UPHS_Enrollment_Guide_FINAL

Print this Guide
Human Resources/
Benefits Locations
Making Changes
During the Year
Contact
Information
Search this
Document
>
Welcome What’s New Cost for Coverage Plan Highlights
Carewise Health
Programs
Medical
Behavioral Health
Prescription Drug
Vision
Dental
Flexible Spending
Accounts (FSAs)
Health Care FSA
Dependent Care
FSA
Life Insurance
AD&D Coverage
Disability
Legal Notices
Welcome > Flexible Spending Accounts
Flexible Spending Accounts
Flexible Spending Accounts (FSAs) allow you to pay for eligible health care
and/or dependent care expenses with tax-free money. You pay no federal or
Social Security taxes on money in these accounts. When you enroll in a Health
Care and/or Dependent Care FSA, the dollars you designate will be deducted
from your paycheck on a before-tax basis and credited to your FSA. For a
complete list of eligible expenses, visit www.enrollone.com/uphs.
Reimbursements
You can use your Health Care Flexible Spending Account Card to pay for eligible
health care expenses. When you first enroll for the FSA, SHPS will mail your
card. Once you activate the card, you can use it to pay for your eligible health
care expenses. If you are currently enrolled in an FSA, you will receive a new
card when your current card expires (the expiration date is listed on your card).
You can still choose to submit paper claims instead of using the Flexible
Spending Account Card. Reimbursement checks will either be mailed directly to
your home or wire-transferred to an account you designate via Electronic Funds
Transfer (EFT).
When submitting a claim, remember to include your Explanation of Benefits
(EOB) if you are filing a claim for health care expenses partially covered by an
insurance plan.
Please keep your receipts until your claim is validated by SHPS.
Use It or Lose It!
According to IRS
regulations, you must
forfeit any unused funds
left in your Flexible
Spending Account after
the applicable deadline:
• Health Care FSA: Any
unused funds left after
September 15, 2011, will
be forfeited. You can
submit expenses until
December 31 after the
plan year.
• Dependent Care FSA:
Any unused funds left
after June 30, 2011, will
be forfeited. You can
submit expenses until
September 30 after the
plan year.
Forms
Health Care FSA Claim Form
Dependent Care FSA Claim Form
Electronic Funds Transfer
Eligible Expenses
Health Care FSA
Dependent Care FSA
Contact Your Provider
SHPS at 800-678-6684