FSA Member Guide - HealthEquity

FSA debit card paymentsAfter you have received an invoice from your provider and matched it with anEOB from your health plan, you are ready to make a payment. You can use yourHealthEquity FSA debit card to make payments to your provider(s). This is especiallyconvenient at the pharmacy. Most providers will also accept the card over the phone,online or written-in on the statement for payment. In order for your card to work, youmust have the balance available in your FSA; no overdraft is available. The card willnot work at ATMs and will typically only work at appropriate medical facilities. Thecard should always be run as “credit” and no PIN is required. Lastly, be sure to keepall receipts as documentation of your purchases or upload them to the HealthEquityDocumentation Library in the member portal.Direct payments to providersYou can also use the HealthEquity member portal to setup a direct payment, using ouronline payment tool. We’ll send the payment directly to the provider and include all ofthe information necessary to apply the payment to your bill.Qualified medical expensesQualified medical expenses are designated by the IRS. They include medical, dental, vision and prescription expenses. See IRSpublication 502 for a list of specific examples. Some highlights include: Acupuncture Alcoholism (rehab, transportation formedically advised attendance at AA) Ambulance Amounts not covered under anotherhealth plan Annual physical examination Artificial limbs/teeth Birth control pills/prescriptioncontraceptives Body scans Breast reconstruction surgery followingmastectomy for cancer ChiropractorContact lensesCrutchesDental treatmentsEyeglasses/eye surgeryHearing aidsLong-term care expensesMedicines (prescribed, not imported fromother countries)Nursing home medical careNursing servicesOptometristOrthodontia Oxygen Stop-smoking programs Surgery, other than unnecessary cosmeticsurgery Telephone equipment and repair forhearing-impaired Therapy Transplants Weight-loss program (if prescribed by aphysician for a specific disease) Wheelchairs Wigs (if prescribed)Copyright 2017 HealthEquity, Inc. All rights reserved.Note: Some employers may institute exclusions to this list. Consult with your benefits administrator or call HealthEquity for details.Non-qualified medical expensesYou are not able to use FSA funds for non-qualified medical expenses, and ineligible expenses will be recouped from the memberwhen necessary. Some examples of non-qualified medical expenses include: Concierge servicesDancing lessonsDiaper serviceElective cosmetic surgeryElectrolysis or hair removalFuneral expensesFuture medical care Hair transplants Health club dues Insurance premiums otherthan those explicitly included Medicines and drugs from other countries Nonprescription drugs, medicines (unlessprescribed) Nutritional supplements, unlessrecommended by a medical practitioner astreatment for a specific medical conditiondiagnosed by a physician Teeth whitening9

Helpful support for our members,available every hour of every dayOur team of specialists based in Salt Lake City is available 24 hours a day, providingyou with the tools and information you need to optimize your FSA. They can answerany questions you may have.866.346.580010Copyright 2017 HealthEquity, Inc. All rights reserved.ExpertfriendsCathy, Member ServicesSalt Lake City, UT

Tips to maximizeyour savingsGeneric prescriptionsGeneric prescriptions typically cost 30-80% less than their brand equivalent. Weencourage you to consult your provider about generic prescription options. Yourinsurance plan may offer a prescription pricing tool for comparisons.Urgent care vs. emergency roomA visit to the emergency room can cost three to seven times more than a visit to anurgent care facility that can provide the same treatment. You should consider onlygoing to the emergency room in a potentially life-threatening situation. Furthermore,an appointment made with your primary physician will typically be less expensive thana visit to the urgent care.Optimize your elected FSA amountIf you aren’t contributing at least the amount you spend on health care, you areessentially leaving money on the table for the government. This worksheet may helpyou estimate your election amount as well as your estimated tax savings.Copyright 2017 HealthEquity, Inc. All rights reserved.Estimated annual expensesEligible ExpensesSample estimateAnnual dental plan deductibleDental fillings and crownsOrthodonticsAnnual health plan deductibleChiropractor visitsCounselor or therapist visitsDoctor’s office visitsContact lenses and solutions 100 150 1500 300Your estimated amount 60 30Corrective eye surgeryPrescription sunglasses/glassesEstimated election amount*Estimated expense total: 2,140Your effective tax ratex 0.40 (40%)Savings estimate* 856x*Estimated savings are based on an assumed combined federal and state income tax bracket of 40%. Actual savings will depend on your taxable income and tax status. Thisinformation is intended to be used for FSA education purposes only. You should consult your tax advisor or account consultant regarding you own personal situation and as towhether participating in an FSA is right for you.11

