Flexible Spending Accounts

Enroll in a Flexible Spending Account to save on taxes for eligible health care and dependent day care expenses! 

You elect an annual amount to contribute to your account.  Your contributions:

  • are made by payroll deduction
  • are pre-tax, and
  • are taken out of your paycheck in equal amounts over the course of the year

 The 石榴直播 Flexible Spending Accounts are provided by HSA Bank.

HSA Bank will provide a Debit Card to participants in the Health Care, Limited Purpose and Dependent Accounts.  The Debit card can be used at medical and dental offices, hospitals, healthcare clinics and pharmacies and at child day care centers that accept MasterCard as a form of payment.  Always keep your receipt!  Documentation may be required in some instances to substantiate the eligibility of a Debit Card purchase.  To request a new card or to replace a lost or stolen card, call 1-877-470-1771.

For information on eligible expenses and how the plans work, visit the HSA Bank website at: 

Health Savings Accounts

A Health Savings Account (HSA) is a medical savings account governed by federal law that allows you to contribute pre-tax payroll dollars to an account to use towards future out-of-pocket medical expenses.
 

  • To be eligible to contribute to an HSA, you must meet IRS guidelines.  In general, the IRS eligibility rules surrounding HSAs include the following:

    1. You must be enrolled in a qualified High Deductible Health Plan; the Anthem BCBS Consumer Choice HSA plan qualifies as a High Deductible Health plan under this rule;
    2. You cannnot be covered by any other health insurance that reimburses for health expenses, unless it is another HSA-qualified HDHP.  Employees with coverage under two HSA-qualified HDHPs do not get to double their HSA contribution;
    3. Enrollment in other traditional Flexible Spending Accounts (FSAs) and Health Reimbursement Arrangements (HRAs) may make you ineligible for an HSA;
    4. Employees who are enrolled in Medicare or Medicaid cannot open an HSA.

    For complete information about eligiblity, please visit the .

    The amount you are eligible to contribute to an HSA is determined by:

    1. The number of months you are covered under the High Deductible Health Plan and by the type of coverage you have on December 1st; and
    2. The maximum amount allowed by the IRS. Individuals age 55 and older can make additional 鈥渃atch-up鈥� contribution of $1,000.  The employer matching contribution made on your behalf will be included in these limits.

    If you enroll in the Anthem BCBS Consumer Choice HSA High Deductible Health Plan and contribute to an HSA, you are not allowed to contribute to the Health Care Flexible Spending Account (FSA). You may contribute to the Limited Purpose Flexible Spending Account for Dental and Vision expenses only.

  • You may use your HSA to cover qualified eligible out-of-pocket healthcare expenses. Qualified eligible medical expenses generally include out of pocket expenses for medically necessary health services and supplies and also include medical, dental & vision deductibles, co-pays & co-insurance. Detailed information regarding qualified health expenses may be found in.

    Over-the-counter medications are not eligible for reimbursement unless you have a prescription from your doctor. You are responsible for making sure your expenses meet the IRS definition of 鈥渜ualified鈥� expenses.

    If you have questions regarding Eligible Medical Expenses, please contact Human Resources or see your tax advisor. You are responsible for ensuring purchases made with your HSA card are qualified eligible medical purchase or are reimbursable towards a prior qualified eligible medical purchase. Make sure to keep your receipts and withdrawal slips as documentation.

  • NO 鈥淯se it or Lose it鈥�: Your HSA rolls over from year to year. You may continue to contribute to the account as long as you are enrolled in the High Deductible Health Plan. If you change medical plans or lose coverage, you may no longer contribute to the account, but you are able to continue using the savings to pay for out-of-pocket medical expenses.

    Flexibility: You can use the savings in the account to pay for current out-of-pocket medical expenses. If you don鈥檛 need the savings to pay for current medical expenses, you can save money for future medical needs.

