Copyright 2012 PayFlex Confidential

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Copyright 2012 PayFlex Confidential 1

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• PayFlex is your administrator for Flexible Spending Accounts.
• PayFlex processes your claims and provides you with customer service support.
• More than 25 years of experience in administering reimbursement accounts.
• HealthHub is PayFlex’s brand name for all our products and services.
• HealthHub.com
is your resource to:
• View your account information
• Submit claims for reimbursement
• View claim and card transaction history
• And more!
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An FSA is a Flexible Spending Account.
• There are two types of FSAs:
• Health Care account
• Dependent Care account
• Let’s you pay for eligible expenses with pre-tax dollars
•
You contribute to an FSA with pre-tax money from your paycheck
• You do not pay Federal income or Social Security taxes on this money
Why should you enroll in an FSA?
You could save up to 30% in what you pay for taxes.
Annual Salary
$30,000
$50,000
$70,000
Health Care FSA
Annual Contribution
$1,500
Dependent Care FSA
Annual Contribution
$0
$1,750
$2,000
$4,000
$4,500
Savings
$310
$1,188
$1,343
At HealthHub.com, find out how much you can save by using the Savings Calculator and Dependent Care Tax Wizard!
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Annual minimum contribution
$120
Annual maximum contribution
$2,500
• Helps you pay for eligible medical, dental, prescription, vision and/or hearing expenses that are not covered by insurance.
• 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 plan year)
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Your dependent who is permanently and totally disabled.
• Your entire contribution is available at the beginning of the plan year.
• The Health Care FSA maximum for 2013 will be $2,500, due to health care legislation.
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Eligible expenses:
• Medical & dental deductibles, co-pays and coinsurance
• Prescriptions
• Over-the-counter items (OTC)
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As of 1/1/2011 - OTC drugs & medicines require Rx
• 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:
• 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
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Annual minimum contribution
$120
Annual maximum contribution
$5,000
• Helps you pay for child or adult care costs.
• You and your spouse, if married must be actively working, seeking employment, or full-time student, in order to get reimbursed.
• 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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You can only be reimbursed up to the amount that is available in your account.
• If married and both individuals are enrolled in a dependent care FSA, the combined IRS maximum contribution remains at $5,000.
For example: Each individual could elect $2,500 for their dependent care FSA.
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Eligible expenses:
• Licensed day care provider
• In-home provider as long as the provider is not your child under age 19, or someone you claim as a tax dependent
• Summer camps (not overnight)
• Tuition through preschool
• Before and after school care (under age 13)
Ineligible expenses:
• 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
View a detailed listing of eligible expenses at HealthHub.com
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• You can enroll in an FSA during the annual enrollment period.
• You can also enroll when you first become eligible.
• Once you enroll, you may only change your election if you have a change in status
(i.e., birth, death, marriage, divorce, change in day care provider).
• You and/or your spouse do not need to be covered by your employers health plan to participate in an FSA.
• Expenses must be for services received, not for services to be provided in the future.
• Your employer offers the grace period , which allows you additional time to spend your money. (2 ½ months)
• Your employer also offers a run-out period , which allows you additional time to submit claims for reimbursement. (90 days)
• 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
1/1/2013 – 12/31/2013
Grace Period last day to spend
FSA dollars
March 15, 2014
Run-out period last day to submit claims
March 31, 2014
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Review your expenses from the prior plan year. Use our online planning & education tools.
• My HealthHub resources – education materials, planning tools, forms and IRS publications
• Eligible expense items
– general list of eligible health care and dependent care expenses
• Savings calculator – estimate your health care and dependent care expenses
• Frequently asked questions
– helps you understand your FSA
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Digital library
– helps you understand FSAs and the PayFlex Card
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Once you know how much you want to contribute for the year, you can figure out how much will be deducted each pay period. Divide your annual contribution by the number of pay periods you have
(e.g., 12, 24, or 26).
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Login to HealthHub.com, click on Online Enrollment under Quick Links.
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The accounts available to you will be displayed. Check the box for the account(s) you wish to enroll in. If you do not wish to enroll in a particular account, do not check the box.
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Enter the amount you want to deduct from your paycheck each pay period. Your annual election will calculate automatically. Click on Save My Elections .
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This page will show:
• The account(s) you have selected to enroll in
