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Frequently Asked Questions

You’ve got questions? We’ve got answers!

To assist VitaFlex participants in learning more about Flexible Spending Arrangement benefits, we’ve created the following helpful resource of Frequently Asked Questions (FAQs). If you have a question about your VitaFlex account not addressed below, please feel free to contact the VitaFlex Service Center for additional assistance.

What is the VitaFlex Flexible Spending Account (FSA) Plan?

The VitaFlex Flexible Spending Account (FSA) Plan is an employee benefit Plan that allows employees the opportunity to reduce their taxable income. With this Plan, employees may pay for certain medical, dental, and dependent care expenses with pre-tax dollars. Employers arranged this Plan so that employees can take advantage of these tax savings. These Plans are sometimes known as Section 125 Cafeteria Plans, since Section 125 of the Internal Revenue Code authorizes and governs them.

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What does “pre-tax” mean?

Pre-tax means your gross pay before income taxes and Social Security taxes are taken out. Paying with pre-tax dollars means the dollars that you would have paid in taxes are redirected and used to help pay your eligible medical or dependent care expenses. In other words, you do not have to pay taxes on the money spent for eligible expenses. Federal income taxes, State income taxes (in most states) and Social Security taxes are all reduced under this Plan.

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How does the Plan work?

First, you must estimate your eligible medical, dental, and dependent care expenses for the Plan Year. Next, you elect that amount of money to be allocated into your Medical Reimbursement Account and/or your Dependent Care Reimbursement Account. Your compensation is reduced by this amount via salary reductions and these funds are held as a general asset of your Employer. Once you incur an eligible expense, you can submit a claim to VitaFlex and you will be reimbursed for eligible expenses from your account balance on a tax-free basis.

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How does the FSA Plan increase my take-home pay?

Making a VitaFlex FSA election lowers your taxable income and therefore reduces your annual taxes. Ultimately, this means that you will have more money in your paycheck. Here is an example of the difference a VitaFlex FSA can make to take-home pay in a month:

  Without FSA With FSA
Monthly Salary $5,000 $5,000
Actual Expenses – Funded Pre-Tax    
Medical
$        0 $   100
Dependent Care
$        0 $   350
Premium Contributions
$        0
$      90
Income Before Taxes
$5,000 $4,460
Taxes (Marginal Bracket)*    
Federal Income Tax (25%)
$1,250 $1,115
CA State Income Tax (9%)
$   450 $   402
Social Security Tax (7.65%)
$   383 $   342
Income After Taxes
$2,917 $2,601
Actual Expenses – Funded After Tax    
Medical
$   100 $       0
Dependent Care
$   350 $       0
Premium Contributions
$   90
$       0
Take Home Pay
$2,377 $2,601
Net Pay Increase (Monthly) $   224
Net Pay Increase (Annual) $2,688

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Important FSA Plan Provisions

Why does the Plan have rules and restrictions?

The IRS provides significant tax breaks for participating in a Medical or Dependent Care Reimbursement Plan. The IRS allows this because they recognize the fundamental necessity of paying for certain medical and dependent care expenses, and they believe that offering tax savings on these expenditures is appropriate. However, in exchange for the tax savings, the IRS does impose important rules and restrictions on how you can use Medical or Dependent Care Reimbursement Plans.

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What does “use it or lose it” mean?

The “use it or lose it” rule is a crucial provision to consider when making an FSA election. FSA elections are made prospectively by estimating the amount you will spend on medical, dental, vision, or dependent care expenses from your effective date through the end of the Plan Year. If you over-estimate your expenses and do not actually incur your estimated dollar amount of eligible expenses by the Claims Incurred Deadline, your unused salary reduction contributions will be forfeited at the end of the Plan Year. If this is your first time making an FSA election, it may be best to be conservative in your election unless you are certain about the amounts you will be paying in expenses.

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What does it mean to “incur” an expense?

To “incur” an expense means to receive care that gives rise to a medical expense. This does not refer to the date when the participant is formally billed or actually pays for the care.

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What is a Plan Year?

The Plan Year is January 1st through December 31st. Each Employer outlines a specific claim submission deadline and in some cases an Employer may adopt a grace period that extends the date for incurring claims. Please refer to your Employer-specific plan documentation for these dates.

