse, and your children in the option you choose at different price points. 26. When will I find out actual costs? You ll be able to see the credit amount from Payless and your price options when you enroll on the Payless Health Exchange website at https://payless.benefitsnow.com between November 7 and November 27. 27. Do I get to keep the Payless credit if I don t enroll in coverage? No. The credit you get from Payless is for the medical, and/or dental coverage you purchase through the Corporate Health Exchange. A cash refund or credit for other benefits is not available. 28. What will I have to pay when I need medical care? Other than preventive care, which is paid 100%, how much you have to pay when you need medical care depends on your plan level. With the Bronze and Bronze Plus plans, you ll pay the full negotiated costs of all in-network services until you meet your deductible. The negotiated costs are the payments providers (doctor, hospital, lab, etc.) have agreed to accept for a particular service from the insurance carrier. The deductible is what you pay out of your own pocket before your insurance begins to pay a share of your costs. (See question #28 for more details about the deductible.) Once you ve met your deductible, you and the plan pay a share of coinsurance. If you see an in-network provider, you pay 20% and the plan pays 80% in the Bronze and Bronze Plus plans. (Note: If you have money in a Health Savings Account (HSA), you can use the money in your HSA to pay for your qualified expenses.) 12

With the Silver plan, you pay a $30 copay at each in-network doctor s office visit and $50 when you see a specialist. With the Gold or Platinum plan, you pay a $20 copay at each in-network doctor s office visit and $35 when you see a specialist. 29. What s a deductible and how does it work? The deductible is what you pay out of your own pocket before your insurance begins to pay a share of your costs. How the deductible works depends on your plan level: The Silver and Gold plan levels have a traditional deductible. For example, in the Gold plan, once a covered family member meets the $600 individual deductible, your insurance will begin paying benefits for that family member. Charges for all covered family members will continue to count toward the family deductible. Once the family deductible is met, your insurance will pay benefits for all covered family members. The Bronze and Bronze Plus plan levels have a true family deductible. This means that the entire family deductible must be met before your insurance will pay benefits for any covered family members. There is no individual deductible in these plans when you have family coverage. To clarify, if you choose a Bronze and Bronze Plus plan level, the individual deductible only applies if you have Associate Only coverage. If you choose Associate + Spouse, Associate + Children, or Family coverage though, you must satisfy the family deductible before coinsurance will kick in, even if only one family member has expenses. The Platinum plan level does not have an in-network deductible. Keep in mind that in exchange for no deductible though, the Platinum plan is usually the most expensive plan per paycheck. The annual deductible doesn t include copays or amounts taken out of your paycheck for health coverage. Do you use out-of-network providers? Your out-of-network charges may not count toward your in-network deductible, depending on the insurance carrier you choose. You can use the Compare Plans tool when you enroll to check, or contact the carriers directly. 30. What s an out-of-pocket maximum and how does it work? The annual out-of-pocket maximum is the most you and your covered family members would have to pay in a year for health care costs. What counts toward your out-of-pocket maximum depends on your plan level: With the Bronze and Bronze Plus plans, all medical and prescription drug amounts you pay will count toward the out-of-pocket maximum. With the Silver and Gold plans, medical and prescription drug copays and amounts you pay as coinsurance will count toward the out-of-pocket maximum. If you choose Kaiser Permanente (Kaiser) as your insurance carrier, though, your prescription drug copays will not count toward your out-of-pocket maximum. With the Platinum plan, medical and prescription drug copays will count toward the out-of-pocket maximum, unless you choose Kaiser as your insurance carrier, in which case your prescription drug copays will not count toward your out-of-pocket maximum. 13

The out-of-pocket maximum doesn t include amounts taken out of your paycheck for health coverage. Do you use out-of-network providers? Your out-of-network charges may not count toward your in-network out-of-pocket maximum, depending on the insurance carrier you choose. You can use the Compare Plans tool when you enroll to check, or contact the carriers directly. 31. What is a Health Savings Account (HSA)? An HSA is a special bank account that you can use when you enroll in a Bronze or Bronze Plus plan level. It allows you to set aside tax-free money to pay for qualified health care expenses, like your medical, dental, and vision copays; deductibles; and coinsurance. Because you ll be responsible for 100% of your medical and prescription drug expenses until you meet your deductible in the Bronze or Bronze Plus plan levels, an HSA is a great way to pay less for those out-of-pocket expenses because you re using tax-free money. Just make sure you only use money in your HSA for qualified health care expenses. Otherwise, you ll pay income taxes on that distribution and an additional 20% penalty tax if you re under age 65. Keep careful records of your health care expenses and the corresponding withdrawals from your HSA, in case you ever need to provide proof that your expenses were qualified. You can decide whether to enroll in an HSA and how much (if any) money you want to save when you enroll. And if you don t have a lot of health care expenses, your money can stay in your account and earn tax-free interest. 32. How is an HSA different from a Health Care Flexible Spending Account (FSA)? Do I need to be enrolled in a particular medical plan to participate? Can I contribute to my account before taxes? Do unused dollars roll over from year to year? Does the money in the account earn interest? Can I use a debit card to pay for expenses? Can I use the account to pay for vision or dental expenses? How much can I contribute to the account per year? HSA Yes, you must be enrolled in a Bronze or Bronze Plus plan level Yes Yes Yes Yes Yes, as long as you do not also have a Health Care FSA For 2014, the annual limits set by the IRS are $3,300 for Associate Only coverage, and $6,550 for Family coverage. If you ll be age 55 or older next year, you can also contribute an additional $1,000 catch-up contribution. Health Care FSA No, but if you enroll in a Bronze or Bronze Plus plan level, your FSA is limited to dental and vision expenses, and medical expenses after you have met the deductible Yes No No Yes Yes $ 2,500 14

33. Can I enroll in both the HSA and Health Care FSA? Yes. If you enroll in the Bronze or Bronze Plus plan, you can enroll in both an HSA and a Health Care FSA. If you enroll in both accounts, your FSA can only be used to pay eligible dental and vision expenses, and expenses after you have met the deductible in your medical plan. 34. Why would I want to use both an HSA and an FSA? Both accounts allow you to pay for eligible expenses with tax-free dollars. The biggest difference between the accounts is that your HSA balance rolls over from year to year, even if you change medical plans, leave the company, or retire. Whereas any remaining balance in your FSA at the end of the year will be forfeited. Since dental and vision expenses are often easier to estimate, it may make good financial sense to use both accounts. 35. What are the tax advantages of an HSA? The HSA has the following tax advantages: Your contributions to an HSA are tax-free, meaning that they are deducted from your paycheck before taxes are taken out. Interest earnings on your HSA balance are not taxed. You are not taxed on the HSA dollars when you use them to pay eligible expenses. 36. Can I use my spouse s FSA for medical expenses if I m contributing to an HSA? No. When you re contributing to an HSA, you cannot use an FSA for medical expenses. 15