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<<Plan Year>>
January-December
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© 2007 PAYFLEX SYSTEMS USA, INC.
What is an FSA?
Flexible Spending Accounts (FSAs)
Allows you to pay for certain out-of-pocket health care
expenses with “pre-tax” dollars. This means you get a tax
deduction for these expenses before you ever file your tax
return.
You don’t pay Federal income or Social Security taxes on
this money and, in most states, you don’t pay state taxes
either. On average you will save about 30% on your total
FSA contribution.
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© 2007 PAYFLEX SYSTEMS USA, INC.
What does this mean to you?
Tax Savings!
Decrease Taxable Income
Increase Spendable Income
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© 2007 PAYFLEX SYSTEMS USA, INC.
FSA Savings - Example
Real world example:
Let’s say someone in your family needs braces at an average
cost of $4,500. This is typically paid over the course of one or
two years. If you put this money into a Health Care Flexible
Savings Account you will save approximately $1,350 in taxes.
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© 2007 PAYFLEX SYSTEMS USA, INC.
Eligible FSA Expenses
Medical & dental deductibles,
co-pays and co-insurance
Prescriptions
Over-the-counter medicines
& supplies
Hospital expenses
Selected durable medical
Orthopedic devices
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© 2007 PAYFLEX SYSTEMS USA, INC.
Eligible FSA Expenses
Eye Glasses, contact lenses
Saline/cleaning solutions
LASIK surgery
Hearing aids and batteries
Orthodontic care
Chiropractic expenses/
co-pays
Insulin, syringes for insulin
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© 2007 PAYFLEX SYSTEMS USA, INC.
Eligible OTC Medications
Antacids
Anti-fungal ointments
Antiseptic ointments
Cold & Allergy
Throat Sprays
Lozenges
Nasal Sprays
Cough Syrups
Cough Drops
Eye drops
Gas Relief
Hemorrhoid medications
Laxatives
Motion-sickness pills
Pain Relievers
Arthritis Pain
Back / Head Pain
Sleep Aids
Stop smoking
gums/patches
Vapor rubs
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© 2007 PAYFLEX SYSTEMS USA, INC.
Ineligible Healthcare Expenses
Anti-Bacterial Soaps
Acne Treatments
Dandruff Shampoo
Dry Skin Creams/Treatments
Foot Care Products
Hair Loss Treatments
Electrolysis – hair removal
Cosmetic surgery
Teeth Bleaching
Mouthwash
Suntan /Sunscreen Lotion
Dietary Supplements
Supplements
Varicose veins treatment
Tattoo removal
Herbal supplements
Child birth classes
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© 2007 PAYFLEX SYSTEMS USA, INC.
Calculating Your Contribution
Determine out-of-pocket expenses that recur every year for you
and all of your dependents.
Prescriptions, over-the-counter medicines, etc.
Braces
Routine doctor visits – co-pays/non covered visits
Estimate out-of-pocket expenses that you plan to incur during the
plan year (e.g., laser surgery, extra glasses, acupuncture)
Use our expense planning worksheets to assist you in determining
your annual contribution (available at www.payflex.com)
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© 2007 PAYFLEX SYSTEMS USA, INC.
Special IRS Plan Rules
Once you establish your plan year contribution, you may only
change it if you experience a “life event” change.
Qualifying events include: marriage, divorce, and death
Any amount left in your flexible spending account at the end of
the plan year will be forfeited unless employer has
implemented a “grace period”.
Even if you or another family member are covered under
another health insurance plan, you can still participate in the
PayFlex FSA plan.
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© 2007 PAYFLEX SYSTEMS USA, INC.
New IRS Ruling – Grace Period
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© 2007 PAYFLEX SYSTEMS USA, INC.
What is a “grace period”?
An extra 2 ½ month period to use up your healthcare
and dependent day care spending account dollars
Internal Revenue & PayFlex Guidelines:
Eligible health care & dependent care expenses
incurred after end of plan year, must be incurred and
submitted to PayFlex by the end of the 2 ½ month
period
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© 2007 PAYFLEX SYSTEMS USA, INC.
FSA Educational Tools
Comprehensive participant website
Online FSA expense planning
calculator and worksheets
Frequently Asked Questions
Eligible FSA expenses
Express Claims
Web-based FSA tutorial
Printable enrollment and claim forms
www.payflex.com
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© 2007 PAYFLEX SYSTEMS USA, INC.
www.mypayflex.com
Login: New user registration & login screen
Accounts: Account Summary with balances, claims history and payroll transactions
Debit Cards: List of debit cards active in your account
My Info: Username, password, security question & answer, email address and option for
electing e-Notify to receive emails for processed claims
Express Claims: To submit your claims during the plan year, print claims and
instructions to fax claims. Express Claims promises 72 hour turnaround time for claims
processing
Education Tools: FSA Tutorial, FAQ’s to help you use PayFlex services, savings
calculator, and expense planning worksheets
FSA Calculator: Directs you to a site to calculate your medical care, prescriptions,
dental care, eye care, and over-the-counter drugs as well as your potential savings
Eligible/Ineligible Expense Items: A comprehensive list of IRS-eligible Health Care &
Dependent Care expenses
Forms: Administrative forms and publications and IRS forms and publications including
direct deposit forms and claim forms
FAQs: Includes general questions as well as questions regarding filing claims, changing
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your election, health care, dependent care, flex debit card and grace period.