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When must I incur expenses?

All eligible expenses must be incurred during the specific Plan Year in which you have elected to participate. As mentioned above, some Employers may adopt a grace period that extends the date for incurring claims.

Eligible expenses must be incurred after your initial eligibility date if you are a new hire, and after you have signed the election form. Expenses are not eligible if they are incurred prior to the beginning of the Plan Year, prior to your initial effective date under the Plan, or after the end of the Plan Year.

If your employment terminates, the rules for when eligible expenses must be incurred are different for Medical Reimbursement Accounts and Dependent Care Accounts:

  • For Medical Reimbursement Accounts, you may be reimbursed only for expenses incurred prior to your employment termination date. If you elect to continue your Medical Reimbursement Account under COBRA, the eligibility date for incurring expenses may be extended to the end of the Plan Year.
  • For Dependent Care Reimbursement Accounts, you may be reimbursed for expenses incurred after your termination, as long as the expense is work related and is incurred prior to the end of the Plan Year.

You have until the specified claims submission deadline to submit claims for these expenses, assuming your Employer’s Plan is still active. Please refer to your Summary Plan Description or Plan Detail Document for information on your Plan’s claim submission deadline. 

If you are unsure of your deadline for incurring claims or your claims submission deadline, please contact the VitaFlex Service Center.

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Do I have to make contributions before getting reimbursed?

The answer to this is different for a Medical Reimbursement Account and a Dependent Care Reimbursement Account. With a Medical Reimbursement Account, the entire annual amount you elected is available to you for reimbursement from the start of the Plan Year. However, if you terminate your Medical Reimbursement Account without ever making a contribution, your account is revoked and no expenses are eligible. With a Dependent Care Reimbursement Account, your reimbursements are limited to the amount you have contributed to date.

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Can I transfer my balance between medical and dependent care accounts?

No. You must estimate and allocate your medical expenses and your dependent care expenses independently. If you incorrectly estimate your expenses, you cannot transfer your balance between your medical account and your dependent care account. Additionally, you may not transfer your balance to any other person or from one Plan Year to the next.

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Does my participation affect my social security benefits?

Yes. Your salary reductions through a Flexible Spending Account Plan will lower your taxable wages for future Social Security benefit calculations. This means you pay lower taxes for Social Security and other social benefit programs, but you will also receive commensurately lower future benefits. While participation in the Plan may lower your taxable income for Social Security purposes, generally the benefit difference received from Social Security will be minimal. If you are near your Social Security retirement age or anticipating any disability benefits, you may want to look closely at how a salary reduction might offset your future Social Security benefits.

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Does my participation affect other benefits?

Participating in the Plan will reduce the amount of your taxable compensation. Accordingly, there could be a slight decrease in any employee benefits that are determined based on your taxable compensation. Examples of other benefits that might be affected are pension, disability and life insurance benefits.

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Can I stop participating or change my salary reduction during the Plan Year?

The general rule is that you cannot change or terminate your election during the Plan Year. You may change your elections only during the annual Open Enrollment Period for the upcoming Plan Year.

There are several specific exceptions to this rule. You may change or terminate your election at any time during the Plan Year if you experience a qualified Change in Status or one of the other specific mid-year exceptions to the irrevocability rules as specified by the IRS. The rules about Election Changes and Status Changes are complex. More details are described in your Summary Plan Description.

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Can I claim the same expense twice?

No. It is important to understand that you may not submit a claim for reimbursement for any expenses that have been, will be, or have the potential to be reimbursed by any other source. All other potential reimbursement sources must be exhausted prior to a claim being eligible for reimbursement through an FSA. Submitting expenses for duplicate reimbursement is considered tax fraud. Penalties for such fraud are severe and include payment of state and federal back-taxes and interest.

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Medical FSA Plan

How does the Plan Work?

The Plan allows you to use tax-free dollars to pay for eligible medical expenses that are not fully covered or not covered at all under your group health insurance plan. Only certain expenses will qualify to be reimbursed under this Plan. The Internal Revenue Service provides guidelines on which expenses are eligible to be reimbursed in Section 213 of the IRS Code and the accompanying regulations. Normally, only IRS-approved health care expenses that exceed 7.5% of your adjusted gross income qualify as a deduction on your itemized personal income tax return. With the VitaFlex Reimbursement Plan, you can realize tax savings immediately on all eligible medical expenses. Since you contribute to the account on a pre-tax basis, you save on taxes that you would otherwise have to pay.

