Transcript Over-the-Counter Eligible Expenses

BeneFLEX HR Resources &
Benny Say:
FSA
Flexible Spending Account
With Benny Card
The more you know about
Flexible Spending Accounts
The more you save!
Section 125 Plan
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Benefit paid for by the Company
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HIPAA – Confidential/Private
Help you save money
We are here to help you get the most out of this benefit
Completely voluntary benefit for you and your whole
family
You do not have to enroll in the company insurance to
participate
Your election can be used for expenses incurred by
you, your spouse, and dependents. They also do not
need to be on your insurance plan to participate.
What is a Flexible Spending Account?
An FSA is a benefit program that enables pre-tax dollars
to be used to pay for eligible out-of-pocket health care
expenses like:
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Prescription co-payments and nondrug over-the-counter (OTC) items
Mail order prescription invoices and online pharmacy
“Amount Due” on medical and dental statements incurred in the plan year
Doctor and emergency room co-payments
Health plan deductibles and coinsurance
Dental expenses
Orthodontics
Vision services and eyeglasses
LASIK surgery
An Example:
In this example, the employee participating in the FSA plan saves $100 a month - $1,200 a year pre-tax.
Use It or Lose It – THE FEAR IS GONE
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Good Elections
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Nondrug Over-the-Counter items
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24/7 Account balance availability
Online at www.beneflexhr.com
 IVR at (913) 789-4600
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Worksheet
Talk with your medical providers to help forecast your upcoming expenses.
Dependent Care FSA
The maximum election is $5,000 per
year per household
 Covers expenses for the following:
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Daycare
 Latchkey
 Summer/Sports Camp (No overnight)
 Adult Daycare
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Medical FSA
The maximum election is determined by
your company
 Covers expenses for the following:
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Dr. visit and prescription copayments
 Vision Expenses
 Dental Expenses
 Nondrug Over-the-Counter items
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Contact your HR department to determine the medical election
amount available to you.
FSA Medical Expenses
Over-the-Counter Eligible Expenses
The recently enacted Patient Protection
and Affordable Care Act of 2010 has
changed the rules for the purchase of
over-the-counter (OTC) products using
your Flexible Spending Account (FSA)
pre-tax funds.
 The IRS currently allows OTC drugs and
nondrug items to be reimbursed using
your FSA dollars.
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Over-the-Counter Eligible Expenses
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As of January 1, 2011
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FSA funds can no longer be used to purchase OTC
medicine and drugs unless a medicine or drug is
prescribed. A “prescription” means a written or
electronic order for a medicine or drug that meets
the legal requirements of a prescription in the state
in which the medical expense is incurred and that is
issued by an individual who is legally authorized to
issue a prescription in that state.
Over-the-Counter Eligible Expenses
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The OTC items affected include items
in the following categories
Acid Controllers
Allergy & Sinus
Antibiotic products
Anti-diarrheals
Anti-gas
Anti-itch & insect bite
Antiparasitic treatments
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Baby rash ointments
creams
Cold sore remedies
Cough, cold & flu
Digestive aids
Feminine anti-fungal/itch
Hemorrhoidal pres
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Laxatives
Motion sickness
Pain relief
Respiratory treatments
Sleep aids & sedatives
Stomach remedies
Over-the-Counter Eligible Items
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If you have a prescription for an OTC medicine or
drug, you must pay out-of-pocket at point-of-sale and
then submit a manual claim requesting
reimbursement.
You can continue to use your FSA funds to purchase
OTC items that are not considered a medicine or drug
(e.g. bandages, splints, contact lens solution, etc.)
Please note that insulin remains an eligible expense
with or without a prescription.
Remember to consider these new OTC rules when
estimating the dollar amount to put in your FSA for the
next plan year.
Dual Use
In addition to OTC drug or medication requiring a doctor’s prescription.
Items under the “dual use” require a doctor’s letter. Once BeneFLEX
receives the letter, it is placed on file for the remainder of the year.
FSA Reimbursement Method
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Manual
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Deadline Tuesday 3:00 p.m. CST
Complete Claim Form – fax or mail along with a
copy of receipts to BeneFLEX
Checks issued on Thursday
Direct Deposit
Benny Card
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The Benny Card works at any MasterCard terminal
coded as medical, i.e. Doctor’s office, dentist,
vision, pharmacy
To download a direct deposit form, go to www.beneflexhr.com, click
on Section 125 & HRA, Click Printable Forms
To download a claim form, go to www.beneflexhr.com, hover
over Section 125, HRA & HRA, Click Printable Forms
Claim Form – Employee Information
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Complete all employee information
 Check the box if you have a new address
Claim Form – Dependent Care
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Complete all requested information
The claim form can be used as the receipt if the
provider signs the form and provides his or her Social
Security Number or Tax ID
Claim Submission Guidelines
Dependent Care
Dependent Care Reimbursement
 Canceled checks are ok. If you include a copy of the
front & back, the dates of service & either the facility
federal ID number or the social security number of the
individual providing service.