© 2007 PAYFLEX SYSTEMS USA, INC.
FSA Education Tools
Online FSA tutorial
Expense planning tools
Enrollment & claim forms
www.mypayflex.com
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© 2007 PAYFLEX SYSTEMS USA, INC.
Frequently Asked Questions
How does an FSA account work?
You estimate the amount you will spend on out-of-pocket health care expenses
You decide how much you wish to set aside into your FSA Health Care
account
The amounts you wish to set aside into your accounts will come out of your
paycheck (on a pretax basis) in equal amounts each pay period
As you incur health care expenses throughout the year, you can submit a
claim form along with documentation of your expenses OR file your claims
online using our Express Claims
You will be reimbursed via check or direct deposit
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© 2007 PAYFLEX SYSTEMS USA, INC.
Frequently Asked Questions
How much can I put into my FSA Account?
Health Care account- maximum determined by your employer
Dependent Care account- $5,000 maximum per plan year per the IRS
How often can I enroll?
Annually – new employees can join off cycle
How much can I expect to save with and FSA?
This depends on your tax bracket but on average about 30% of your
total contribution/election.
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© 2007 PAYFLEX SYSTEMS USA, INC.
Frequently Asked Questions
Do I have to save and turn in my receipt?
Yes. You can file your claims via fax, mail or online through our
Express Claims service. Express Claims makes it easy to submit
your claim and in most cases your claims are processed within 1 to 2
days.
If I don’t use the money in my account do I lose it?
Yes. You must spend all the money in your account by the end of the
benefit year. However, if your employer offers a “grace period”, you
will be allowed to use your FSA dollars for an additional 2 ½ months
after the end of the plan year.
You will be notified in early November of any funds left in your
account.
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© 2007 PAYFLEX SYSTEMS USA, INC.
Dependent Care
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© 2007 PAYFLEX SYSTEMS USA, INC.
Dependent Care Expenses
Expenses necessary for you and, if married, your spouse to work
Child Care or Adult Day Care Expenses
Care for children under 13 or incapable of support
Care for adult dependent incapable of self care
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© 2007 PAYFLEX SYSTEMS USA, INC.
Qualifying Child Care Providers
Private Sitter
Licensed Day Care Provider
An in-home provider as long as the care provider is not
your child under age 19, or someone you claim as a
dependent for income tax purposes
Summer camps, except overnight camps
Tuition considered a day care expense through
preschool
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© 2007 PAYFLEX SYSTEMS USA, INC.
Introducing…
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© 2007 PAYFLEX SYSTEMS USA, INC.
The PayFlex Debit Card
The PayFlex Card is a “Debit Card” that
electronically accesses your health care account
to pay for IRS-QUALIFIED medical expenses.
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© 2007 PAYFLEX SYSTEMS USA, INC.
Advantages of the PayFlex Debit Card
Increase your personal cash flow
Convenient & easy to use
FAST- no waiting for reimbursement
Provide documentation only as requested
Use at qualified healthcare merchants
accepting MasterCard®
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© 2007 PAYFLEX SYSTEMS USA, INC.
PayFlex Debit Card Reminders
Only use for IRS-eligible expenses
Keep your eligible purchases separate from other purchases made
at the same store
Please save your itemized receipts! PayFlex may request
documentation based on IRS guidelines
UNLIMITED USE! Use your PayFlex Card as often as you wish!
Your card does not expire until the expiration date shown on the
card. PayFlex will re-load your card each year for your new
election period
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© 2007 PAYFLEX SYSTEMS USA, INC.
Filing Paper Claims
Complete a claim form and submit to
PayFlex via mail or fax
Include itemized statement or an
Explanation of Benefits (EOB) statement
showing your out-of-pocket expense
File paper claims as often as you wish
(Remember, claims incurred during your
plan year must be filed by March 31,
2008)
Claims can be direct deposited to a
checking or savings account
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© 2007 PAYFLEX SYSTEMS USA, INC.
Express Claims: filing claims online
Go to www.mypayflex.com
Login with your Username & Password, if first time user, please
register for an account
Once you are logged in, the Accounts screen will appear, then select
Express Claims on the right side
Select the account through which you wish to file a claim
Enter your claim information: date of expense, type of expense and
the amount of expense and click the Next button
Verify your claim and print your claim
Fax claim and itemized receipts to (866) WEB-CLMS
Note: Itemized receipts must include date of purchase, descriptions of
purchase, amount of purchase, name of merchant and if a health care
claim we will also need the name of the patient.
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© 2007 PAYFLEX SYSTEMS USA, INC.
Communication Services
e-Notify - provide us with your e-mail
address and you will receive an
electronic receipt for paper claims that
you submit, letting you know we have
processed it. Sign up for e-Notify at
www.payflex.com!
Year-end notification- reminder to use
your remaining account balance before
the end of the plan year.
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© 2007 PAYFLEX SYSTEMS USA, INC.
PayFlex Contact Information
Please contact us with any questions!
PayFlex Systems USA, Inc.
700 Blackstone Centre
Omaha, NE 68131
Toll-free: (800) 284-4885
Website: www.payflex.com
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© 2007 PAYFLEX SYSTEMS USA, INC.
Thank You
www.payflex.com
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© 2007 PAYFLEX SYSTEMS USA, INC.