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Health FSA Guidelines

Guidelines for Using Your Health FSA

Your Health Flexible Spending Account is a reimbursement account offered by your employer as part of your benefits package. Enrolling in a Health FSA plan saves you money. It allows you to use pre-tax dollars toward eligible Health FSA expenses that are not covered by your health, vision, or dental plan.

Participation in a Health FSA is your choice. If you decide to enroll, you must satisfy any FSA eligibility requirements set up by your employer. The complete rules and regulations for your plan are available in the plan's Summary Plan Description (SPD).

IRS Regulations

Health FSAs are regulated by IRS rules for FSA plans. Some rules are specific to a Health FSA and do not apply to a DepCare FSA.

IMPORTANT: Please review the following information so you are aware of the rules that apply to your Health FSA. Use the links below to navigate to a specific section. 

Eligible Health FSA Expenses
Your FSA Election
Reimbursement Requests
Reimbursement Deadlines
Supporting Documentation
Submitting Reimbursement Requests
Change in Status Events
Additional Health FSA Features
COBRA Elections

Eligible Health FSA Expenses

Only eligible expenses can be reimbursed under the FSA. These expenses are defined by Internal Revenue Code § 213(d) and your employer's plan.

Generally, eligible expenses include items that are meant to diagnose, cure, mitigate, treat, or prevent illness or disease. This also includes transportation for medical care. However, expenses such as cosmetic surgery, insurance premiums, vitamins, and items for general well-being are not eligible expenses.

Over-the-counter (OTC) medicines and drugs require a prescription to be an eligible Health FSA expense. You must obtain a written or electronic prescription from a doctor (or another individual who can legally issue a prescription) in the state in which you purchase the OTC medicines.

Health care expenses are incurred when you (or your spouse or dependents) are provided with medical care - not when you are formally billed, charged for, or pay for the medical care.

Only qualified "out-of-pocket" expenses are eligible for reimbursement. Expenses previously reimbursed by your Health FSA or covered by any other plan or program are not eligible for reimbursement. There's no "double-dipping" allowed.

Expenses reimbursed under your Health FSA may not be used to claim any federal income tax deduction or credit.

Need more information or expense examples? Go to our Health FSA Eligible Expenses page.

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Your FSA Election

The election is your contribution amount - the amount that you put into your Health FSA when you enroll. Your employer determines the minimum (if any) and maximum election amounts for your plan.

Health FSAs are unique. Your annual Health FSA election is available on the first day of the FSA plan year. But your total FSA election amount is deducted from your paycheck in equal amounts throughout the year. You can use your Health FSA funds anytime during the plan year - as long as funds remain in your account.

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Reimbursement Requests

A Request for Reimbursement Form is used to submit a reimbursement claim. The expenses listed must be incurred by you, your spouse, or dependent during the coverage period and the dates noted on the reimbursement form.

After you complete the Request for Reimbursement Form, submit it to CONEXIS along with appropriate supporting documentation.

Reimbursement Deadlines

  • Participants have until December 31 to incur eligible expenses for reimbursement from current plan year funds.
  • The plan has a run-out period, which provides additional time to submit eligible expenses incurred during the prior plan year. The run-out period is January 1 to April 15 of the following plan year.
  • The deadline to file claims for expenses is April 15 of the following plan year.
  • After the April 15 deadline, unused funds up to $500 will be carried over to the following plan year and will be available for reimbursement in early May*. Please note: Unused funds greater than $500 will be forfeited.

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Supporting Documentation

  • For office visits and other services: Your health plan's Explanation of Benefits (EOB) statement or an itemized receipt or bill from the provider that includes the patient's name, a description of the service, the original date of service and your portion of the charge.
  • For prescription drugs: A pharmacy statement or receipt from your pharmacy including the patient's name, the Rx number, the name of the drug, the date the prescription was filled, and the amount.
  • For over-the-counter medicines: A written or electronic OTC prescription along with an itemized cash register receipt that includes the merchant name, name of the OTC medicine or drug, purchase date, and amount, OR a printed pharmacy statement or receipt from a pharmacy that includes the patient's name, the Rx number, the date the prescription was filled, and the amount.
  • For over-the-counter health care-related products: An itemized cash register receipt with the merchant name, name of the item/product, date, and amount.
  • For dual-purpose items or programs: A Medical Determination Form that has been completed by a doctor is required for dual-purpose items or programs that have both a medical purpose and a general health, personal, or cosmetic purpose. See specific details for each dual-purpose item or program in our eligible expenses list. The Medical Determination Form is available online through your personal CONEXIS account.

