Learn more about each type of FSA, the FSA Debit Card, the carryover feature, and more!
Medical FSA Why should I choose a medical flexible spending account?
A medical FSA is a benefit that allows you to choose how much of your paycheck you’d like to set aside, before taxes are taken out, for healthcare expenses. This saves you money by reducing your taxable income.
Funds on Day 1 Schedule that surgery, buy those eyeglasses or finally get those braces. All of your FSA funds are available to spend right away. Use your benefits debit card at the point of purchase.
Discount Think of it like a discount on healthcare expenses at stores such as Amazon, Target, CVS, Walmart, Walgreens and more. Dollars you contribute are taken out of your paycheck before tax which means a $100 purchase would actually cost you over $130 without a medical FSA. *
Plan ahead Think about the money you spent on healthcare expenses last year. Plan ahead and set those funds aside in a medical FSA and save 30%. * * Based on a 30% tax bracket.
What does it cover? There are thousands of eligible items, including:
• Copays and coinsurance • Doctor visits and surgeries • Over-the-counter medications (first aid, allergy, asthma, cold/flu, heartburn, etc.) • Prescription drugs
• Birthing and
lamaze classes • Dental and orthodontia • Frames, contacts, prescription sunglasses, etc.
Fast fact Don’t know how much to elect? Determine how much you spent on healthcare expenses last year and estimate the amount you’ll spend this year using our eligible expense list. Any funds you contribute to the medical FSA must be spent by the end of the plan year.
View our interactive eligible expense list at www.wexinc.com/insights/benefits-toolkit/eligible-expenses/
Can I enroll? Yes, as long as you or your spouse aren’t actively enrolled and contributing to a health savings account (HSA).
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Flexible Spending Account Contribution Limits & IRS Regulations
The IRS sets the maximum dollar amount you can elect and contribute to a medical FSA. The annual contribution limit is $ 3, 200 . We recommend reviewing how much you spend on eligible healthcare expenses every year to determine how much to elect.
Funds on day 1 All of your FSA dollars are available on the very first day of the plan year. For example, if you choose to contribute $1,200 to your FSA, your contributions will be deducted evenly across all of your paychecks for the year, but you have access to all $1,200 on day 1! You can use your funds for expenses incurred by you, your spouse or eligible dependents.
Use-or-lose Don’t forget to spend your FSA dollars. You will forfeit any money left in your account at the end of the plan year. (Check with your employer to confirm how many days you have to submit claims for reimbursement after the plan year ends.)
Changing your FSA election In order to make changes to your election after open enrollment, you need to experience a qualifying life event. These events include:
• Change in marital status • Change in the number of dependents • Increase due to birth, adoption or marriage • Decrease due to death, divorce or loss of eligibility
• Gain or loss of eligibility due to a change in participant, spouse or dependent employment status
If you experience a qualifying life event, contact your employer to make changes to your election.
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Flexible Spending Account Carryover
A carryover allows you to transfer up to $ 6 4 0 of your remaining balance at the end of the plan year into the following year. Think of it like a safety net for your FSA. If you end up spending less than you anticipate when making your elections during open enrollment, you can tap into those funds next year.
Carryover funds become available to you after the run-out (claim filing) period.
You are able to carry over up to $ 6 4 0 while still electing the full maximum annual election in the new plan year.
If you have the benefits debit card, it will continue to work as normal, using your carryover funds first.
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Dependent Care FSA Why should I choose a dependent care FSA? A dependent care FSA allows you to put aside a portion of your paycheck before taxes for eligible dependent care expenses each year.
Save money The dependent care FSA lets you pay for eligible dependent care expenses while you reap the benefits of additional tax savings. You’re spending the money either way. This way, eligible childcare and other dependent care costs are a little less.
Fast Fact For recurring costs, submit our Recurring Dependent Care Form. It makes claim filing simple because you only need to submit one form once in order to get reimbursed each pay period. You can find the form on the back of this handout.
Save strategically Submit all of your dependent care expenses at the end of the plan year for one lump sum reimbursement to give yourself a hard-earned “bonus”.
What does it cover? The list includes, but is not limited to, eligible: • Childcare center, babysitter, nanny (birth through age 12) • Summer day camp • Before- or after-school care
DCA Open Enrollment (video)
• Disabled dependent and/or spouse care • Elder care
View our interactive eligible expense list at www.wexinc.com/insights/benefits-toolkit/eligible-expenses/
Can I enroll? You are eligible if you and/or your spouse (if applicable) are gainfully employed, looking for work, or are attending school on a full-time basis.
WEXH_699323_DG_8.2.2022
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Dependent Care FSA Contribution Limits & IRS Regulations The IRS sets the maximum dollar amount you can elect and contribute to a dependent care lexible spending account (dependent care FSA). The annual contribution limit is: Per household: $5,000 Per person (if married and filing separately): $2,500 Although most people incur more than the limit per year, we recommend reviewing how much you spend on eligible dependent care expenses every year to determine your election.