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Which medical expenses are eligible?

Only medical, dental, and vision expenses that are not reimbursed by an insurance plan or any other source are eligible for reimbursement under the FSA Plan. To be considered eligible, the service or product must be used for medical reasons only. For example, cosmetic services or massage therapy for general well-being would not be considered eligible. Non-prescription drugs that are available “Over-the-Counter” (OTC) might be eligible, but only if prescribed by a doctor. Other OTC items that are not medicines or drugs can be eligible if they are used to treat an illness or injury, and when purchased in reasonable quantities.

Generally, the direct guidance from the IRS on eligible expenses under an FSA plan is limited. As a result, VitaFlex has developed detailed policies on the eligibility of expenses. The VitaFlex policies and procedures directly apply all available guidance from the federal guidelines. IRS Publication 502, “Medical and Dental Expenses,” outlines eligible medical expenses for personal tax deduction purposes. You can find the link to IRS Publication 502 in our Resources Section. Please note that there are certain items that may be eligible for personal tax deduction – and thus listed in Publication 502 – that are NOT eligible expenses under the VitaFlex Plan.

In addition, please note that Section 125 and Publication 502 have different rules on when an expense must be incurred. For the purposes of an FSA, the definition of “incurred” is defined by Section 125: the date when the participant is provided with the care that gives rise to the health expense, not when the participant is formally billed or charged or actually pays for the care. To “incur” a prescription means the date the pharmacy actually fills the prescription, not the date it is called in, dropped off, or picked up.

VitaFlex has created an eligible expense database for participants to determine whether an expense will be eligible to claim for using their FSA. To use the database, click here.

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Which medical expenses are not eligible?

The IRS has provided specific guidelines for expenses that may not be reimbursed on a pre-tax basis. Certain health care expenses are not considered to be qualified and thus are not eligible for reimbursement, even if they are prescribed by a physician. Health care related expenses are not eligible if they are not directly for medical purposes or not deemed medically necessary. In general, expenses must not be for cosmetic purposes. Non-prescription drugs and medicines available over-the-counter must be used to treat a medical condition and not used simply for general health. Therefore, vitamins, dietary supplements, cosmetic drugs, and personal toiletries are not eligible.

Please refer to the VitaFlex Eligible Expense Database to determine whether an expense will be eligible to claim for reimbursement from the FSA.

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Where can I get more information about specific medical expenses?

There may be eligible expenses that are not found in our Eligible Expense Database. If you cannot find information about an expense in our database, or are still unsure about whether an expense is eligible, please seek clarification prior to making an election to participate. If you plan on having an expense reimbursed and you later find out that it is not eligible, you cannot change your election.

For additional information regarding eligibility of certain expenses, call Vita at 650-966-1492 or toll-free at 800-424-3052.

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Dependent Care FSA Plan

The Dependent Care Reimbursement Account allows you to pay for out-of-pocket, work-related dependent day care costs with tax-free dollars. The rules regarding eligible dependents, eligible expenses, and other Plan restrictions are outlined below. Please refer to your Summary Plan Description for details of all Plan provisions.

Who qualifies as a dependent?

There are two types of qualifying individuals. These include your:

  • Dependent child under the age of 13
  • Spouse or other dependent who is physically or mentally unable to provide for his or her own care and who spends a minimum of 8 hours per day in your home.

A “dependent” is someone you actually claim as a dependent on your federal income tax return (for the purposes of VitaFlex Plan eligibility).

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What dependent care expenses are eligible?

Dependent care expenses must be primarily custodial in nature and must be incurred for the care of a dependent, and are incurred to enable you and your spouse (if applicable) to be gainfully employed.

The VitaFlex policies and procedures directly apply all available guidance from federal guidelines. IRS Publication 503, “Child and Dependent Care Expenses,” outlines criteria for eligible dependent care expenses. You can find the link to IRS Publication 502 in our Resources Section. However, please note that there are certain expenses considered eligible by the IRS (either by reference in Publication 503, “Child and Dependent Care Expenses,” or by other IRS guidance) that your Employer and Vita have purposefully excluded from this Plan due to the ambiguity surrounding the eligibility of the expenses.

