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RECEIVING REIMBURSEMENT FROM YOUR HEALTH CARE FLEXIBLE SPENDING ACCOUNT (HCFSA)
You may receive reimbursement from your HCFSA through three (3) different methods:
· File your claims, by mail, directly with UnitedHealthcare, and UnitedHealthcare will mail your reimbursement check to you (or will deposit the reimbursement amount into your bank account, if you have elected to receive reimbursement via direct deposit)
· Use the automatic rollover feature — certain expenses will be submitted to UnitedHealthcare automatically, and UnitedHealthcare will mail your reimbursement check to you (or will deposit the reimbursement amount into your bank account, if you have elected to receive reimbursement via direct deposit)
· Use your UnitedHealthcare Consumer Account Card to pay the service provider directly from your HCFSA at the time you receive the service or product
HCFSA Claim Filing: You must submit your medical and dental claims under your respective coverages (i.e., your Medical Benefit Option, Dental Benefit Option, Prescription Drug Option, Vision Insurance), and those claims must be processed by the claim processor or insurer before you can submit those claims for reimbursement under your HCFSA. File your claims by completing an FSA claim form (available on Jetnet or by requesting the form from UnitedHealthcare), attaching your original receipts and EOBs, and submitting them to UnitedHealthcare).
UnitedHealthcare will process your HCFSA claim and make reimbursement payment to you (either by mailing you a check or by making a direct deposit to your bank account, if you have elected to receive reimbursement via direct deposit).
Automatic Rollover Feature: If you are enrolled in any of the Medical Options offered to employees (other than HMOs), amounts that are not reimbursed under your Medical Option (such as deductibles and your coinsurance amounts or copayments) are, in most cases, automatically submitted to your HCFSA and processed as reimbursements from your HCFSA. Similarly, amounts not reimbursed by the Dental Benefit Option will be automatically forwarded to your HCFSA for reimbursement.
You should stop the Automatic Rollover Feature if:
· You have other coverage. (You should file claims under your secondary coverage before you submit them for reimbursement under the HCFSA.)
· You cover a Domestic Partner under your Medical Benefit Option. You must stop the Automatic Reimbursement Feature to ensure that claims for your Domestic Partner are not automatically paid. (Domestic Partners are not eligible to participate in FSAs.)
· You cover dependents under your health care benefits as the result of a Qualified Medical Child Support Order.
To stop the Automatic Rollover Feature, access UnitedHealthcare's Web site at www.myuhc.com (click on "Manage My Accounts") or call UnitedHealthcare. This must be done annually at the beginning of each year.
Using the UnitedHealthcare Consumer Account Card: Effective January 1, 2005, all FSA enrollees began receiving the UnitedHealthcare Consumer Account Card - this is different than your regular medical ID card. This Consumer Account Card (also referred to as the "FSA Card") carries information about your FSA account(s) (both your HCFSA and your DDFSA, if applicable), including your account balance(s). Your FSA Card can be used at any provider, pharmacy, mail order pharmacy, or other medical provider that accepts MasterCard to pay for certain FSA-eligible expenses at the time and point of service. Each year that you participate in an HCFSA, your existing FSA card will be updated with your selected HCFSA amount, and you need not activate your card unless you are issued a new card (keep in mind that any newly issued/reissued card must be activated after January 1, and you must wait three business days after activating the card before you may use it.) After you've activated your FSA card, each year that your participate in an HCFSA, your FSA Card will be updated ("reloaded") with your selected HCFSA amount, and will be ready for use on January 1 of the year to which your election applies.
When you incur an HCFSA-eligible expense (for example, when you incur expense for a doctor's office visit under the Point-of-Service Option), simply present your FSA Card to the provider. The doctor's office will bill a charge for your $20 or $30 copayment, and run this charge against your FSA Card — the FSA Card will pay your copayment directly from your HCFSA to the doctor's office; thus, you don't have to pay the copayment from your own funds, you don't have to submit the HCFSA claim to the FSA administrator, and you don't have to wait for HCFSA reimbursement. You are not required to use the FSA Card if you prefer to use the automatic rollover feature or file your claims manually. Keep in mind, however, that when you use the FSA Card, the provider of service must bill/run the charge to your FSA Card as credit card, since the FSA Card cannot be assigned a PIN (Personal Identification Number) that is required for debit card transactions.
Any unauthorized transaction (any ineligible HCFSA expense) will be denied at the point of service, and you will be required to pay out of pocket for the portion of the expense that would have been paid by the FSA Card, had the expense been HCFSA-eligible. The card will also be denied at the point of service if the charge exceeds the remaining account balance; however, your HCFSA has the full amount of your elected amount available at the first of the year, as soon as you have made the first deduction from your paycheck.
