Page 42 - 2021 Team Member Benefit Guide - English

Health FSA & LPFSA

What are they, and should I consider enrolling? Enrollment in these accounts
The Company offers two types of accounts that may reimburse you is never automatic. It is
for your eligible out-of-pocket expenses; a Health Care Flexible mandatory that you actively
Spending Account (FSA) and a Limited Purpose Flexible Spending enroll in your FSA each year
Account (LPFSA). during Open Enrollment or
your new hire enrollment.

Health FSA LPFSA (Limited Purpose FSA)

Standard PPO Consumer HDHP with HSA
Which medical Consumer HDHP (No HSA)
plan is this account You don’t need to be enrolled in
available for? a medical plan to contribute to a
Health FSA.
Eligible healthcare expenses, This health care account is only
What would I use this including dental, vision and available if you are contributing
prescription medication expenses. to an HSA and you can only use
account for? it for eligible vision and dental
expenses.
What is the $2,750 - the IRS pre-tax $2,750 - the IRS pre-tax
maximum amount I contribution limit as of this writing contribution limit
can contribute to this as of this writing
account?
Your entire goal amount is Your entire goal amount is
When are the funds available at the beginning of the available at the beginning of the
available? benefit period. benefit period.

You will forfeit amounts not You will forfeit amounts not
What happens if I claimed for expenses incurred claimed for expenses incurred
don’t use the money during the benefit period. during the benefit period.
during the year?

Contribution allowed Yes Yes, to end of year in which
for Medicare Medicare enrollment first occurs
enrolled?
WageWorks - 1-877-924-3967 WageWorks - 1-877-924-3967
Provider Contact

How to File FSA Claims
File claims with WageWorks (now Health Equity.) File claims with HealthEquity
through March 31, 2022 for 2021 FSA expenses incurred through December
31, 2021. Log on to https://www.wageworks.com/paymentoptions/ or use the
WageWorks EZ Receipts mobile app, available in the App Store and Google Play.
To learn more visit www.wageworks.com/myfsa.
There is also an online chat option on the website and the app.

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