smart, simple savings · • eligible health care expenses such as co-pays, prescriptions, vision...

Copyright 2012 PayFlex Confidential

Smart,

simple savings

Flexible Spending AccountsHealth Care

Dependent Care

The University of Tennessee

Plan Year: January 1 – December 31


What will be covered?

• PayFlex® and HealthHub®

• Flexible Spending Accounts

• Online Enrollment

• PayFlex Card®

• Getting reimbursed

• HealthHub.com

• PayFlex Mobile™

• Transition to PayFlex

• Your connection to HealthHub


About PayFlex® & HealthHub®

• PayFlex is your administrator for Flexible Spending Accounts.

• PayFlex processes your claims and provides you with customer service

support.

• More than 25 years of experience in administering reimbursement

accounts.

• HealthHub is PayFlex’s brand name for all our products and services.

• HealthHub.com is your resource to:

• View your account information

• Submit claims for reimbursement

• View claim and card transaction history

• And more!


What is an FSA?

• An FSA is a Flexible Spending Account.

• There are two types of FSAs:

• Health Care account

• Dependent Care account

• Let’s you pay for eligible expenses with pre-tax dollars

• You contribute to an FSA with pre-tax money from your paycheck

• You do not pay Federal income or Social Security taxes on this money

Why should you enroll in an FSA? You could save up to 30% in what you pay for taxes.

Annual SalaryHealth Care FSA

Annual Contribution

Dependent Care FSA

Annual ContributionSavings

$30,000 $1,500 $0 $310

$50,000 $1,750 $4,000 $1,188

$70,000 $2,000 $4,500 $1,343

At HealthHub.com, find out how much you can save by using the Savings Calculator and Dependent Care Tax Wizard!


Health Care FSA

Annual minimum contribution Annual maximum contribution

$120 $2,500

• Helps you pay for eligible medical, dental, prescription, vision and/or

hearing expenses that are not covered by insurance.

• The individuals allowed to use your health care FSA contribution

generally includes:

• Your spouse

• Your child to age 26 (dependent may turn 26 during plan year)

• Your dependent who is permanently and totally disabled.

• Your entire contribution is available at the beginning of the plan year.

• The Health Care FSA maximum for 2013 will be $2,500, due to

health care legislation.


Health Care expenses

Eligible expenses:• Medical & dental deductibles, co-pays and co-

insurance

• Prescriptions

• Over-the-counter items (OTC)

• As of 1/1/2011 - OTC drugs & medicines require Rx

• Hospital expenses

• Selected durable medical equipment

• Orthopedic devices

• LASIK surgery, eye glasses, contact lenses

• Saline/clean solutions

• Hearing aids and batteries

• Bridges, dentures, crowns, orthodontic care

• Chiropractic expenses/co-pays

• Insulin, syringes for insulin

Ineligible expenses:• Anti-bacterial soaps

• Dandruff or dry skin treatments

• Teeth bleaching or mouthwash

• Suntan/sunscreen lotion

• Cosmetic surgery

• Dietary & herbal supplements

• Child birth classes

*A letter of medical necessity may allow

some of these expenses to be eligible

View a detailed listing of eligible expenses at HealthHub.com


Dependent Care FSA

Annual minimum contribution Annual maximum contribution

$120 $5,000

• Helps you pay for child or adult care costs.

• You and your spouse, if married must be actively working, seeking

employment, or full-time student, in order to get reimbursed.

• The cost of care must be for your child under age 13 or for a spouse or

dependent who is not able to take care of him or herself.

• You can only be reimbursed up to the amount that is available in your

account.

• If married and both individuals are enrolled in a dependent care FSA,

the combined IRS maximum contribution remains at $5,000.

For example: Each individual could elect $2,500 for their dependent

care FSA.


Dependent Care expenses

Eligible expenses: • Licensed day care provider

• In-home provider as long as the provider is not your child

under age 19, or someone you claim as a tax dependent

• Summer camps (not overnight)

• Tuition through preschool

• Before and after school care (under age 13)

Ineligible expenses: • Tuition expenses for kindergarten and beyond

• Overnight camps

• Child care expenses for a child 13 or older (unless

disabled)

• Child care expenses for night-time babysitting

• Child care expenses while you are on an extended leave

of absence

• Care provided by an older dependent or sibling

View a detailed listing of eligible

expenses at HealthHub.com


Things to remember…• You can enroll in an FSA during the annual enrollment period.

• You can also enroll when you first become eligible.

• Once you enroll, you may only change your election if you have a change in status

(i.e., birth, death, marriage, divorce, change in day care provider).

• You and/or your spouse do not need to be covered by your employers health plan to

participate in an FSA.

• Expenses must be for services received, not for services to be provided in the future.