Practically speaking, the IRS guidelines generally mean that the following types of expenses would be considered eligible, provided the expenses are for the care of a Qualifying Individual:

  • Expenses paid to a dependent care center or dependent care provider. If care is provided at a day care center, it must be licensed according to the laws of the state where the provider is located.
  • Expenses paid to an in-home dependent care provider.
  • Expenses paid for preschool education.
  • Expenses paid to an adult day care facility for a qualified dependent.
  • Expenses paid for after school care or summer camps that are primarily custodial in nature.

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What dependent care expenses are not eligible?

Dependent care expenses must be primarily custodial in nature, as opposed to primarily educational or primarily recreational. If a dependent care expense is primarily educational or primarily recreational in nature, it is not an eligible expense. Expenses for classes and educational enrichment programs are not eligible for reimbursement. Examples of expenses that are not eligible include, but are not limited to:

  • Language classes
  • SCORE
  • Tutoring
  • Gymnastics lessons
  • Piano lessons
  • Sports classes or leagues
  • Summer camps under three hours in length per day

Marketing materials and discussions with staff of after school programs may also be considered to verify the custodial nature versus the educational/recreational nature of the program.

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Are there restrictions on plan participation?

IRS guidelines require that dependent care expenses must be employment-related in order to qualify as eligible expenses. This means the employee’s dependent incurs the expenses to enable the employee (and the employee’s spouse, if married) to be gainfully employed. The IRS guidelines regarding what qualifies as employment-related are very strict and require that you actually be at work or looking for work at the time the dependent care is provided.

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What is the maximum dependent care benefit I can elect?

If you are married and file a joint tax return the combined dependent care elections between spouses cannot exceed $5,000. If you are a single parent, the maximum annual election is $5,000. If you are married and file separate tax returns, the two separate dependent care elections must not exceed $2,500 each. Additional guidelines are outlined below.

  • You may not claim reimbursement for dependent care expenses which are greater than your earned income or your spouse’s earned (taxable) income, if you are married.
  • If your spouse is a full-time student or is incapable of self-care, then spousal income will be presumed to be $250 per month if one dependent is receiving care and $500 per month if two or more dependents are receiving care.
  • The $5,000 maximum may be split in any way between spouses filing jointly. However, if one spouse earns less than the annual Social Security wage base, deferring the money under the person who earns less will save more taxes since Social Security taxes will not be paid on the salary deferral.

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What restrictions are there regarding who may provide dependent care?

There are two major restrictions regarding who you may pay to provide dependent care:

  • The care provider may not be your spouse.
  • The care provider may not be one of your children or your dependent, unless he or she is at least 19 years of age.

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How do dependent care accounts compare to the dependent care tax credit?

The circumstances that determine which option offers greater savings vary from family to family. Therefore, the decision to choose the tax credit or the dependent care salary reduction can only be made by carefully examining your personal tax situation. As a rule, if your combined family income is under $15,000, you should not participate in this reimbursement plan as the Dependent Care Tax Credit will be more tax advantageous. If your combined income is between $15,000 and $43,000, you need to examine your circumstances very carefully as one plan may be better depending on your exact income and the number of dependents receiving care. Generally, if your combined household income is $43,000 or more, participation in this VitaFlex Plan may be more advantageous than the Dependent Care Tax Credit. VitaFlex provides an immediate tax reduction, whereas the tax credit is filed at the end of the year.

Additional information may be found in your Summary Plan Description. We recommend consulting your tax advisor regarding whether it is more advantageous to participate in an FSA plan or to take the tax credit.

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How do I report dependent care expenses on my taxes?

All dependent care expenses and salary reductions must be reported on IRS Form 2441. When a participant fails to use all of their Dependent Care Reimbursement Plan Election, the IRS does not require the participant to pay taxes on the unused balance.

Your Employer will report all Dependent Care salary reductions in Box 10 on your W-2. You will need to fill out the same amount on IRS Form 2441. When figuring your exclusions, enter the amount forfeited on IRS Form 2441 or Schedule 2 (IRS Form 1040A). This will prevent you from being taxed on any forfeiture for the Plan Year. For more information regarding IRS Form 1040 or 2441, we recommend consulting your tax advisor.

