The Health Care FSA benefit (referred to as "Medical FSA" by Wex) permits eligible employees to contribute pre-tax income to a Health Care FSA. The Health Care FSA will reimburse you on a pre-tax basis for your unreimbursed medical expenses. It is like getting a discount on these bills, so you don't have to earn as much to pay for them.
It is likely you will have some medical expenses that will not be covered by your health care insurance that you will have to pay for in the coming year. For example, you or your family may have medical expenses that are subject to deductibles and copayments under the Blue Cross Blue Shield medical insurance plan. Or, you may incur expenses that are not reimbursed at all, such as hearing aids or eyeglasses. Normally, you would pay for these expenses with after-tax income. Because taxes reduce the value of a dollar, you would have to earn considerably more than $100 to pay for $100 of expenses.
How Much to Contribute
Determine your annual predictable unreimbursed medical expenses for the plan year. You should take into account all health insurance deductibles and copayments, as well as uninsured medical, dental, vision, and hearing care expenses.
Maximum
The maximum amount you may elect to defer to a Health Care FSA for 2024 is $3,200.
Minimum
The minimum amount you may elect to defer to a Health Care FSA is $130.
Authorized salary reductions into your Flexible Spending Account may not be changed during the calendar year unless you experience an eligible change in status as defined by Section 125 of the Internal Revenue Code (IRC) and permitted by the Plan.
Covered Expenses
Generally, the expenses covered must be "medically necessary" as determined by a physician. Reimbursem*nt of expenses must be for expenses incurred (not billed or paid) during the applicable coverage period. Claims must be properly substantiated prior to reimbursem*nt. Expenses deductible under IRS Code Section 213 may be reimbursed from a Health Care FSA. For more detailed information on reimbursable expenses, you may call the Internal Revenue Service at 1-800-829-3676 for a copy of the IRS publication 502.
Some expenses which cannot be reimbursed include premiums paid for coverage for you or your spouse's medical and/or dental plan; nursing care for a healthy infant; elective cosmetic surgery; domestic help for primarily non-medical services; recreation and health club fees; nutritional services, even if prescribed by a physician; dancing or swimming lessons; expenses not incurred during the plan year; marriage counseling; swimming pools; hot tubs; exercise equipment; vacations; or weight loss programs.
A new change this year in the IRS regulations is to allow the expenses for smoking cessation to be paid for through a flexible spending account.
Using Your Account
For quick and easy access to your FSA account, please download the mobile app: Benefits by Wex
Debit Card
Health Care FSA expenses can be paid for with a debit card provided by the administrator, Wex. You may use the debit card to quickly and conveniently draw funds from your FSA to pay for eligible expenses.
The use of the debit card will not require substantiation for certain type of expenses. Substantiating an expense normally requires you to submit itemized receipts and Explanation of Benefit statements to Wex. Your expenses will be auto-substantiated as long as each swipe of the debit card meets the parameters of your plan (i.e., office visit or emergency room co-pay, orthodontia monthly recurring payments or medicines prescribed by a physician from an IIAS-certified merchant). All other claims must be substantiated by submitting documentation of the expense to the claims administrator. Failure to provide substantiation of the expense will result in the card being turned off. In addition, you must pay back any improperly paid claims. If you are unable to provide adequate or timely substantiation as requested by the claim administrator, you must repay the Plan for the unsubstantiated expense.
Reimbursem*nt
To receive reimbursem*nt or pay a provider directly, you can file a claim in your online account or the WEX benefits mobile app. Simply upload anitemized bill for the expense, or the explanation of benefits indicating the insurance company's disposition, and proof of payment of the claim and such other information as WEX requires. When WEX approves the claim, payment will be issuedup to the full amount of the eligible expense, not to exceed your elected Health Care FSA annual amount, less any amount already reimbursed during the Plan Year. According to IRS rules, the full reimbursem*nt amount agreed to at the beginning of the year must be available for reimbursem*nt at the beginning of the Plan Year.
You should submit all reimbursem*nt claims during the Plan Year. Claims must be submitted no later than 120 days after the end of the Plan Year. However, if you terminate employment or your coverage ends during the Plan Year, you must submit your claims within 120 days after your termination of employment or coverage end date. Only expenses incurred during the plan year and prior to the date your employment or coverage ends are eligible..
Claim submissions may be submitted to:
WEX
Website: http://wexinc.com/
Mobile App: Benefits by Wex
Mail: P.O. Box 2926 Fargo, ND 58108
Claim inquiries: 1-866-451-3399
