Fidelity Health℠
Health Care Flexible
Spending Account (HCFSA)
A Health Care Flexible Spending Account allows you to set aside pre-tax dollars that you
can use to reimburse yourself for eligible out-of-pocket medical, dental, prescription, and
vision expenses.
Using a Health Care FSA is a great way to stretch your benefit dollars because the amount
of your paycheck that goes into the health care FSA does not count as taxable income, so
you will have immediate tax savings and increased take-home pay.
With a Health Care FSA, you elect an annual contribution amount that is deducted from
your paycheck each pay period, in equal installments throughout the year, until you reach
the amount you have specified. The maximum amount you may elect is set by your
employer and cannot exceed the IRS limit for the year.
Your annual contribution amount is available to you on the first day of the coverage period;
you do not need to wait to accrue the funds. Plus, the convenience of the NetBenefits
AccessCard® allows you to easily pay for qualified medical expenses.
What is a Health Care FSA?
Qualified Medical Expenses
Use your Health Care FSA to reimburse yourself for certain eligible expenses, as allowed
by the IRS. Some examples include
1
:
• Out-of-pocket expenses like co-pays, coinsurance,
or deductibles for medical, prescription, dental, or
vision plans
• Health conditions that require the purchase of
prescription medications on an ongoing basis
• Purchasing glasses, contact lenses, or laser eye
surgery
• Orthodontia care such as braces, or dental
expenses
You can submit Health Care FSA claims as often as qualified medical expenses are
incurred. Expenses must be incurred during the plan year, and any reimbursement must
be requested before the end of the run-out period.
Decide how much you want to contribute.
Before you enroll in the Health Care FSA, you will need to decide how much
you want to contribute to your account. You can use your funds to pay for
qualified medical expenses for yourself, your spouse, or your eligible
dependents. Spend time estimating your anticipated eligible medical,
prescription, dental, and vision expenses for the year.
Health Care FSAs are use-it-or-lose-it accounts.
The funds you contribute don’t roll over from year to year.
Make sure your expenses qualify for Health Care FSA spending.
It is important to ensure that the funds being used from the HCFSA are for
qualified medical expenses. Tracking receipts and reimbursements is a best
practice. Refer to IRS
Publication 502 or your summary plan description, for a
complete list of qualified medical expenses.
Planning Ahead
Easy Access
Health Care FSA
NetBenefits AccessCard®
• You will receive a NetBenefits
AccessCard to make it easy to pay for
eligible services and products. When
you use the NetBenefits AccessCard,
payments are automatically
withdrawn from your account.
• Most expenses can be validated
through the card transaction, but you
may be required to provide a copy of
the receipt for certain transactions, in
accordance with IRS rules. When
necessary, receipts can be easily
uploaded to NetBenefits
.
Reimburse Yourself
• You can submit a claim by logging
in to NetBenefits
and selecting the
“Flexible Spending and
Reimbursement Accounts” tile.
From there, you can select the
“Reimburse Yourself” tile.
• Request a check disbursement or
link a bank account for faster
transfers. Reimbursements can only
be processed for expenses that
have already been incurred.
How do I par
ticipate in
a Health Care FSA?
To participate you must enroll during your employer’s annual
enrollment or as the result of a qualifying life event. Contact your
benefits administrator for more information.
How do I change my
Health Care FSA
deduction amount?
Employers only allow changes to your election during annual
enrollment or a qualifying life event, such as the addition or loss of a
dependent. Contact your benefits administrator for more information.
Can I enroll in both an
HSA and an FSA?
If you enroll in both an HSA and an FSA, you cannot make
contributions to the HSA for that coverage period if the FSA is a “full
purpose” Health Care FSA that pays or reimburses for qualified
medical expenses. However, you will be able to make contributions to
an HSA and an FSA if you are covered under a Limited Purpose FSA
because that kind of FSA restricts reimbursements to certain qualified
medical expenses such as vision, dental, or preventive care benefits.
When are my funds
available?
The full benefit amount that you elect is available at the beginning of
the coverage period, regardless of how much has been contributed at
that point. Once you submit a claim, a review occurs within two
business days, and reimbursement can take as little as three business
days through direct deposit once the claim is approved. Visit
NetBenefits
for more information and instructions on linking your bank
account.
What do I do if I
requested HCFSA funds
in error or a provider
refunds me for an
expense that I paid for
with my HCFSA?
A refund can be submitted via check along with the claim number to
the standard address listed on claim notifications. You can also contact
our call center to have the corresponding claim denied so you can
repay the claim on NetBenefits
. If the provider refunds your
NetBenefits AccessCard® then the account will be repaid, but you may
need to contact the call center if the claim is unresolved. At that point,
we can have the refund applied to that claim.
Frequently Asked Questions
Health Care FSA
How much will I really
save in taxes by
contributing to an
HCFSA?
No payroll or income taxes are withheld from contributions to an FSA.
The amount you may save depends upon:
• The amount you put into your HCFSA
• The tax percentage you would normally pay on that money (tax
bracket)
Let’s say you want $2,000 taken out of your paycheck this year to put
into your HCFSA. The money you direct to your HCFSA is taken out of
your check before taxes are taken out. That reduces your taxable
income by $2,000.
Let’s say you normally pay 30% in federal, Social Security, and state
taxes on your income. In this example, you would have a tax savings of
30% of the $2,000. In other words, you could get an estimated tax
savings of $600 on the $2,000 you directed to your HCFSA
.
What happens if I
terminate employment?
The health care FSA on your NetBenefits AccessCard® will be
deactivated, and you will have a run-out period to submit claims for
eligible expenses incurred while you were still actively employed. Your
employer determines the length of the run-out period. After the run-out
period ends, any remaining funds in your account will be forfeited to
your employer.
Typically, Health Care FSAs can be continued under COBRA. If you wish
to enroll in COBRA coverage for your health care FSA, please contact
your benefits administrator for more information.
Frequently Asked Questions
Health Care FSA
1
For a complete list of health care expenses, see IRS Publication 502.
The NetBenefits AccessCard® is issued by PNC Bank, N.A. and the debit card program is administered by BNY
Mellon Investment Servicing Trust Company. Those entities are not affiliated with each other or with Fidelity. Visa is
a registered trademark of Visa International Service Association, and is used by PNC Bank pursuant to license from
Visa U.S.A. Inc.
Fidelity Workplace Services LLC, 245 Summer Street, Boston, MA 02210
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