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Where can I get more information about specific dependent care expenses?

While VitaFlex seeks to provide as much information regarding eligible expenses as possible in our Eligible Expense Database and on our Web site, we understand that determining whether a particular provider’s care is eligible can be difficult. If you have a question about whether a dependent care expense is eligible, please call for clarification prior to making an election to participate. If you plan to have a dependent care expense reimbursed and you later find out that it is not eligible, you cannot change your election.

For additional information regarding eligibility of certain expenses call Vita at 650-966-1492 or toll-free at 800-424-3052.

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VitaFlex Debit Cards

Does VitaFlex offer debit cards?

Your employer can choose to offer debit cards as an FSA Plan option. However, not all FSA Plans provide participants with debit cards. If you are unsure of whether your plan offers the VitaFlex Debit Card, you can contact the VitaFlex Service Center to confirm.

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Where can I use my card?

The VitaFlex debit card can only be used in one of three places:

  • Licensed healthcare providers
  • Pharmacies
  • Stores with a point-of-sale FSA approval system

If you attempt to use your card at a location where the vendor is not a part one of the above listed categories, the card will decline. Our resources page includes a link to a site with a listing of stores with a point-of-sale approval system.

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Do my debit card Purchases require documentation?

YES! While your card does allow you to pay for expenses with FSA dollars up front, IRS documentation requirements still exist. The debit card does allow for some items to be purchased without having to provide VitaFlex with documentation. Those include:

  • Payments that match your employer’s health plan copayments exactly (or any multiple thereof up to 5 times the copayment)
  • Purchases of over-the-counter items at a store where FSA eligibility is approved at the point of sale.

If you use the debit card to pay for expenses that do not fall into one of the two categories above, you will be required to provide VitaFlex with documentation to substantiate the eligibility of your charge. We suggest you save receipts for any purchases made with your VitaFlex debit card.

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How will I know if I need to provide documentation for my debit card charge?

Whenever you pay for an expense with the VitaFlex debit card, you will receive an explanation of benefits (EOB) confirming whether you need to submit documentation or not.

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What is my deadline to submit documentation for debit card charges?

VitaFlex provides two deadlines for submitting documentation to substantiate debit card charges. The deadlines will be indicated on your EOB. If documentation is not provided by the first deadline, your debit card will deactivate until sufficient documentation is provided. If documentation is not provided by the second deadline, the expense will be deemed ineligible, and you will be required to repay the cost of the expense to your employer.

If for any reason you need additional time to submit documentation, VitaFlex will be happy to grant you an extension. All you need to do is call or email the Vita Service Center and request an extension.

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What if I lose my debit card?

If you lose your card, contact the Vita Service Center immediately. We will deactivate your current card and issue you a new one at no additional cost.

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Can I request an additional debit card for my spouse or dependent?

Yes. VitaFlex can issue 1 additional debit card for a spouse or dependent. The card will link directly to your VitaFlex account and can be requested by sending in the Second Debit Card Request Form.

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What happens if a charge I make is ineligible?

If you make a debit card charge that is deemed ineligible, you must repay the charged amount to your employer. The repayment is generally taken from a future paycheck; however, there are instances where you may be required to make a repayment in another manner (e.g. writing a check). If you are unsure how your repayment will be made, please contact your HR department.

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Making and Changing Elections

How do I make an election?

You must complete and make a formal election when you first become eligible under the Plan. Please check with your Human Resources Department in order to confirm your Employer’s VitaFlex election process. It is important to note that FSA elections do not automatically renew from Plan Year to Plan Year. You must make a formal election each Open Enrollment period for the next Plan Year (January 1st through December 31st).

The Open Enrollment period usually occurs anywhere from late October to early December. Your Employer will educate you on the Open Enrollment process each year. If you do not submit a new election form by the scheduled Open Enrollment due date, your participation will terminate at the end of the Plan Year and your salary reductions will automatically return to zero for both the Medical and Dependent Care Reimbursement accounts for the following Plan Year.

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When can I change my election?