The following chart outlines which HCFSA-eligible expenses can be paid with the FSA Card, which are subject to automatic rollover, and which must be submitted manually to the FSA administrator: e of Expense
Can You Use FSA Consumer Account Card?
Can You Use Automatic Rollover?
Must You File FSA Claim Manually?
Medical Expenses — Point-of-Service (POS) Medical Option
Copayments, Deductibles, Coinsurance at a UHC network provider
Yes
Yes
No
Deductibles and Coinsurance at an out of network (or non-UHC) provider
No
Yes
No
Retail Prescription Drugs (network pharmacies)
Yes
Yes
No
Mail Order Prescription Drugs (Medco by Mail)
Yes
Yes
No
Medical Expenses — Standard Medical Plans, High Deductible Healthcare Option (HDHO / HDHP)1, Preferred Provider Organization (PPO), Out-of-Area, Reduced Work Schedule (RWS)2, Job Share (JS)3 Medical Options
Deductibles and Coinsurance at a UHC network provider
Yes
Yes
No
Deductibles and Coinsurance at an out of network (or non-UCH) provider
No
Yes
No
Retail Prescription Drugs
No
Yes
No
Mail Order Prescription Drugs (Medco by Mail)
Yes
Yes
No
Medcal Expenses - HMOs
Copayments
Yes
No
No
Coinsurance and Deductibles
No*
No
Yes
Dental Expenses, Including Orthodontia
Coinsurance and Deductibles
No*
Yes
No
Vision Expenses
Copayments, Deductibles and Coinsurance at a Spectera or UHC network provider
Yes
Yes
No
Vision expenses incurred with an out-of-network provider or if you are not enrolled in the Spectera Vision Plan
No
No
Yes
Over-the-Counter (OTC) Drugs purchased Retail or Online
Walgreens — in store purchases only
· Point-of-Service (POS)
Yes
No
No
· Standard Medical Plan or PPO
No
No
Yes
Drugstore.com — online only
Yes
No
No
Any Other FSA-Eligible Expenses Not Filed with your AMR Health Coverages
No
No
Yes
Dependent Day Care
Some providers — check locally
Yes
No
No
1New: Modifications to the 2008 High Deductible Healthcare Option (HDHO) - may also be referred to as the High Deductible Health Plan (HDHP) For the 2007 Plan year, a standard, high deductible medical option was created for OMSS/ARP employees - an option that is compatible with the use of a Health Savings Account (HSA) and is provided at no contribution cost to employees. For 2008, this option is renamed the High Deductible Healthcare Option (HDHO).
2 The Reduced Work Schedule (RWS) Medical Option is available to Officers, Management/Specialists and Support Staff employees.
3 The Job Share Medical Option is available to the Agents/Representatives/Planners workgroup.
*The consumer Account Card (CAC) is designed to work for any United Healthcare (UHC) provider since it is set up through UHC. If your HMO doctor or healthcare provider is in the UHC network, your card may work for these expenses as well. Likewise, if your dentist is in the UHC network (not the MetLife dental network used by the AMR health plan), your card may work for FSA-eligible dental expenses as well. To see if your dentist is a participating UHC dentist, go to www.myuchdental.com and search for Dental Options PPO or check with your dentist. PLEASE NOTE -- this is not the MetLife dental network for the AMR dental plan. This is only an option that may allow you to use your CAC at the dentist, but it may be out of network under your MetLife dental Plan.
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2 ˝ Month Carryover of Unused HCFSA Funds
Effective November 1, 2005, you may carry over into the next calendar year any unused funds remaining in your HCFSA as of December 31 — and you may use these carryover funds to reimburse eligible expenses incurred not only in the year in which the funds were deposited, but also eligible expenses incurred between January 1 and March 15, inclusive, of the following calendar year. For example, if you still have $300 of unused funds in your 2007 HCFSA on December 31, 2007, that $300 can be carried over into 2008, and you have until March 15, 2008 to incur the eligible expense to be reimbursed from this carryover amount of $300. However, you must have incurred the eligible expense on or before March 15, 2008, and you must submit the carryover claim for reimbursement by June 15, 2008. If you use the Consumer Account Card or the automatic rollover feature for eligible expenses, you do not have to submit a separate claim for Grace Period claims.
IMPORTANT— this new June 15 filing deadline applies to BOTH claims submitted for expenses incurred during the year in which you deposited the funds, AND claims incurred during the 2 ˝ carryover period.
If you plan to submit claims for reimbursement of the carryover amount, it will be necessary for you to file such claims with UnitedHealthcare using the special claim form available on Jetnet-UnitedHealthcare's Grace Period Extension form. You cannot use your UnitedHealthcare Consumer Account Card to pay for expenses incurred in the carryover period. Likewise, you cannot use automatic rollover to pay for expenses incurred in the carryover period. If you have questions or need further information, contact HR Employee Services or UnitedHealthcare.
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