What issubstantiation?What is substantiation?Because FSAs use pre-tax dollars, the IRS requires that all FSA payments be validatedto confirm that funds were used for qualified medical expenses. Substantiation isthe proof that a purchase is eligible, which is confirmed through itemized receipts/invoices/explanations of benefits.When is it needed?Always. Every transaction using FSA dollars must be validated. Some transactionscan be verified automatically, but others may require you to submit documentationor receipts supporting your purchases. Because of this, HealthEquity recommendskeeping an itemized receipt for every debit card purchase you make.Convenient, automatic substantiation CoPay matching – If your employer notifies HealthEquity of your health plancopay amounts, we will attempt to match transactions against those copays.Recurring claims logic – By sending in documentation for the first transaction,any subsequent transactions at the same location for the same amount will notrequire documentation.Claims file matching – if we receive files from your health plan and we can matchthat claim to a card transaction, no additional documentation will be required.You are also able to match a card transaction to a claim if it did not matchautomatically.Where can I use my debit card?IRS rules state that FSA debit cards cannot be used at locations unless the retaileruses a certain type of medical coding. If your pharmacy or provider does not havethese merchant category codes, your debit card may be declined. However, you canstill submit a reimbursement request if purchasing a qualified item or service.12Copyright 2017 HealthEquity, Inc. All rights reserved.Our debit card process allows for auto-substantiation at the point of service in manycases.

Requests for DocumentationCard transactions that are not substantiated at the point of service will trigger acommunication to the member with clear and concise instructions on how to submitsupporting documentation. Please respond to these requests as quickly as possible toensure continued use of your FSA debit card funds.Your documentation type can vary. It can be an itemized receipt, invoice, explanationof benefits or other, but must include the patient name, name of the provider/pharmacy, the service/item purchased, date of the service/transaction, and dollaramount. If used for prescribed over-the-counter items, you must also include aletter of medical necessity detailing the condition being treated, medication type anddosage, and duration of the treatment. Letters of medical necessity must be renewedeach year.Once appropriate documentation is received, it is routed to a HealthEquity teammember for review and approval.Where can I view which transactions still need substantiating?You can view all transactions requiring substantiation by visiting the HealthEquitymember portal. The ‘Debit Cards’ tab on the ‘Reimbursement Account Detail’ pageprovides a complete list of transactions requiring additional documentation, andallows you to upload your receipts directly to the member portal for review.What if I can’t find the required documentation?In cases when a transaction is deemed ineligible or documentation is not provided,members may submit an alternate receipt that has not yet been reimbursed, or apersonal check to reimburse the account.Copyright 2017 HealthEquity, Inc. All rights reserved.Documentation LibraryHealthEquity makes it easy for you to keep track of your documentation and archiveitems for later access. You can upload receipts on our easy-to-use online memberportal. Your files will remain stored in a safe, secure place. You can also see the statusof current substantiation requests online at any time.How to submitsubstantiation:Online:Select the ‘Debit Cards’ tab on the‘Account Detail’ page, located inthe ‘FSA’ menu under the ‘MyAccount’ tab. From here you willbe able to view all transactionsrequiring substantiation and attachyour receipts directly to the claim.Fax:(801) 999-7829 Please include the original requestspecifying which transaction is beingsubstantiated.13

Onlinemember portalIntroduction14Copyright 2017 HealthEquity, Inc. All rights reserved.Your online member portal is a powerful tool that gives you access to all of your accountmanagement features. To access your account, visit www.myHealthEquity.com. Theportal is best experienced using Internet Explorer (8.0 or later) and current versions ofFirefox, Chrome and Safari.