The election you make is considered irrevocable for the Plan Year and cannot be changed until the end of the Plan Year. You may change your election annually at Open Enrollment. You will receive Open Enrollment materials from your Employer each year, before the new Plan Year. All forms must be returned by the deadline established by your Employer. Open enrollment elections are effective on January 1st of the following year. There are several specific exceptions to this Irrevocability Rule.

If you experience a qualified status change during the Plan Year, or if you experience one of the other special exceptions to the Irrevocability Rule, you may change your election mid-year. However, your new election must be specifically due to and consistent with the status change that occurred. The IRS has many complex rules surrounding election changes. Please refer to your Summary Plan Description for full details.

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What is a “Status Change”?

A Status Change is a change in your personal, employment or family situation that affects your participation in or eligibility for your employee benefit plans. The IRS rules governing Status Changes are very specific and detailed, and only allow certain changes. The IRS also requires that any election changes made must be consistent with the status change. This requirement means the change must be on account of and correspond to the status change. For more detailed information on Status Changes and Election Changes, please refer to your Summary Plan Description.

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What must I do to change my election?

You must complete a VitaFlex Change of Election form indicating your requested election change. The VitaFlex Change of Election form can be requested from your Employer. For the election change to be to be considered, your form must be received by your Employer within 30 days of the Status Change. If approved, the election change will be made as soon as administratively possible. Election changes cannot be made or applied retroactively.

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What are the rules for Status Changes?

In order to change your Medical Reimbursement or Dependent Care Reimbursement election, your change of status must fit into one of the “Change of Status” categories as defined by the IRS. The requested change must be “consistent” with the status change. Generally, this means that your election change must be on account of and correspond to the status change. In addition, your eligibility for benefits must be affected in order to qualify. Simply having a change in benefits without an eligibility change will not generally qualify as a valid status change. Following is the list of eligible status changes:

  • Change in your legal marital status (marriage, divorce, death of spouse, legal separation).
  • Change in your number of tax dependents (birth, adoption, placement for adoption).
  • Change in Employment Status (any change in the employee’s or spouse’s employment that affects benefit eligibility, including termination or commencement of employment, strike, commencement or return from unpaid leave of absence, a change in worksite, or any change in employment or work schedule that affects eligibility for benefits).
  • Termination or commencement of employment for you, your spouse or your eligible dependents.
  • Change in your dependent’s eligibility (either satisfying or ceasing to satisfy eligibility requirements, including attainment of age limit, marriage, etc.).
  • Commencement or termination of adoption proceedings.

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What other reasons qualify for mid-year Election Changes?

There are several other circumstances which allow for a mid-year election change. These special cases are listed below. In all cases, the election change must be consistent with the election.

  • Mid-Year Change in Cost or Coverage - Applies only to Dependent Care reductions, not to Medical. If the cost of dependent care changes, a new corresponding election may be made. However, this exception does not apply if care is provided by a relative.
  • HIPAA Special Enrollment Rights
  • COBRA Qualifying Events
  • Judgment, Decree, or Court Order
  • Entitlement to Medicare or Medicaid
  • FMLA Leaves of Absence

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Documentation Requirements

Must I substantiate my claims for reimbursement?

Yes. The IRS requires specific documentation of eligible expenses. When making your FSA election, do not include any expenses that cannot be appropriately documented in your estimated reimbursement calculation, as they cannot be reimbursed.

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What documentation must I provide for medical expenses?

The IRS requires that claims be substantiated by detailed third-party documentation. For most – not all – medical FSA claims, the following details must be included on the documentation:

  • Service Provider’s name (not your insurance carrier)
  • Patient’s name
  • Date of Service (not the billing date or date of payment)
  • Description of Service (or name of drug)
  • Cost of service
    • If insurance is covering any portion of the expense, we cannot accept documentation with estimated insurance amounts.

If any of the above pieces of information are missing in a claim, VitaFlex will not be able to approve the claim until additional documentation is provided.