• Your per pay deduction(s)
• Your annual election(s)
• Terms and Conditions
To complete the enrollment process, you’ll need to review and accept these Terms and
Conditions. If you agree, click
Submit.
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A confirmation screen will show the account(s) you have enrolled in. You will also receive an e-mail if you have signed up to receive electronic notifications from PayFlex.
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®
Spending made simple. Select. Swipe. Save.
What is the PayFlex Card?
It is similar to a debit card. You use it to pay for eligible expenses. Generally all you need to is swipe your card and save your receipt.
Benefits of using the card
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Immediate payment from your account
• Increases your personal cash flow
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No claim filing
• Ease of use
Where can I use the card?
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Physician and dentist offices, vision care providers, and hospitals
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Grocery stores, discount stores, web-based merchants
• Drug stores and retail pharmacies who have implemented an IRS-approved system
• Dependent care providers accepting MasterCard ®
*Merchants must accept MasterCard
® in order for the card to work
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Spending made simple. Select. Swipe. Save.
What can I purchase with the card?
• Eligible health care expenses such as co-pays, prescriptions, vision and hearing products and certain over-the-counter (OTC) items.
• Eligible dependent care expenses such as before- and after-school programs, day care, summer day camps, adult care, etc.
Things to remember…
• Save all receipts and Explanation of Benefits in case documentation is requested by PayFlex or the IRS.
• If you enroll in an FSA, you will receive a PayFlex Card via mail in a plain, white envelope before the beginning of the plan year.
• Select “credit” when you use your card. There is no PIN number.
• View your account balance, card transaction history and any outstanding card transactions requiring documentation online at HealthHub.com
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According to IRS guidelines, PayFlex is required to verify that all purchases made with your
PayFlex Card
® are eligible expenses.
• During the plan year, you may receive a Request for Documentation letter OR see an alert on HealthHub.com that states you have a claim requiring substantiation .
• If you receive a letter, you must respond to keep your PayFlex Card ACTIVE.
• If you see an alert on HealthHub.com, click on “Learn More” and upload your documentation
Common reasons when documentation may be required:
• The amount of the expense does not match your co-pay.
• The merchant description provided to PayFlex from the card swipe does not clarify the type of expense. This generally occurs with dental or hospital expenses.
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If you see an alert message or receive a Request for Documentation letter, you have three options for substantiating your card transactions.
Option 1: Send us the documentation for the expense.
Upload, fax or mail an Explanation of Benefits (EOB) or itemized receipt for the expense(s) listed in the letter or displayed online.
Option 2: Send us another expense.
Upload, fax or mail an EOB or receipt for another eligible expense. The amount must be equal to or great than the amount in question.
Option 3: Pay back your account for the amount in question.
Send a personal check or money order to PayFlex to cover the amount.
Note:
• If you do not respond, we will suspend your card.
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Once we receive and process your documentation or payment, your card will be active again.
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If you choose not to use your PayFlex Card
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, you can:
1. Submit a claim online at HealthHub.com (Pay Me or Pay Them)
• Pay Me – reimburse yourself for out-of-pocket expenses
• Pay Them – pay your provider directly
2. Submit a claim through the PayFlex Mobile app
3. Complete a claim form and fax to PayFlex
4. Complete a claim form and mail to PayFlex
Quick Tips:
• An Explanation of Benefits (EOB) or itemized receipt must be sent with your claim form
• Your EOB or receipt must include:
• the amount you owe
• name of merchant/service provider
• date of service
• service/item received
• name of patient (if applicable)
• Receive quick reimbursements by enrolling in direct deposit online.
• Download a claim form online in My HealthHub Resources.
• View your claim history and payments online at HealthHub.com.
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To fax or mail a claim, download & print a claim form via My HealthHub Resources .
Log in to HealthHub.com. Click on File a Claim under Quick Links. Enter your expense type, date of purchase and amount. UPLOAD or FAX or your documentation.
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Go to HealthHub.com. Click on Employee Account Login. Click on Register Now.
Note: You do not need to login to access the top navigation links.
Copyright 2012 PayFlex Confidential
Top Navigation Links
• Legislative news – important legislative updates regarding your account
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My HealthHub resources
– education materials, planning tools, forms and IRS publications
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Eligible expense items
– listing of eligible health care and dependent day care expenses
• Savings calculator – A calculator to help you estimate your annual expenses and potential savings
• Frequently asked questions – key information to help you understand your PayFlex account(s)
• Digital library – engaging videos to learn more about FSAs and the PayFlex Card ®