Portal guideUsing the HealthEquity online member portal, you can check your balance, reviewtransactions, view insurance claims, pay providers and submit for reimbursement.Member portal login pageLogging into your member portal is easy. Simply follow the steps below to accessyour HealthEquity FSA.Logging in to your portal the first time:1.2.3.4.5.6.Go to www.myHealthEquity.com, click ‘Begin Now.’ Enter the information requested on the ‘Find your account’ screen. Enter the information asked for on the ‘Verify your identity’ screen.On the ‘Set up your login’ screen: Pick a user/login name of at least six characters with numbers and letterson the ‘Set up your login’ screen. Choose a password of at least eight characters with an uppercase letter, alowercase letter and a number. Follow password creation recommendations as listed in the log in screen. On the ‘Your email settings’ screen, enter your email address. Click the box to agree to the terms of the website and save the agreement.Logging in to your portal after your first login:Copyright 2017 HealthEquity, Inc. All rights reserved.1.2.Go to www.myHealthEquity.com. Log in with the same username and password you created the first time youlogged in.15

Home page dashboardWelcome to the HealthEquity member portal home page. This interactive and dynamic dashboardprovides you with all the information you need to easily manage your health account.MyAccountClaims &PaymentsHelpful tools andinformation tomanage youraccountEasy claims,payments, anddocumentationmanagementDocs &FormsContains accountforms, and taxdocumentsContact UsPersonalized contactinformationMessageCenterImportant remindersand updates fromHealthEquityAccountBalancesView all accountbalances hereShowcaseHighlights importantinformation andlearning opportunitiesQuickLinksOne-click access tothe most commonaccount actionsTo DoListSuggested actionitemsFSA/HRAPlan DetailsBalances and plan detailslocated here for yourreimbursementaccountsResourcesTools and resourcesto maximize healthsavings and overallwellnessDashboard widgetsAccount balanceYour account balance is the first item on the home page dashboard. To view balance details, clickon each type of account to view your transaction history.Quick linksIn a hurry? The ‘Quick Links’ panel expedites common account action items such as makingpayments, requesting reimbursement, and viewing claims. This allows for simplified accountmanagement with one click of the mouse.16Copyright 2017 HealthEquity, Inc. All rights reserved.The home page dashboard gives you quick and easy access to key information and commonaccount actions. This provides for a complete account overview at a glance by using informativewidgets containing your account’s most important details:

FSA/HRA plan infoThere is an FSA widget on your dashboard. Including your current balance andimportant plan dates, click on the links provided for a comprehensive overview of yourreimbursement account(s). If you elect for an HRA in addition to your FSA, an HRAwidget will also be displayed.ResourcesWorking in conjunction with your insurance/employer, the ‘Resources’ widgetdisplays the tools and links you need to become a better consumer of health care, andimprove your overall wellness.To doWith suggested action items, your ‘To Do’ list features helpful reminders andalerts to keep you up to date with your account. The ‘To Do’ list includes importantalerts, any open claims that might require payment, unlinked receipts located in theDocumentation Library (see page 23), and any unread messages in the MessageCenter. Clicking on each item takes you to the page where you can view/resolve anyincidents.Intuitive navigationThe member portal navigation provides a new intuitive and user-friendly interface foreasy, self-service account management. Simply hover your mouse over the tabs toview the complete list of sub-menu options. Clicking on a specific link will take youdirectly to the desired page. For common action items, view the ‘Quick Links’ widgeton the home page dashboard for faster access.Responsive web designCopyright 2017 HealthEquity, Inc. All rights reserved.Customized to all viewing devices, the HealthEquity member portal dashboard isoptimized for desktop, laptop, tablet, and mobile access. Including an ever-presentnavigation bar, your tabs and other helpful features remain visible as you scroll.17