Funds available as you contribute Funds will be available to you as they’re deducted from your paycheck and contributed to the plan. This means when payroll is processed and your paycheck is available to you, your dependent care FSA contributions will be applied to your account and available for reimbursement. Use-or-lose Don’t forget to spend your FSA dollars. If you have not used all of your FSA dollars before the end of the plan year, you will forfeit any money left in your account. (Check with your employer to confirm how many days you have to submit claims for reimbursement after the plan year ends.)
Fast Fact A great way to set it and forget it is to use our Recurring Dependent Care Form that allows you to submit one claim for the entire year and you will be reimbursed after each payroll.
Changing your dependent care FSA election In order to make changes to your election after open enrollment, you need to experience a qualifying life event. These events include:
• Gain or loss of eligibility due to a change in participant, spouse or dependent employment status • Change in daycare providers • Child turning age 13
• Change in marital status • Change in the number of dependents • Increase due to birth, adoption or marriage • Decrease due to death, divorce or loss of eligibility
• Increase or decrease in the cost of qualifying daycare expenses • Judgement, decree or order requiring a change in coverage
If you experience a qualifying life event, contact your employer to make changes to your election.
Simplifying benefits for everyone.
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www.wexinc.com
866-451-3399 866-451-3245 PO Box 2926 Fargo, ND 58108-2926 forms@wexhealth.com
Recurring Dependent Care Request Form This form is to be completed each plan year and as changes occur when you want to receive recurring reimbursement of dependent care expenses. Documentation must be retained for your records and provided to WEX when requested to do so (if a receipt is unavailable, a signature from the provider is sufficient). If any information on this request form changes during the plan year, you must submit an updated Recurring Dependent Care Request Form. * = Required Fields
Step 1: Participant information
*Social Security Number - -
*Participant Name (First, MI, Last)
*Employer Name (Do not abbreviate)
Employee ID
Updates or changes to your information can be made by logging into your account at www.wexinc.com .
Step 2: Recurring dependent care FSA information *Please select only one: Start Recurring Dependent Care FSA: Please start my recurring reimbursement with the information provided in Step 3. Change Recurring Dependent Care FSA Information: Please update my recurring reimbursement with the information provided in Step 3 as of the Effective Date listed on the right.
Effective Date (mm/dd/yyyy)
Effective Date (mm/dd/yyyy) Stop Recurring Dependent Care FSA: Please stop my recurring reimbursement for the information provided in Step 3 as of the Effective Date listed on the right. Step 3: Dependent care provider information and signature (to be completed by the provider) I certify the information provided below is accurate. I understand the purpose of my signature on this form is to substantiate the name of the dependent care provider, the dates of service care is being provided and the dollar amount of the services. I agree to provide the necessary receipts for documenting the participant’s incurred dependent care expenses. *Dependent(s) Name *Start Date of Service *Provider’s Signature *Cost Per Week *Total Cost
*End Date of Service Must be within current plan year (mm/dd/yyyy)
Must be within current plan year (mm/dd/yyyy)
Step 4: Participant certification To the best of my knowledge, the provided information is complete and accurate. By submitting this, I acknowledge my child is under the age of 13, the services are eligible dependent care expenses as defined by the IRS, that I have not been previously reimbursed for these expenses and that I will not seek reimbursement from any other source. I understand that WEX, including its agents and employees, will not be held liable if I submit ineligible expenses for reimbursement. I have obtained or made reasonable efforts to obtain the provider’s Tax ID (TIN) and I will include the TIN on IRS Form 2441, which I must attach to my federal income tax return. If there are any changes in the provided information, I understand it is my responsibility to notify WEX. I understand that WEX may require me to submit any additional documentation, receipts and an updated request form at any time. I should retain a copy of all submitted documentation in the event of an IRS audit. I confirm my payroll deductions are less than my daycare costs per week so recurring reimbursements will occur when payroll deductions post to my Dependent Care FSA. By submitting this form I certify the above.
*F001*
*K101*
Revised 08/2/22
Limited FSA Why should I choose a limited flexible spending account?
A limited FSA is a benefit that allows you to choose how much of your paycheck you’d like to set aside, before taxes are taken out, for qualified dental, vision and preventative care expenses. It pairs well with a health Savings Account (HSA). This plan offers instant access to funds for expenses you incur throughout the year. And saves you money by reducing your taxable income.
Funds on Day 1 Buy those eyeglasses or finally get those braces. All of your FSA funds are available to spend right away. Use your benefits debit card at the point of purchase.
Discount Think of it like a discount on healthcare expenses at stores such as Amazon, Target, CVS, Walmart, Walgreens and more. Dollars you contribute are taken out of your paycheck before tax which means a $100 purchase would actually cost you over $130 without a limited FSA. * Plan ahead Think about the money you spent on healthcare expenses last year. Plan ahead and set those funds aside in a limited FSA and save 30%. * *Based on a 30% tax bracket.