• Your employer offers the grace period, which allows you additional time to spend

your money. (2 ½ months)

• Your employer also offers a run-out period, which allows you additional time to

submit claims for reimbursement. (90 days)

• FSAs have a use-it-or-lose-it rule. If you have funds left in your FSA at the end of the

plan year you will lose them.

Plan YearGrace Period - last day to spend

FSA dollars

Run-out period - last day to submit

claims

1/1/2013 – 12/31/2013 March 15, 2014 March 31, 2014


Getting started is easy with HealthHub®!Review your expenses from the prior plan year. Use our online planning & education tools.

• My HealthHub resources – education materials, planning tools, forms and IRS publications

• Eligible expense items – general list of eligible health care and dependent care expenses

• Savings calculator – estimate your health care and dependent care expenses

• Frequently asked questions – helps you understand your FSA

• Digital library – helps you understand FSAs and the PayFlex Card®

Once you know how much you want to contribute for the year, you can figure out how much will be

deducted each pay period. Divide your annual contribution by the number of pay periods you have

(e.g., 12, 24, or 26).


FSA Online Enrollment: 10/1 – 11/1Login to HealthHub.com, click on Online Enrollment under Quick Links.


Select accountThe accounts available to you will be displayed. Check the box for the account(s) you wish to

enroll in. If you do not wish to enroll in a particular account, do not check the box.


Enter per-pay deduction amountEnter the amount you want to deduct from your paycheck each pay period. Your annual

election will calculate automatically. Click on Save My Elections.


Confirm

EnrollmentThis page will show:

• The account(s) you have selected

to enroll in

• Your per pay deduction(s)

• Your annual election(s)

• Terms and Conditions

To complete the enrollment

process, you’ll need to review

and accept these Terms and

Conditions. If you agree, click

Submit.


Enrollment confirmation pageA confirmation screen will show the account(s) you have enrolled in. You will also receive an

e-mail if you have signed up to receive electronic notifications from PayFlex.

Using your

FSA dollars


PayFlex Card®

Spending made simple. Select. Swipe. Save.

What is the PayFlex Card?

It is similar to a debit card. You use it to pay for eligible expenses. Generally all you

need to is swipe your card and save your receipt.

Benefits of using the card

• Immediate payment from your account

• Increases your personal cash flow

• No claim filing

• Ease of use

Where can I use the card?

• Physician and dentist offices, vision care providers, and hospitals

• Grocery stores, discount stores, web-based merchants

• Drug stores and retail pharmacies who have implemented an IRS-approved system

• Dependent care providers accepting MasterCard®

*Merchants must accept MasterCard® in order for the card to work


PayFlex Card®

Spending made simple. Select. Swipe. Save.

What can I purchase with the card? • Eligible health care expenses such as co-pays, prescriptions, vision and hearing products

and certain over-the-counter (OTC) items.

• Eligible dependent care expenses such as before- and after-school programs, day care,

summer day camps, adult care, etc.

Things to remember…

• Save all receipts and Explanation of Benefits in case documentation is requested by PayFlex or

the IRS.

• If you enroll in an FSA, you will receive a PayFlex Card via mail in a plain, white envelope before

the beginning of the plan year.

• Select “credit” when you use your card. There is no PIN number.

• View your account balance, card transaction history and any outstanding card transactions

requiring documentation online at HealthHub.com


Substantiating your card transactionsAccording to IRS guidelines, PayFlex is required to verify that all purchases made with your

PayFlex Card® are eligible expenses.

• During the plan year, you may receive a Request for Documentation letter OR see an alert

on HealthHub.com that states you have a claim requiring substantiation.

• If you receive a letter, you must respond to keep your PayFlex Card ACTIVE.

• If you see an alert on HealthHub.com, click on “Learn More” and upload your

documentation

Common reasons when documentation may be required:

• The amount of the expense does not match your co-pay.

• The merchant description provided to PayFlex from the card swipe does not clarify the type

of expense. This generally occurs with dental or hospital expenses.


How to keep your card activeIf you see an alert message or receive a Request for Documentation letter, you have

three options for substantiating your card transactions.

Option 1: Send us the documentation for the expense.

Upload, fax or mail an Explanation of Benefits (EOB) or itemized receipt for

the expense(s) listed in the letter or displayed online.

Option 2: Send us another expense.

Upload, fax or mail an EOB or receipt for another eligible expense. The

amount must be equal to or great than the amount in question.

Option 3: Pay back your account for the amount in question.

Send a personal check or money order to PayFlex to cover the amount.

Note:

• If you do not respond, we will suspend your card.

• Once we receive and process your documentation or payment, your card will be

active again.


Getting reimbursedIf you choose not to use your PayFlex Card®, you can:

1. Submit a claim online at HealthHub.com (Pay Me or Pay Them) • Pay Me – reimburse yourself for out-of-pocket expenses

• Pay Them – pay your provider directly

2. Submit a claim through the PayFlex Mobile app

3. Complete a claim form and fax to PayFlex

4. Complete a claim form and mail to PayFlex

Quick Tips:• An Explanation of Benefits (EOB) or itemized receipt must be sent with your claim form

• Your EOB or receipt must include:• the amount you owe

• name of merchant/service provider

• date of service

• service/item received

• name of patient (if applicable)

• Receive quick reimbursements by enrolling in direct deposit online.