 All receipts must show the following information:
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Who rendered the services (name and address)
What type of service was rendered
Date of original service, not a billing date
Amount of charge
Federal ID number (facility) or social security number
(individual)
Claim Form – Flexible Medical Account
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Claim must include a requested amount.
 Claim must be itemized or group by item.
 If claiming a “dual use” item or an OTC drug, doctor’s
prescription must be attached along with receipts.
Claim Submission Guidelines
Acceptable Receipts
GUIDELINES FOR SUBMISSION OF CLAIMS: The Internal
Revenue Code provides the following guidelines:
Medical Reimbursement
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The best receipt is an Explanation of Benefits from your insurance
company.
 If other receipts are submitted, they must show the following
information:
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Who rendered the service (name and address)
What type of service was rendered
Date service was provided, not a billing or due date
Amount of charge
Any insurance payment, if applicable
Canceled checks and credit card slips are not allowable receipts.
Claim Submission Guidelines
Over-the-Counter
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Over-the-Counter (OTC) drugs –
Partial listing online at www.beneflexhr.com
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When and who sold the product (date, name &
address)
Type of OTC was purchased - *Must show product
or brand name
Amount of charge
Any insurance payment, if applicable
*If the receipt does not show the name of the
product you can write the product name on the
receipt.
Claim Submission Guidelines
Over-the-Counter Drugs
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Over-the-Counter (OTC) drugs –
Doctor’s prescription required
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When and who sold the product (date, name &
address)
Type of OTC was purchased - *Must show product
or brand name
Amount of charge
*If the receipt does not show the name of the
product you can write the product name on the
receipt.
Claim Form – Signature
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According to the IRS guidelines, requested
reimbursements cannot be claimed through any other
plan, the claim form must be signed acknowledging
the participant is aware and abiding by this IRS rule.
If you use your Benny card, a manual claim is not
required.
FSAs Are a Smart Move
Benny Makes Them EASY to Use!
Introducing The Benny Debit
MasterCard Card
for All Your Qualified FSA Expenses
It is a MasterCard – when asked “Debit” or “Credit” always select “Credit”.
Getting started is easy!
You’ll receive TWO Cards in the mail,
along with important information on
using the Cards.
ACTIVATE and SIGN your Cards. Each
eligible user signs his or her own name.
Now you’re ready to pay for eligible
expenses directly from your FSA.
NOTE: THE PHYSICAL CARD IS GOOD FOR FIVE YEARS
If a merchant or provider does not accept MasterCard,
you can still submit a manual claim.
New Users – Watch for your Card
There is a $10 fee for a third card or a replacement card.
How Does It Work?
At the time of payment for prescription or office visit…
Simply Present Benny™.
The Card gets SWIPED...
And, payment is automatically deducted
from your FSA account.
Then, save your receipts in an envelope.
How does the card minimize paperwork?
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ALWAYS KEEP YOUR RECEIPTS
Co-pay Match
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BeneFLEX has obtained your co-pay information
and loaded it into the system
Co-pay swipes are auto adjudicated in the system
Learning Logic
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The card can learn eligible repeat swipes
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Orthodontic Payments
Inventory Information Approval System (IIAS)
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Grocery Stores, Discount Stores
Pharmacies
What is the IIAS?
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Have the cashier scan your
entire purchase
Swipe your Benny Card for the
FSA eligible items
Participating merchant systems
will allow the cost of the FSAeligible items to be deducted
from your FSA balance
The clerk will request another
form of payment for non-eligible
items.
No receipts will be needed to
verify Card purchases from
participating stores.
The Card works at major participating
merchants, including…
Benny Also Works For:
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Mail order or online pharmacy purchases
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Write the Benny™ ID number on the order form
When the provider sends you a bill instead of
charging at the time of service
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Simply write your Benny ™ ID number on your
statement and send it back to the provider
Receipt Requests – always keep receipts
Receipt Requests – always keep receipts
Know your Account Balance
Web Site – www.beneflexhr.com
 Interactive Voice Response (IVR)
(913-789-4600)
 Office Hours (7:00 a.m. to 5:30 p.m. CST)
(314-909-6979) or (800-631-3539)
 3rd Quarter Statement
 Reimbursement Checks
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To access your account information, click on “Section 125, HRA & HSA” in the menu bar.
Then click on “FSA & HRA Employee Account Information”.
If you are a new user, click “New User” on the right and follow the steps to setup your account.
Questions
Please call BeneFLEX
at (800) 631-3539
or
(314) 909-6979