Following are some further guidelines for necessary documentation for specific expenses:

  • Prescription expenses: a copy of the Rx receipt provided by the pharmacy, indicating name of medicine, date dispensed (not the date you picked up/paid for the prescription), name of person for whom the drug was dispensed, and amount paid (a cash register or credit card receipt is not sufficient)
  • Over-the-Counter products: a copy of the cash register receipt (or other similar receipt) itemizing the individual product and date purchased. In addition, a doctor’s prescription noting the treatment of a specific medical condition is required for reimbursement of any over-the-counter medicine that includes a drug component.
  • Orthodontic Treatment: a copy of the treatment plan including the banding date, the estimated date of completion (or duration of treatment), the total cost of the treatment, the amount (if any) that will be covered by insurance, and any amount that you are required to pay “up front” or as a down payment. For more information, you can access the Orthodontia Reimbursement Form and Guidelines here.

NOTE: There are several expenses, including therapy claims of any kind, which might require additional pieces of information in order to be approved for reimbursement. Additional documentation requirements might include a confirmation of medical diagnosis and/or a physician’s statement of the medical necessity of the treatment. We strongly recommend consulting the Eligible Expense Database for information on what is necessary to approve a claim.

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What documentation must I provide for dependent care expenses?

For dependent care expenses, a care provider’s receipt is always necessary. The receipt must identify the following pieces of information:

  • Provider Name
  • Dependent Name
  • Dates of Care (not the invoice date or date of payment)
  • Amount Paid for Care

VitaFlex must also have the Tax ID Number or Social Security Number of the provider. It must be included on the claim form, or VitaFlex must have it on file from a prior claim. Receipts for home day care may be hand written, but they must include all of the above requirements as well as the signature of the provider. 

To help make dependent care FSA claims easier, VitaFlex also provides a consolidated VitaFlex Dependent Care Claim Form. If you have your provider fill out and sign the VitaFlex Dependent Care Claim Form, you can use it in lieu of any additional provider receipts.

NOTE: If you wish to use the consolidated Dependent Care Claim Form, you must obtain your provider’s signature on a new form each time you submit a dependent care claim. We cannot accept any consolidated claim form that is not newly signed by the care provider to verify the dates and costs of care.

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What is a Statement of Medical Necessity (SMN)?

A Statement of Medical Necessity (SMN) is a written document signed by a licensed physician or other healthcare provider attesting to the medical necessity of a specific procedure or treatment.  The IRS requires that all expenses be incurred for the treatment of a present medical condition and in most cases medical necessity can be inferred based on the type of service or treatment received.  However, there are certain types of services and treatments where medical necessity cannot be inferred; and for these types of expenses, we require an SMN be provided.

A copy of the VitaFlex Statement of Medical Necessity (SMN) form can be found here.

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What documentation is inadequate?

If the documentation provided does not include the information described in the previous FAQ answers, VitaFlex will be unable to approve the claim. It is important to be aware that there are certain medical expenses (including therapies such as acupuncture, massage therapy, physical therapy, chiropractic care, to name a few) that require additional information. We strongly suggest using our Eligible Expense Database to determine what type of documentation would be required for your specific treatment.

Credit card receipts, “balance forward” billing statements, and cancelled checks are all examples of documentation that are not sufficient.

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Claim Guidelines

How do I submit claims?

All FSA claims require third-party substantiation, and the IRS provides guidelines for what is necessary in order to approve a claim. In addition to a VitaFlex Claim Form, each claim you submit must be accompanied by documentation that includes the following information:

  • Service Provider’s Name
  • Patient’s Name (for Medical claims)
  • Name of Dependent receiving care (for Dependent Care claims)
  • Date of Service/Care (not the billing date or date of payment)
  • Description of Service
  • Cost of Service
    • If insurance is covering any portion of your medical expense, we cannot accept documentation with estimated insurance amounts.

There are several expenses that require additional pieces of information in order to be approved for reimbursement, so we strongly suggest consulting the Eligible Expense Database for information on what is necessary to approve a claim.

There are several ways to submit your claims to VitaFlex:

  • E-mail:
claims@vitamail.com
  • Fax:
(650) 964-3539 or toll-free (866) 964-3539
  • U.S. Mail:
VitaFlex
900 North Shoreline Boulevard
Mountain View, CA 94043

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How long does it take for claims to be processed and reimbursed?

Generally, claims are processed in one to two working days. Once a claim has been processed, you will receive an Explanation of Benefits (EOB) which will indicate whether or not your claim has been approved. If the claim has been approved, the EOB will specify the date you will receive your reimbursement. If the claim has not been approved, the EOB will include footnotes that detail the reasons for denial, or specify what additional information we require in order to reprocess it.