• Download a claim form online in My HealthHub Resources.

• View your claim history and payments online at HealthHub.com.


How to file a claim Log in to HealthHub.com. Click on File a Claim under Quick Links. Enter your expense type, date of

purchase and amount. UPLOAD or FAX or your documentation.

To fax or mail a claim, download & print a claim form

via My HealthHub Resources.


HealthHub Participant WebsiteGo to HealthHub.com. Click on Employee Account Login. Click on Register Now.

Note: You do not need to login to access the top navigation links.

Top Navigation Links

• Legislative news – important legislative updates regarding

your account

• My HealthHub resources – education materials, planning

tools, forms and IRS publications

• Eligible expense items – listing of eligible health care and

dependent day care expenses

• Savings calculator – A calculator to help you estimate your

annual expenses and potential savings

• Frequently asked questions – key information to help you

understand your PayFlex account(s)

• Digital library – engaging videos to learn more about FSAs

and the PayFlex Card®


Registering your accountEnter your personnel number (without leading zeros) and enter your home zip code.

Enter your personnel number (without

leading zeros) as the Member ID.


Create your online profileOnce you click Confirm, you can access your account information.


My DashboardAfter successfully registering your account,

you can do the following:

• View your account balance(s)

• Submit a claim for reimbursement

• Enroll in direct deposit

• View any upcoming payments for claims

submitted

• View your claim history & card transactions

• View card status and order additional cards

• View any outstanding card transactions

requiring documentation

• Print claim forms & educational materials

• Enroll in eNotify to receive important account

notifications

• Shop online with your FSA dollars

• View legislative updates and important

HealthHub news

• View frequently asked questions

• Access wellness videos, tips & recipes


My SettingsStay up to date on your account.

Click on My Settings and select

Notifications / Email Address.

eNotify via email Reimbursement Account

• Balance Reminder (weekly/monthly)

• Claim Received

• Explanation of Benefits

Debit Card

• Card Declined

• Card Documentation Processed

• Card Inactivated

• Receipt Request Letter

eNotify via web alertsReimbursement Account

• Claim Received

Debit Card

• Card Declined

• Card Documentation Processed


PayFlex Mobile™Keeping you connected for FREE!Available for iPhone®, BlackBerry® and Android™ smartphones

Getting Started with PayFlex Mobile

1. Register your account online at

HealthHub.com to create a username and

password.

2. To download the app, access your phone’s

app store and select PayFlex Mobile.

3. To use the app, login to your account using

your HealthHub username and password.

Features & Benefits

Account AlertsReceive notifications related to account status and actions needed

to keep your account active.

Account ActivityAccess real-time account information including account balances,

claims processed and transaction details.

Claims SubmissionSubmit claims for reimbursement and even substantiate a debit card

transaction.

Benefit Plan DetailsStore important health plan information and view a list of typical

eligible expenses.

Who to contact for assistance

Downloading issues – contact your phone carrier directly for assistance.

All other issues – contact PayFlex Customer Service at 800-284-4885.


Transition to PayFlex

Deadline How it affects you What you should do

1/2/2013First day to submit 2013 plan year

claims to PayFlex

You can use the PayFlex Card, submit claims

online at HealthHub.com or submit paper

claims to PayFlex.

3/15/2013Last day to incur 2012 plan year

expensesNo action necessary.

4/30/2013Last day to submit 2012 plan year

expenses

Submit all claims for the 2012 plan year to the

University of Tennessee Payroll Office using

current claim forms available at

flexiblebenefits.tennessee.edu

5/14/2012 BW

5/31/2012 Monthly

Last payday to receive 2012 plan

year reimbursements on University

of Tennessee payroll.

No action necessary after you have turned in

claims forms and supporting documentation to

the University of Tennessee Payroll Office.

2012 claimsComplete the University’s claim form available at http://flexiblebenefits.tennessee.edu/claims.htm

print, sign and submit with your supporting documentation to the UWA Payroll Office.

2013 claimsSubmit a claim online at HealthHub.com or complete a paper claim a mail or fax to PayFlex


Your connection to HealthHub®

Customer Service

Phone: 800.284.4885

Hours: Monday – Friday, 7am - 7pm CT

Saturday, 9am - 2pm CT

Submit a Claim

Online: Log in to www.HealthHub.com > select File a Claim

Fax: 402.231.4310

Mail: PayFlex Systems USA, Inc.

P.O. Box 3039

Omaha, NE 68103

smart, simple savings · • eligible health care expenses such as co-pays, prescriptions, vision...

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