Credit card receipts, canceled checks, and balance forward statements do not meet the requirements for acceptable documentation.

For some expenses, a Medical Determination Form from a doctor may be required. See our Eligible Health FSA Expenses page. Find a Request for Reimbursement Form and a Medical Determination Form by logging in to your online account.

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Submitting Reimbursement Requests

You can submit your reimbursement requests several ways.

  • MyCONEXIS app: The easiest way to submit a reimbursement request is by using your smartphone or tablet. Simply use the app to provide claim details and then take or upload a photo of your supporting documentation. You'll have your claim submitted in a matter of moments.
    • Download MyCONEXIS app from the App StoreSM
    • Download MyCONEXIS app from Google PlayTM
  • Online: Log in to your online account, download and complete a reimbursement form, and then upload your supporting documentation. You will need access to a scanner to do this.
  • Fax: Submit your completed reimbursement form and supporting documentation using the fax number listed on the form.
  • Mail: Send in your completed reimbursement form and copies of your supporting documentation using the address noted on your form.

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Change in Status Events

Your election cannot be changed during the plan year, unless you experience a qualifying change in status event based on IRS regulations, such as:

  • A change in legal marital status (marriage, divorce or death of your spouse)
  • A change in the number of your dependents (birth or adoption of a child, or death of a dependent)
  • A change in employment status of you, your spouse or dependent
  • An event causing your dependent to satisfy or cease to satisfy an eligibility requirement for benefits

Your requested change must be due to and consistent with the event. For example, you may increase your FSA election after the birth or adoption of a child.

For more information regarding eligible status change events under your plan, see your Summary Plan Description (SPD).

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Additional Health FSA Features

Your FSA plan includes the features below that can help you take full advantage of your FSA dollars.

Health FSA Carryover

With a carryover, you do not have to rush to spend all of your health FSA funds or worry about losing money when the plan year ends. As long as you are an active employee and eligible to participate in the UC Health FSA plan, you may carry over the maximum amount allowed by the plan - that's $500. If you plan to re-enroll for the following year, there is no minimum carryover balance required and you can spend your carryover dollars until the account funds are gone. However, if you do not re-enroll in the health FSA, you must have at least $25 from the prior plan year in your account at the end of the run-out period (April 15 of the next plan year) to be able to carry over funds to the next plan year. Funds under $25 are forfeited. You may only carry over funds for one plan year.

Example: Let's say you have a $300 carryover balance from the previous plan year. After your current plan year ends, your account has $300 of unused funds plus the $300 carryover amount from the previous plan year - a total of $600. Since the health FSA plan has a $500 carryover limit, you may only carry over $500 to the next plan year, and you forfeit the remaining $100.

Keep this feature in mind when estimating your health FSA election. Even if your plan has a carryover feature, the IRS "use-it-or-lose-it" rule still applies. You will lose the funds remaining in your health FSA after the carryover is applied after the run-out period ends (see below).

Important: IRS rules do not allow a health FSA to have both the carryover feature and a grace period extension. Plus, a dependent care FSA may not have a carryover.

Run-out Period

A run-out period is a pre-determined time frame after the plan year ends that lasts from January 1 to April 15. During this time frame, you may file health FSA claims for expenses incurred during the plan year.

Example: On December 31, your plan year ends, but your FSA has a run-out period. When the next plan year begins on January 1, you have until April 15 to submit claims incurred during the previous plan year.

IRS rules state that when the run-out period is over, you forfeit any unused FSA dollars after the carryover funds have been deducted from your account.

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COBRA Elections

You may be entitled to elect COBRA continuation coverage under the Health FSA and receive reimbursement for qualified expenses incurred after your termination if you continue to make your required contributions on a post-tax basis. However, you generally do not have the right to elect COBRA if the cost of continuation coverage for the remainder of the plan year equals or exceeds your remaining account balance. Please see your Summary Plan Description (SPD) for specific rules governing your plan.

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IMPORTANT: The information on this website provides basic information regarding participation in your employer's FSA plan. Our site does not contain all of the rules that are specific to governing your employer's plan. For complete rules and plan information, review your plan's Summary Plan Description (SPD).

* If you choose to re-enroll the Health FSA for the following plan year, there is no minimum balance requirement and you will be enrolled in the carryover if any funds are available. However, if you do not re-enroll in the Health FSA, you must have at least $25 from the prior plan year in your account at the end of the run-out period to be enrolled in the carryover plan and will only be allowed to carry over funds for one year.

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