Health Care

What is a Health Care Flexible Spending Account (FSA)?
A Health Care FSA is an employer-sponsored benefit that allows you to set aside money from your paycheck on a PRE-TAX basis to pay for certain out-of-pocket health care expenses for you and your eligible dependents.

How do I benefit from using pre-tax dollars to pay for out-of-pocket expenses?
FSA contributions and reimbursements are exempt from federal income taxes, Social Security (FICA) taxes, and in most cases, state income taxes. Depending on your tax bracket, you can expect savings between 20% and 40% on your elected amount.

How much should I contribute to my FSA?
Look at last year’s out-of-pocket health care expenses to get the best idea. For additional help estimating your expenses, use the FSA savings calculator found in the Tools and Resources section of our website.

Can I change the amount of my election during the plan year?
You may only change your Health Care FSA election during the plan year if the requested change is due to and consistent with a qualifying event such as change in marital status, change in dependent status, or change in employment status.

Do I have to be enrolled in my employer’s health plan to participate in the FSA?
You may enroll in your employer’s FSA plan even if you receive health care insurance through your spouse’s employer. You may use your FSA for eligible expenses for all of your qualified dependents, including your spouse.

 

Dependent Care

What is a Dependent Care Flexible Spending Account (DCA)?
A DCA is an employer-sponsored benefit that allows you to set aside money from your paycheck on a PRE-TAX basis to pay for daycare expenses for your eligible dependents.

Can I use both the Dependent Care Flexible Spending Account and the Federal Dependent Care Tax Credit?
Expenses reimbursed from a Dependent Care Flexible Spending Account reduce the amount you can claim under the federal Dependent Care tax credit. You will have to determine which approach is best for you.

Am I eligible to participate in the Dependent Care Flexible Spending Account?
To be eligible, you (and your spouse, if married) must work, be looking for work or attend school full-time.

Who is an eligible dependent for the Dependent Care Account?
An eligible dependent is someone who spends at least eight hours a day in your home and is one of the following:

• A child under the age of 13 for whom you can claim as an exemption for income tax purposes.
• A dependent under the age of 13 for whom you have custody for more than half of the year if you are divorced or legally separated.
• A dependent that is physically or mentally incapable of self-care (regardless of age).
• Your spouse who is physically or mentally incapable of self-care.

Are there limits to what I can contribute to the Dependent Care Flexible Spending Account?
Yes, the IRS limits your deferrals to $5,000 each plan year (or $2,500 if married, filing a separate tax return). Your total contributions cannot be more than your earned income or your spouse’s earned income, whichever is less.

What expenses are eligible for reimbursement under the Dependent Care Flexible Spending Account?
The following are eligible expenses:

• Nursery care
• Pre-school
• Before-school and/or after-school care
• Day camp

What expenses are not eligible for reimbursement under the Dependent Care Flexible Spending Account?
The following expenses are not eligible:

• Dependent health care expenses
• Dependent care for children age 13 or older (unless disabled)
• Overnight camp
• Babysitting that is not work-related
• School costs for kindergarten and higher grades (e.g., tuition for private schools)
• Long-term care services (e.g., nursing homes)

Transportation Accounts

What are “Transportation Benefits”?
Transportation Benefits are reimbursements for eligible Transportation Expenses. You contribute a certain amount of your salary to the Transportation Plan on a pre-tax basis.   Your federal income and employment taxes are lower because your overall salary is lower, and the amount you are contributing is not subject to taxes.

What types of expenses are eligible for reimbursement?

• You incur eligible Transit Pass Expenses when you purchase passes, tokens, fare cards, vouchers, or similar items for transportation on mass transit facilities (such as trains, buses, subways or ferries). Such facilities may be publicly or privately owned, but must have seating capacity for at least six adults, not including the operator.
• You incur eligible Commuter Highway Vehicle (Vanpool) expenses for transportation that takes place between your residence and your place of employment. Such transportation must occur in a Commuter Highway Vehicle, which is any vehicle that has a seating capacity of at least six adults (not including the driver) and for which at least 80% of the mileage for a year is used in connection with travel between your home and your job. During these trips, half of the seats must be occupied (not including the driver).
• You incur eligible Commuter Parking Expenses when you park at or near your regular place of employment or when you park your car at a location from which you commute to your regular place of employment by carpool, Commuter Highway Vehicle, or mass transit.

*Reimbursable up to the monthly statutory or plan limit

What expenses are not reimbursable??
Non-work related parking expenses and parking expenses for your spouse or dependents are not reimbursable.

What do I have to do to be reimbursed for Transportation Expenses?
For the fastest turnaround, use Online Claims Submission (OCS). Fill out the required form and list all necessary information. Once your claim is completed, print the Substantiation Cover Sheet, attach your receipts, and fax both to UPMC Health Plan.

You also may submit a claim manually by downloading the appropriate claim form. Complete the claim form, attach your receipts, and either fax, email, or send the information in the mail. UPMC Health Plan will review your claim and send your reimbursement via check or direct deposit (if available).

What amounts are available for reimbursement during a Period of Coverage?
The amount available for reimbursement of Transportation Expenses is only as great as your available balance at the time the claim is paid. You can check your balance online by logging in to your account. Information is available on the Web 24 hours a day/7 days a week. If you are unable to log in to your account, contact Member Services at 1-888-876-2756.

What if I overestimate my Transportation Expenses?
If your reimbursement request was for less than your current Transportation Account balance, the unused amounts in your Transportation Account will roll over and be available for future reimbursements, so long as you continue to participate in the Plan. You may need to adjust the election for the next monthly Period of Coverage in order to use up your surplus Transportation Account balance.

MyFlex Advantage card

What is the MyFlex Advantage card?
It is a special purpose MasterCard® that provides instant access to the funds in your Flexible Spending Accounts. The card allows you to pay for eligible products and services at the point of sale without submitting a claim form and waiting for reimbursement.

What type of expenses can I pay for with the card?
Eligible expenses may include co-payments, deductibles, and prescription drugs, just to name a few.

Do I need to submit a claim form when I use my MyFlex Advantage card?
No. When you use the card to pay for eligible expenses, there is no need to submit a claim form. The merchant or provider has been paid and the transaction amount has been deducted from your account. However, you may be required to confirm the eligibility of the benefits card purchases to comply with IRS rules. Please keep all your itemized receipts and be prepared to provide them if you are requested to do so. With the MyFlex Advantage plan, most Receipt Notification Requests are eliminated.

Why should I participate in MyFlex Advantage?

• Save 20% to 40% on the cost of health care expenses by contributing a portion of your payroll dollars into your FSA on a pre-tax basis.
• The MyFlex Advantage card provides you with the convenience of paying for health care expenses at the point-of-sale without paying out-of-pocket.
• MyFlex Advantage enables a high percentage of transactions to be approved without the need to submit receipts.
• UPMC Health Plan members and FSA participants receive a combination Member ID and MyFlex Advantage card.
• 24/7 online account access.
• Online Claim Submission (OCS) allows for faster processing of your claims.
• Highly knowledgeable Member Services staff to answer all of your Health Care and MyFlex Advantage questions.