My accountThe ‘My Account’ tab gives you access to information and settings regarding yourflexible spending account.Account balance:From the ‘My Account’ tab, you can review your account balance. Always refer to the‘Available Balance’ for the most accurate account balance.Profile:‘Profile’ is where you can review and edit your profile settings, including personalinformation, login credentials, and system preferences.If you have not done so already, you can add your banking information directlyon the ‘Profile Details’ page for EFT contributions and reimbursements:1. Go to the ‘Account Information’ section.2. Click on the blue ‘Add/Edit’ button under ‘External Accounts.’3. Enter your bank account’s routing number, account number, financialinstitution name and indicate how the account will be used. If solely used for reimbursement, account verification is not required. You can add as many accounts as you would like, however, if you will beadding the same account to multiple accounts (i.e. yours and a spouse’saccount), HealthEquity requires a voided check to be submitted to verifythe account information.FSA:From this menu, you are able to access account details such as current balance,payment history, transactions requiring card substantiation, and important plan dates.Use the drop down to view account details for prebious years.View your monthly statements here at any time. Select a year to view a statement andclick the link to download and print. A document reader that is compatible with AdobeAcrobat’s PDF format is required to view all account statements. You are able todownload Adobe Reader by clicking the icon on this page.Manage cards:The ‘Card Manager’ page allows you to view and activate cards from the memberportal. To request additional cards or to report your card lost or stolen, contactMember Services (additional fees may apply).18Copyright 2017 HealthEquity, Inc. All rights reserved.Statements:

Add individuals:‘Add Individuals’ will allow you to add dependents to your account, and to authorizeany users you would like to have access to your account information.‘Authorized Account Users’ lists those associated with your account. For anyoneother than the primary account holder to receive specific account information over thephone, the primary account holder must first authorize them. An authorization form islocated under the ‘Docs & Forms’ tab.Insurance information:Copyright 2017 HealthEquity, Inc. All rights reserved.Insurance Information contains specific insurance information like provider, policynumber, coverage type, deductible, and employer, when available. If your informationis not listed here, contact your insurance company for specific coverage details.19

Claims & paymentsClaims:Occasionally you might receive an email notification of a new claim received for youor one of your dependents. This is usually due to the fact that your health insurancehas chosen to integrate with HealthEquity, meaning that when your doctors andpharmacies bill your insurance company, the insurance sends a copy of that claim toHealthEquity. Each claim listed gives you a breakdown of services, what was appliedto your deductible, and the estimated patient responsibility.20Copyright 2017 HealthEquity, Inc. All rights reserved.When your insurance pays the expense, the claim will display in the HealthEquitymember portal as “Closed.” When the insurance shows that there is a patientresponsibility, HealthEquity’s system will give you the option to ‘Pay Provider,’‘Reimburse Me,’ or ‘Close Expense.’ Selecting ‘Pay Provider’ will issue a paymentdirectly to the provider from your HealthEquity account. If you pay out-of-pocket forthat expense, you can use your HealthEquity funds to reimburse yourself by clicking‘Reimburse Me.’ If you paid the provider with your HealthEquity debit card, or do notwant to use your HealthEquity funds to pay that expense, simply click ‘Close Expense.’

To view/pay a claim:1. Go to the ‘View Claims’ page located under the ‘Claims & Payments’ tab.2. To send a check to a provider or reimburse yourself for expenses you paidout-of-pocket, select the action buttons that accompany open claims. Provider information is usually included on claims sent to us by yourinsurance, but we recommend verifying the address before submittingfor payment. If you pay with your HealthEquity debit card, the payment status of theclaim will not update automatically on the ‘View Claims’ page; you canmanually match the transaction to the claim by following the promptswhen clicking ‘Close Expense.’Claims marked as ‘Private’You may see claims in the member portal that are marked ‘Private.’ HealthEquity protects personal health informationand does not display details of claims for any dependent without their consent. To access ‘Private’ claim information,a Dependent Privacy Access form must be completed by your dependent(s) and submitted to HealthEquity. Forms areavailable under the ‘Docs & Forms’ tab in the HealthEquity member portal.Copyright 2017 HealthEquity, Inc. All rights reserved.Pay doctor/provider:The ‘Pay Doctor/Provider’ page allows you to make payments to your provider forexpenses incurred for procedures performed. To pay your provider, simply:1. From the ‘Claims & Payments’ tab, select ‘Pay doctor/provider.’2. Select to have the funds come out of your FSA and then select ‘Enter claimrecord and send payment’ before clicking ‘Next.’3. Select ‘Pay Provider’ to send payment directly to a provider.4. Choose to enter new expense or select an existing expense if HealthEquity hasreceived claim information from your insurance. Clicking ‘New’ will allow you to enter specif

Activate your debit card Upon the creation of your FSA, you will receive a member welcome kit which may include a HealthEquity FSA debit card*. Card activation instructions are included with the card. If you would like, you can speak to one of our “expert friends” to activate your card and receive additio