    Tax Savings: If you enroll in the HSA through payroll deduction, the contributions are made pre-tax. If you make your contribution after-tax, you can deduct your contribution as an 鈥渁bove-the-line鈥� deduction on your tax form to reduce your taxable income.

    HSA Bank Health Savings Account
    Your HSA will be with HSA Bank. You will need to activate your HSA Bank MasterCard and register on the Once you have completed both steps, you will be able to access your HSA funds as they are deposited.

    Employer Matching Contribution
    Employees enrolled in the HDHP will receive an employer matching contribution into their HSA. The employer matching contribution will match your HSA contribution dollar for dollar each payroll up to the employer matching contribution limit of $375 for single coverage and $750 for family coverage.

Resources

  •  - Medical and Dental Expenses 
  • - Health Savings Accounts and Other Tax-Favored Health Plans

  • The Health Care Flexible Spending Account helps you pay for medical related expenses not covered by the health benefit plans or any other insurance plan. Some eligible expenses are:

    • Out-of-pocket medical and dental expenses such as co-payments, co-insurance, deductibles, eyeglasses, etc.
    • Over-the-counter medications such as Advil or Claritin (does not include vitamins, dietary supplements, or topical applications)
    • Vision Care expenses such as glasses and contacts
    • Hearing aids or hearing tests

    In general, reimbursable medical expenses must be incurred primarily for the prevention or improvement of a physical or mental defect or illness. The plan does not include reimbursement for any type of cosmetic procedure.

    If you contribute to an HSA, you may not contribute to the Health Care FSA

  • The Limited Purpose Flexible Spending Account helps you pay for dental and vision related expenses not covered by the benefit plans or any other insurance plan. This account is only available if you are enrolled in the BCBS Consumer Choice HSA (High Deductible Plan) and works in conjunction with your Optum Bank Health Savings Account.
  • You may use the Dependent Care Flexible Spending Account to be reimbursed for work-related expenses for any Qualifying Individual described below whom resides with you:
    • A dependent age 12 or under who entitles you to a personal tax exemption; or
    • A spouse or other tax dependent that is physically or mentally unable to care for himself/herself.
  • To submit a claim, complete the correct form below and e-mail or mail to HSA Bank.
    • To Submit Claims by e-mail, e-mail to: askus@hsabank.com 
    • By Mail to: HSA Bank Healthcare Payment Solutions, c/o Health Account Services, P.O. Box 6122, Fargo, ND 58108-6122
    • Or you may log into your personal account and complete an on-line claim reimbursement request at: 
    • When you submit a claim for medical care expenses, you can be reimbursed for the claim up to the total amount you have elected to deposit for the year.
    • When you submit a claim for dependent day care expenses, you will be reimbursed up to the current balance of your account.
    • Medical care, dependent care, or eligible medical purchases must be made by March 15 of the following year. Claims must be submitted by March 31 to be reimbursed for the prior plan year's funds.  You must indicate between January 1 and March 15 that you are submitting a claim for the prior year remaining contributions.  
    • Money remaining in your FSA account(s) will not be returned to you at the end of the grace period (March 15). Any amount remaining after the end of the runoff or grace period will be forfeited. Because of this 鈥淯se it or Lose it鈥� rule, it is important for you to carefully estimate your out-of-pocket expenses.
    • Your participation in the plan ends on the last day of the month following the date you separate from 石榴直播 and you will no longer be able to incur expenses for your reimbursement.
    • You have 90 days from your last date of eligibility to file a claim for either account for your eligible expenses occured on or prior to your last date of eligibility.

  • Login to  to register or access your account and click on the 'Tools & Support' tab to request additional debit cards, submit reimbursement requests, online bill pay and FAQ's!


    HSA Bank Customer Service: 1 (833) 228-9352 or 1 (800) 357-6246
    HSA Bank Fax Number: 1-888-403-5029
    HSA Bank Website:  
    HSA Bank Email: askus@hsabank.com