You will receive your EOB in one of three different ways:

  • E-mail with a PDF attachment of your EOB
  • U.S. Mail
  • E-mail notification that a claim has been processed, with a link to the VitaFlex website where you can log in to your account on our secure server and receive your reimbursement information.

In your welcome kit, VitaFlex provides cutoff dates which indicate when you need to submit claims in order to be reimbursed by the next reimbursement date. If you receive reimbursement via your paycheck, generally the deadline is six to ten days prior to each pay date, depending on your Employer. If you receive your reimbursement via direct deposit to your bank account each Friday, the deadline for submitting claims is the Tuesday prior to the Friday on which you wish to be reimbursed.

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How are reimbursements made?

FSA reimbursements are paid out either in your paycheck or through direct reimbursement each Friday (a direct deposit into your bank account). The reimbursement method is chosen by your Employer. You will receive an Explanation of Benefits prior to each reimbursement, which will explain whether the claims you submitted were eligible, how they were processed, and when you will receive your reimbursement.

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How can I access account information?

Your account information is sent to you in several ways:

  • Explanations of Benefits (EOBs) EOBs are sent to you after any claim has been submitted and processed. In addition to information about your most current claim, the EOB provides you with your most current account balance.
  • Quarterly Statements At the end of each quarter, you will receive a statement showing the activity and account balances for your Medical FSA and/or Dependent Care FSA as of the close of the most recent calendar quarter.
  • Online Access You may check your account status, review claims processed, and print prior EOBs by logging in to your VitaFlex online account. This is a secure site and you will be required to set up a login and a password the first time you use the site. You will need your company code in order to initially set up your account.

If you are unable to locate your desired account information through the media listed above, or you have any questions about your Plan, please don’t hesitate to contact the VitaFlex Service Center

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Other Commonly Asked Questions

I’ve heard about discrimination tests . . . How does this work?

The IRS rules require that an FSA Plan be nondiscriminatory, which means it cannot provide a benefit which favors highly compensated or key employees. Each year, the Plan must pass tests to confirm that no discrimination exists. Sometimes, it may be necessary to modify your election(s) downward if you are a Key Employee or a Highly Compensated Individual (as defined by the IRS). This action would only be taken to prevent the plan from becoming discriminatory within the meaning of the federal income tax law.

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What happens when I terminate my employment?

When your employment terminates, your pre-tax salary reductions discontinue and your last day to incur eligible Medical FSA claims is the final day of your employment. Depending on the size of your Employer, you may have the option to continue your Medical FSA under Federal COBRA continuation coverage provisions described in your Summary Plan Description.

You can continue to incur Dependent Care claims and submit the receipts toward any unused balance after your termination date, as long as you and your spouse are working or looking for work.

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Where does my money go?

FSA reductions don’t “go” anywhere. When reductions are taken from your paycheck, they are accounted for in your personal Medical Reimbursement Account or Dependent Care Reimbursement Account. Your salary reductions are held as a general asset of your Employer, and are subject to all creditors; there is no separate trust account. The actual money is simply retained by your Employer until you submit a claim for your eligible expenses. At that time, your Employer provides reimbursement with tax-free dollars. If your Employer goes out of business, your salary reductions may be forfeited and normal Plan guidelines for submitting claims may change.

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What happens to money that is forfeited?

Money that is forfeited under the Plan – either because the eligible claims you submitted prior to the Claims Submission Deadline did not reach the amount of your election for that Plan Year, or because your Employer has gone out of business – is retained by the Employer and is used to offset plan losses and the cost of administering the plan.

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Do I need to change insurance providers to participate?

The VitaFlex Plan is not tied to any insurance plan or company; therefore, there is no need to change insurance providers. You may participate in the VitaFlex Medical and Dependent Care Plans even if you have waived coverage under your Employer’s health plans because you are covered through a spouse’s plan or other plan.

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Do I need to be covered under my employer’s health plan?

No. You may elect to participate in the Medical or Dependent Care Reimbursement Plan regardless of whether you or your dependents are actually covered under your Employer’s health plan.

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How do I contact Vita?

Vita’s contact information can be found on our Contact Us page.

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