FSA FAQs
Claim Reimbursement
How do I submit an expense for reimbursement?
How long will it take to receive reimbursement for my claim?
Is there a minimum claim submission amount?
Must all my claims be submitted before the plan year ends?
Can I submit a claim for a medical service prior to paying for it?
Can I submit a claim for a medical service before the service is provided if I have already paid for it?
How does reimbursement for orthodontia expenses work?
Will my FSA claims be paid directly to the provider?
Where should I submit my claim first for medical expenses: to my insurance or my Medical FSA?
What supporting documentation do I need to submit with my completed claim form for reimbursement from my Medical FSA?
Can I submit a Dependent Care claim before a service is provided if I have already paid for it?
What supporting documentation do I need to submit with my completed claim for reimbursmenet from my Depedent Care FSA?
What happens if the cash balance in my Dependent Care FSA is less than the amount of an eligible claim that I submit?
If I pay my daycare center the same amount every single week, can I automatically receive reimbursement from my Dependent Care Account without submitting a claim every week?
How do I submit an expense for reimbursement?
After a service is provided, you will need to submit a completed claim with supporting documentation to Benefit Resource. You can do this in one of two ways:
| (a) | Log in at the Benefit Resource website and select Online Claim Entry. Complete your claim form, then either upload it to Benefit Resource or print it so you can fax or mail it to Benefit Resource. (This option is only available if allowed by your plan.) |
| (b) | Complete a paper claim form and fax or mail it to Benefit Resource. |
How long will it take to receive reimbursement for my claim?
Claim reimbursements are processed every Wednesday and will include claims received by Benefit Resource at least 5 business days prior to the processing day. If you elect Direct Deposit reimbursement, funds should be available in your account on Friday (unless your bank delays availability of electronically transferred funds). Reimbursement checks and Direct Deposit advices will be mailed to you on the Friday following Wednesday's processing.
Is there a minimum claim submission amount?
There is no minimum claim amount, but your Plan may have a minimum reimbursement amount (usually $15). If your eligible claim amount is less than the minimum, it will be held until additional claims are submitted. (During the run-out period after the end of each plan year, reimbursements will be issued even if they are less than the minimum amount.)
Must all my claims be submitted before the plan year ends?
No. Claims for eligible eligible services must be received by Benefit Resource within the timeframe indicated in your Plan Highlights.
Can I submit a claim for a medical service prior to paying for it?
As long as the service has been provided, a claim can be submitted for reimbursement whether or not payment has been made.
Can I submit a claim for a medical service before the service is provided if I have already paid for it?
No, you need to wait until after a medical service has been provided before submitting your claim. (Note the IRS exception for orthodontia below.)
How does reimbursement for orthodontia expenses work?
IRS regulations allow reimbursement of eligible orthodontia expenses based on date of payment, date of service or payment due date on statements/coupons. (Note that reimbursement of other eligible dental services is based on the date of service.)
Will my FSA claims be paid directly to the provider?
No, payment will be made to you. You are still responsible for paying the provider.
Where should I submit my claim first for medical expenses: to my insurance or my Medical FSA?
Your claim must always be submitted to your insurance carrier first. The remaining eligible expenses that you pay out-of-pocket can then be submitted for reimbursement from your Medical FSA.
What supporting documentation do I need to submit with my completed claim when requesting reimbursement from my Medical FSA?
Acceptable supporting documentation for medical claims must include the following information:
| – | Name of provider of the service/product |
| – | Date of service/date product was purchased |
| – | Type of service/product (drug name required for prescription claims) |
| – | Your out-of-pocket expense for the service/product (amount not covered or reimbursed elsewhere) |
| – | Name of employee or dependent for whom the service/product was provided |
For services covered in whole or in part by insurance, the expense must first be submitted to your insurance carrier. The insurance carrier will issue an Explanation of Benefits (EOB) to you, indicating your out-of-pocket cost and the amount covered by your insurance. When you submit your claim, include this EOB with your completed claim form.
If all of the required information listed above is not clearly indicated on the EOB, you will also need to submit a receipt/statement from the provider of the service/product.
For expenses not covered by insurance, include just the detailed receipt/statement from the provider of the service with your claim form.
Note that cancelled checks and credit card statements are not acceptable as supporting documentation.
Additional supporting documentation may be required for certain medical claims, such as those that could have a cosmetic, personal or non-medical element. When this is needed, have your licensed medical practitioner complete a Certification of Medical Necessity form and include that with your claim. (The practitioner must indicate a specific medical diagnosis and that the service is required to treat that medical condition.)
Can I submit a Dependent Care claim before a service is provided if I have already paid for it?
No, you need to wait until after a Dependent Care service has been provided before submitting your claim. For example, if you pay a summer day camp registration in March but the day camp will be held in July, the claim for reimbursement of the March registration fee cannot be submitted until the end of July.
What supporting documentation do I need to submit with my completed claim for reimbursement from my Dependent Care FSA?
Acceptable supporting documentation for a Dependent Care FSA claim must include the following information:
| – | Type of service provided |
| – | Date(s) the service was provided (e.g. 2/2/06 - 2/6/06) |
| – | Name of dependent for whom service was provided |
| – | Provider of the service |
| – | Your out-of-pocket expense for the service |
Note that cancelled checks and credit card statements are not acceptable as supporting documentation.
What happens if the cash balance in my Dependent Care FSA is less than the amount of an eligible claim that I submit?
Your claim will be reimbursed up to the cash balance available in your Dependent Care FSA. You will be reimbursed for the remaining amount once additional funds are deposited into your Dependent Care FSA.
If I pay my daycare center the same amount every single week, can I automatically receive reimbursement from my Dependent Care Account without submitting a claim every week?
Since eligible Dependent Care services cannot be claimed until after the service has been provided, reimbursements cannot be automatically generated to you. You can submit claims weekly or accumulate claims and submit several weeks at a time (as long as the services have already been provided).