Flexible Spending Account Plan

For the current plan year, you may submit a claim for an eligible expense at any time during the plan year to Health Equity. 

Health Equity and WageWorks Health and Dependent Care reimbursement forms are available in the Human Resources, Payroll and Employee Benefits Office for your use when submitting claims, can be downloaded or submitted via mobile app or online by accessing www.healthequity.com.

You may also fax to (801) 999-7829, or mail: HealthEquity, Atten Reimbursement Accounts P.O. Box 14374, Lexington, KY 40512. With your claim form, you must include an itemized receipt or Explanation of Benefits (EOBs), especially if your insurance paid a portion of the expense.

Itemized receipts must contain the five pieces of information required to help ensure the approval of your claim. They are:

• Patient Name: Person who received the service or who the item is for. For retail store purchases, this may be excluded.

• Provider: Who delivered the service or if a purchase, where was the item purchased.

• Date of Service: Date services occurred or date item was purchased.

• Type of Service: Detailed description of what service or product was paid for. Bag Tag is sufficient for prescriptions.

• Financial Responsibility: The amount paid for the service or product and/or the portion not reimbursed through your insurance carrier.

Please send copies of your receipts and retain the originals for your files.

Here are some helpful tips for submitting documentation to Health Equity:

• Please make sure documentation is legible; check that it isn’t too dark or light and that information is not cut off.

• Do not use highlighters on documentation. Handwritten documentation must include stamped provider information.

• Do not send carbon copies or canceled checks, they typically do not include all five key pieces of information.

Claims are submitted directly toHealth Equity, our plan administrator. Reimbursements are made by check or direct deposit. It typically takes between 4 to 6 days from the time you submit a claim to when it is adjudicated and either a check or an Explanation of Benefits (EOB) is issued or a direct deposit is made.

Each reimbursement check from Health Equity is valid for 180 days from the date of issue. Keep in mind that it is always a good idea to cash reimbursement checks as soon as they are received. With direct deposit, you could prevent this from occurring with future reimbursements.

To set up direct deposit:

1. Log into your account at www.healthequity.com. 

2. Choose Profile.

3. Select Reimbursement Method: Pay Me Back or Pay My Provider.

4. Choose Direct Deposit and enter your banking account information.

Please note that it takes 10-12 business days for the pre-note process to complete once you set up the direct deposit option for the first time. Until the pre-note is completed, reimbursement will be issued via check.

For employees enrolled in the Dependent care reimbursement plan, you can submit a reimbursement request to Health Equity for services even though you do not have funds available in your account. Once funds become available during the current plan year,Health Equity will reimburse you for eligible dependent care claims with proper document either in full or partially (depending on the reimbursement and the available funds in the account).

Each employee participating in the Medical Reimbursement Account will be issued a debit card that may be used to pay for eligible expenses at participating health care providers and pharmacies at the time of service or purchase. You can also use it for non-drug over-the-counter (OTC) items at merchants that have a standardized (IIAS) IRS-approved Inventory Information Approval System. For a current list of IIAS merchants you can visit www.sigis.com.

When the debit card is presented at a participating doctor’s office, or pharmacy, the co-pay amount is transferred from your spending account immediately. Health Equity will attempt to verify your transactions without asking for more information, such as using known plan co-pays.

If we are unable to do so, you will be asked to submit the itemized receipt for verification toHealth Equity within 5 days of incurring the expense. Please use the Card Use Verification (CUV) form available on your account on www.healthequity.com or submit via mail. Use of the debit card is an additional optional convenience but is not a requirement. If you chose to utilize the Health Equity debit card, please retain all receipts for your records.

You may be required to submit proof of the transactions to Health Equity, or need it for tax purposes. If documentation is not received within 90 days, your card and those issued to eligible dependent(s) may be subject to suspension until documentation is received.

Each employee will have the option to utilize the Pay My Provider reimbursement option. This payment option is similar to online bank payment feature. To initiate the Pay My Provider payment option you must submit the required documentation in order for the eligible claim to be processed.

The request must be submitted by accessing www.wageworks.com and logging into your account. All requests must be in place 10 days prior to the date that you want Health Equity to mail out the payment and the payment mail date is no more than 10 days to the service date. The Pay My Provider option can be used for as a one-time payment option, or set-up for recurring expenses.