What does it cover? There are thousands of eligible items, including: • Dental and orthodontia office visits and expenses • Dental implants, veneers, dentures and bridges • Optometrist and ophthalmologist visits and expenses
• Eye glasses, contacts, prescription sunglasses, solutions and drops • Laser eye surgery
Fast fact Don’t know how much to elect? Determine how much you spent on dental and vision expenses last year and estimate the amount you’ll spend this year. Any funds you contribute to the limited FSA must be spent by the end of the plan year.
Can I enroll? The limited FSA pairs nicely with a health savings account (HSA). However, a limited FSA cannot be paired with a medical flexible spending account (FSA). Pairing these plans allows you to spend your limited FSA dollars on eligible expenses while saving or investing your HSA dollars.
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WEX Benefits Card
Our benefits debit card is the fastest and most convenient way to access your funds and pay for eligible expenses. Just one debit card is all you need for your card-eligible benefits with us.
While the IRS requires documentation for certain spending and reimbursement benefits, we automate some of that substantiation through:
IIAS approval: If a merchant uses the Inventory Information Approval System (IIAS), the debit card will automatically approve eligible expenses. You can view a list of IIAS merchants at www.sig-is.org/card-holders/store-locator.
Copayments: If your employer provides us copayment amounts for your insurance plans, we can auto-approve expenses that match these copayment amounts.
Recurring claims: If you use your debit card for a purchase that requires substantiation, once the claim has been approved and you make that same purchase for the same dollar amount at that merchant, the recurring claim will be automatically approved.
How do I get a card? We’ll automatically mail you two debit cards to the address listed in your account the first time you enroll. If you’re already enrolled, continue using the debit card you have.
Additional cards You can request additional debit cards for your spouse or dependents from your online account. Log in, under Accounts select Banking/Cards.
Expiring debit card We will automatically mail you a new debit card 30 or more days prior.
Lost or stolen cards If your debit card is lost or stolen, you can report it in your online account or mobile app and request a new card.
Simplifying benefits for everyone.
Benefits Mobile App Access your benefits anytime, anywhere
Access your benefits on the go 24/7 with the WEX benefits mobile app. Our free app gives you convenient, real-time access to all your benefits accounts in one spot. This makes it easy to use your hard-earned dollars and view recent account activity without ever needing to call in. The benefits mobile app keeps your benefits always within reach. Want to know the status of a recent claim or easily check the balance of your accounts? Log in to our secure app to get answers to those questions and so many more — wherever and whenever you want.
With our benefits mobile app, you can:
Get instant updates on the status of your claims.
File a claim and upload documentation in seconds using your phone’s camera.
Report a card as lost or stolen, which cancels the card and ships you a new one.
Log in through face recognition or fingerprint (depending on your phone).
Check your balance and view account activity.
Use your benefits debit card directly from your mobile phone with Apple Pay or Samsung Pay.
Scan an item’s bar code to determine if it’s an IRS code section 213(d) eligible expense.
Reset login credentials.
Security on the go Our mobile apps use encryption and won’t store photos, keeping your documentation safe and secure.
Download the app for free on Apple and Android smartphones and tablets
Simplifying benefits for everyone.
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Benefits Technology & Resources
Benefits debit card The benefits debit card is the fastest and most convenient way to pay for eligible expenses. Just one debit card is all you need for your benefits regardless of how many plans you have with us.
Benefits eligible expenses There are thousands of eligible procedures, items and expenses based on your plan. View our interactive list of eligible expenses a www.wexinc.com/insights/benefits-toolkit/eligible-expenses/
Knowledgebase Once you’re enrolled, check out the knowledgebase to quickly search for answers to your questions. The knowledgebase boasts millions of views of our microvideos, articles and step-by-step how-tos empowering you to get the most out of your benefits. Have a question? Visit any time of day or night by logging in to your online account on www.wexinc.com .
Benefits mobile app & participant portal Access your benefits 24/7 with the WEX mobile app. Our app is free, convenient and offers real-time access to all your benefits accounts. With our benefits mobile app you can:
• Get instant updates on the status of your claims. • File a claim and upload documentation in seconds using your phone’s camera. • Scan an item’s bar code to determine if it’s an IRS Code Section 213(d) eligible expense.
• Report a card as lost or stolen, which cancels the card and ships you a new one. • Log in through face recognition or fingerprint (depending on your phone). • Check your balance and view account activity. • Reset login credentials.
Don’t have a smartphone? Go to www.wexinc.com , hover over Solutions and select Participants/ Employees. This page provides login buttons for accessing your online account, along with helpful resources like a benefits knowledge base, a link to current eligible expenses, and chat.
Questions when enrolled: 1-866-451-3399 Questions before you enroll: 1-844-561-1337 Email a question: customerservice@wexhealth.com Submit a form: forms@wexhealth.com Live chat: go to www.wexinc.com , hover over Solutions and select Participants/Employees.
Have questions? Our Participant Services team is available Monday - Friday 6:00 a.m. to 9:00 p.m. Central time.
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