Enter your personnel number (without leading zeros) and enter your home zip code.
Enter your personnel number (without leading zeros) as the Member ID.
Copyright 2012 PayFlex Confidential

Once you click Confirm, you can access your account information.
Copyright 2012 PayFlex Confidential

After successfully registering your account, you can do the following:
• View your account balance(s)
• Submit a claim for reimbursement
• Enroll in direct deposit
• View any upcoming payments for claims submitted
• View your claim history & card transactions
• View card status and order additional cards
• View any outstanding card transactions requiring documentation
• Print claim forms & educational materials
• Enroll in eNotify to receive important account notifications
• Shop online with your FSA dollars
• View legislative updates and important
HealthHub news
• View frequently asked questions
• Access wellness videos, tips & recipes
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Stay up to date on your account.
Click on My Settings and select
Notifications / Email Address .
eNotify via email
Reimbursement Account
• Balance Reminder (weekly/monthly)
• Claim Received
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Explanation of Benefits
Debit Card
• Card Declined
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Card Documentation Processed
• Card Inactivated
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Receipt Request Letter
eNotify via web alerts
Reimbursement Account
• Claim Received
Debit Card
• Card Declined
• Card Documentation Processed
Copyright 2012 PayFlex Confidential

Available for iPhone®, BlackBerry® and Android™ smartphones
Getting Started with PayFlex Mobile
1.
Register your account online at
HealthHub.com to create a username and password.
2.
To download the app, access your phone’s app store and select PayFlex Mobile.
3.
To use the app, login to your account using your HealthHub username and password.
Features & Benefits
Account Alerts
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 typical 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.
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Deadline
1/2/2013
3/15/2013
4/30/2013
How it affects you What you should do
First day to submit 2013 plan year claims to PayFlex
You can use the PayFlex Card, submit claims online at HealthHub.com or submit paper claims to PayFlex.
Last day to incur 2012 plan year expenses
No action necessary.
Last day to submit 2012 plan year expenses
Submit all claims for the 2012 plan year to the
University of Tennessee Payroll Office using current claim forms available at flexiblebenefits.tennessee.edu
5/14/2012 BW
5/31/2012 Monthly
Last payday to receive 2012 plan year reimbursements on University of Tennessee payroll.
No action necessary after you have turned in claims forms and supporting documentation to the University of Tennessee Payroll Office.
2012 claims
Complete the University’s claim form available at http://flexiblebenefits.tennessee.edu/claims.htm print, sign and submit with your supporting documentation to the UWA Payroll Office.
2013 claims
Submit a claim online at HealthHub.com or complete a paper claim a mail or fax to PayFlex
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Customer Service
Phone: 800.284.4885
Hours: Monday – Friday, 7am - 7pm CT
Saturday, 9am - 2pm CT
Submit a Claim
Online: Log in to www.HealthHub.com > select File a Claim
Fax: 402.231.4310
Mail: PayFlex Systems USA, Inc.
P.O. Box 3039
Omaha, NE 68103
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