Smart,
simple savings
Flexible Spending Accounts
The Texas A & M University System
Plan Year: 9/1/2013 – 8/31/2014
What will be covered?
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Flexible Spending Accounts
PayFlex Card®
Getting reimbursed
HealthHub.com
PayFlex Mobile™
Your connection to HealthHub
© 2013 PayFlex Systems USA, Inc.
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What is an FSA?
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An FSA is a Flexible Spending Account.
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Lets you set aside money from your paycheck (on a pretax basis) to use for
eligible expenses for you, your spouse and your tax dependents.
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There are two types of FSAs:
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Health care account
Dependent care account
You do not pay Federal income or Social Security taxes on this money.
Why should you enroll in an FSA?
An FSA helps reduce your taxes and increase your take-home pay!
Annual Salary
Health care contribution
Dependent care contribution
Savings
$20,000
$1,500
$0
$340
$40,000
$1,750
$4,000
$1,303
$60,000
$2,000
$4,500
$1,473
*Based on 7.65% FICA and 15% tax bracket. Please be advised that these examples are for illustrative purposes only. These
projections are only estimates of tax information and should not be assumed to be tax advice. Be sure to consult a tax advisor to
determine the appropriate tax advice for your situation.
© 2013 PayFlex Systems USA, Inc.
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Health Care FSA
Monthly minimum contribution
Annual maximum contribution
$20/month ($240/plan year)
$2,500/plan year
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Due to health care reform, the annual maximum contribution amount
decreased from $4,800 to $2,500.
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Reimburses you for out-of-pocket* medical, dental, prescription, vision or
hearing expenses.
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The individuals allowed to use your health care FSA contribution
generally includes:
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Your spouse
Your child to age 26 (dependent may turn 26 during the plan year)
Your dependent who is permanently and totally disabled.
Your entire contribution is available at the beginning of the plan year.
*Out-of-pocket – expenses not covered by insurance
© 2013 PayFlex Systems USA, Inc.
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Health care expenses
Eligible expenses:
• Medical & dental deductibles, co-pays and
co-insurance
• Prescriptions
• Hospital expenses
• Selected durable medical equipment
• Orthopedic devices
• LASIK surgery, eye glasses, contact lenses
• Saline/clean solutions
• Hearing aids and batteries
• Bridges, dentures, crowns, orthodontic care
• Chiropractic expenses/co-pays
• Insulin, syringes for insulin
Ineligible expenses:
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Anti-bacterial soaps
Dandruff or dry skin treatments
Teeth bleaching or mouthwash
Suntan/sunscreen lotion
Cosmetic surgery
Dietary & herbal supplements
Child birth classes
*A letter of medical necessity may allow
some of these expenses to be eligible
View a detailed listing of eligible expenses at HealthHub.com
© 2013 PayFlex Systems USA, Inc.
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Dependent Care FSA
Monthly minimum contribution
Annual maximum contribution
$40/month
$5,000/plan year
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Helps you pay for child or adult care costs.
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To receive reimbursement, you must be working. If you are married, your
spouse must either be working, looking for work, be a full-time student or
incapable of self-care.
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The cost of care must be for your child under age 13 or for a spouse or
dependent who is not able to take care of him or herself.
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Expenses are reimbursed based on the amount available in your
account.
© 2013 PayFlex Systems USA, Inc.
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Dependent day care expenses
Eligible expenses:
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Licensed day care provider
In-home provider as long as the care provider is not your
child under age 19, or someone you claim as a tax
dependent
Summer day camps
Tuition through preschool
Before and after school care (under age 13)
Ineligible expenses:
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Tuition expenses for kindergarten and beyond
Overnight camps
Child care expenses for a child 13 or older (unless
disabled)
Child care expenses for night-time babysitting
Child care expenses while you are on an extended leave
of absence
Care provided by an older dependent or sibling
© 2013 PayFlex Systems USA, Inc.
View a detailed listing of eligible
expenses at HealthHub.com
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What you need to know about FSAs
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You can only enroll in an FSA during annual enrollment or when you first
become eligible.
Once you enroll, you may only change your contribution if you have a change in
status (e.g., marriage, divorce, birth, adoption, death, etc.)
You do not need to be covered by your employers health plan to participate in an
FSA.
Your FSA has a grace period., which gives you another 2 months and 15 days
(after the plan year) to use your funds. The last day to spend your funds is
November 15.
Your FSA also has a run-out period, which gives you another 122 days to
submit claims for reimbursement. The last day to submit claims is December 31.
FSAs have a use-it-or-lose-it rule. If you have funds left in your FSA at the end
of the plan year you will lose them.
Plan Year
Last day to spend your
FSA dollars
Last day to submit claims
9/1/2012 – 8/31/2013
November 15, 2013
December 31, 2013
9/1/2013– 8/31/2014
November 15, 2014
December 31, 2014
© 2013 PayFlex Systems USA, Inc.
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Getting started is as easy as 1-2-3!
1. Estimate the amount you will spend on out-of-pocket health care and/or
dependent care expenses during the plan year.
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Review expenses from prior plan year.
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Use our planning tools available at HealthHub.com
2. Decide how much you wish to set aside in your health care and/or
dependent care FSA.
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Divide your annual contribution by the number of pay periods in your plan year to
determine the amount that will be deducted from your paycheck each pay period.
3. As you incur eligible health care and dependent care expenses throughout
the year, you can:
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Use your PayFlex Card® to pay for eligible health care expenses (Healthcare FSA Only).
OR
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Pay for eligible expenses out of pocket and submit a claim for reimbursement.
© 2013 PayFlex Systems USA, Inc.
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PayFlex
Card®
Spending made simple.
Select. Swipe. Save.
What is the PayFlex Card?
The PayFlex Card makes it easy for you to spend the money in your health care
FSA. When you swipe the card, it uses the money in your account to pay for eligible
health care expenses.
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$9.00 Annual Fee (Deducted from your election amount)
Optional for Healthcare FSA
If you currently have a PayFlex Card and would like to continue using the card during the
upcoming plan year, you must elect the card during annual enrollment
The card can be elected at anytime during the plan year ($9 fee still required)
If you do not elect the PayFlex Card, you must submit claims to PayFlex to get reimbursed
for your eligible healthcare expenses
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Important Reminders:
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You can use the card as “debit” or “credit.” If you use the card as “debit” you’ll need a
PIN to complete the transaction. To create a PIN, call 1-888-999-0121.
Merchants must accept MasterCard® in order for the card to work
Save your receipts and Explanation of Benefits in case documentation is requested by
PayFlex.
You can order a card online for your spouse or dependent at no cost.
© 2013 PayFlex Systems USA, Inc.
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Getting reimbursed
If you choose not use your PayFlex Card®, you can:
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Submit a claim online at HealthHub.com
Submit a claim through the PayFlex Mobile app
Complete a claim form and fax to PayFlex
Complete a claim form and mail to PayFlex
*Reimbursement will only be provided for services received, not for services to
be provided in the future.
Quick Tips:
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Save receipts and Explanation of Benefits to send to PayFlex
Receive quick reimbursements by enrolling in direct deposit online.
Download a claim form online in My HealthHub Resources.
Claims are paid every Monday & Thursday
View your claim history and payments online at HealthHub.com.
© 2013 PayFlex Systems USA, Inc.
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HealthHub.com
Access
planning tools,
forms, &
educational
materials
Sign up for electronic
account notifications
Access your
claim history
& transactions
Submit a
claim online
View card
status
This section will include
alerts such as card
status, claims requiring
documentation and your
next claim payment.
View FAQs
View wellness
videos & tips
View legislative
updates and
important news
Access your
account balance
© 2013 PayFlex Systems USA, Inc.
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PayFlex Mobile™
Keeping you connected for FREE!
Available for iPhone®, BlackBerry® and Android™ smartphones
Getting Started with PayFlex Mobile
Features & Benefits
1. Register your account at HealthHub.com to
create a username and password.
Account Alerts
2. Access your phone’s app store and select
PayFlex Mobile to download the app.
3. To use the app, login to your account with
your HealthHub username and password.
Receive notifications related to account status and actions needed
to keep your account active.
Account Activity
Access real-time account information including account balances,
claims processed and transaction details.
Claims Submission
Submit claims for reimbursement and even substantiate a debit card
transaction.
Benefit Plan Details
Store important health plan information and view a list of common
eligible expenses.
Who to contact for assistance
Downloading issues – contact your phone carrier directly for assistance.
All other issues – contact PayFlex Customer Service at 800-284-4885.
© 2013 PayFlex Systems USA, Inc.
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FSA Reminders
Re-enroll
• If you are a current FSA participant and would like to have an FSA for the upcoming plan
year, you must re-enroll.
• If you currently have a PayFlex Card and would like to continue using the card during the
upcoming plan year, you must elect the card during annual enrollment
“Use it or Lose it Rule”
• Be conservative when setting your election amount for the upcoming plan year.
• Any amount left in your FSA after December 31, will be forfeited.
Save Receipts & Explanation of Benefits (EOBs)
• You must submit your receipt and/or EOB with your claim form in order to get reimbursed.
• If you use your PayFlex Card, you may be required to submit your receipt or EOB to verify
that you used your card for an eligible expense.
More time to spend your FSA dollars!
• For the 2012-2013 plan year, you have until November 15, 2013 to incur eligible expenses.
• For the 2013-2014 plan year, you have until November 15, 2014 to incur eligible expenses.
• You have until December 31 to submit claims to PayFlex for reimbursement.
© 2013 PayFlex Systems USA, Inc.
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Your connection to HealthHub®
Customer Service
Phone: 800.284.4885
Hours:
Monday – Friday, 7am - 7pm CT
Saturday, 9am - 2pm CT
Submitting a Claim
Online: Login to www.HealthHub.com > select File a Claim
Fax:
402.231.4310 (Toll Free Fax: 855.703.5305)
Mail:
PayFlex Systems USA, Inc.
P.O. Box 3039
Omaha, NE 68103
Learn more by visiting www.HealthHub.com > Employee Account Login >
My HealthHub Resources
© 2013 PayFlex Systems USA, Inc.
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