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  • FSA Resources

    Hands-on member resources help you make the most of your medical flexible spending account

    Crossover Tip Sheet

    Pamphlet that describes the benefits of electing the crossover option

    Debit Card Brochure

    Brochure describing the benefits of the debit card option

    Debit Card Terms and Conditions

    Document detailing the debit card terms and conditions

    Dental Tip Sheet

    Helpful hints for submitting dental claims

    Employee Website Brochure

    Brochure describing the benefits of using the online member service center

    FSA Eligible Medical Expenses List

    List of common expenses that could be eligible for reimbursement from an FSA

    FSA Qualifying Event Tip Sheet

    Helpful hints on events that may qualify you to change your medical FSA or dependent care elections

    FSA Quick Start Guide

    Employee guide explaining the benefits and reimbursement guidelines of a flexible spending account

    Online Anytime

    Instructions for members to manage spending accounts online

    Orthodontia Tip Sheet

    Helpful hints for submitting reimbursement requests related to orthodontia expenses

    Orthodontia Worksheet

    Worksheet to help determine the amount of orthodontia expenses that can be claimed from a medical FSA

    OTC Eligible Expense List

    List of common over-the-counter drug and supply expenses that could be eligible for reimbursement from a spending account

    Spanish: Guía de Comienzo Rápido para las Cuentas de Gastos Médicos (FSA, HRA, VEBA)

    Spanish communication piece that can be used to describe the claim process and optional features for the FSA, HRA and VEBA accounts

    Tips for Submitting Claims

    Helpful hints for submitting medical claims

    Top 10 Ways to Avoid a Claim Being Denied

    Guidelines to avoid delays related to claims

    Vision Tip Sheet

    Helpful hints for submitting vision claims

    Online forms can be completed by signing into your account. Manual forms must be submitted to SelectAccount by mail or fax.

    Dental Crossover Election Form

    Form that can be used to elect the dental crossover option. For fastest processing, complete this form online.

    Direct Deposit Authorization

    Form that can be used to authorize SelectAccount to deposit claim reimbursements directly into your bank account. For fastest processing, complete this form online.

    Medical Crossover Election Form

    Form that can be used to elect the medical crossover option. For fastest processing, complete this form online.

    Spanish: Autorización para Depósito Directo

    Spanish form that can be used to authorize SelectAccount to deposit claim reimbursements directly into your bank account

    Spanish: Formulario de Elección de Traspaso para Gastos Médicos

    Spanish form that can be used to elect medical crossover

    Spanish: Opción Pagar al Proveedor

    Spanish form that can be used to authorize the pay-the-provider crossover option

    Spanish: Solicitud de Tarjeta de Débito

    Spanish form that can be used to elect the debit card

    Can I have crossover and a debit card?

    No. You cannot have both a debit card and crossover at the same time. This is to prevent double payment on the same medical expense.

    Can I request a debit card for my spouse or dependent(s)?

    Yes. You can order multiple cards at no additional cost through the Member Online Service Center.  Click the My Profile tab and the select Debit Card Election from the side menu.

    Can I spend down the funds in my account for expenses incurred after terminating employment?

    No. Expenses incurred after your employment has ended would not be eligible for reimbursement. Additionally, amounts remaining in your account after the end of the claims submission period are forfeited to your employer according to federal tax law.

    Can I use crossover if I am covered under more than one insurance plan?

    If you or any of your covered dependents have more than one health plan (private or Medicare) you should not elect the crossover feature since your patient responsibility amount should be submitted to all insurance companies before your reimbursement account.

    Can I use my debit card for online purchases?

    Yes – you can use your debit card for online purchases, such as prescriptions, if the site is a medical merchant.

    Can I use my debit card like a credit card?

    Yes. Just present your debit card to the merchant to pay for eligible expenses. The account will pay up to the available balance.

    Can I use my medical FSA to pay for my spouse’s deductibles, copayments, or other out-of-pocket medical expenses?

    Yes. Your medical FSA can be used to cover expenses incurred by you, your spouse, and your dependents (as defined by Code Section 152).

    Can I withdraw funds at an ATM?

    The SelectAccount debit card will not work for cash withdrawals from an ATM machine.

    Do I need to keep receipts for my debit card purchases?

    Yes. While most expenses are substantiated at the time of purchase, there are some where you may need to submit documentation to SelectAccount to prove they are eligible to be reimbursed from the account. Failure to respond to a request for proof the expense is eligible can lead to your debit card being suspended. In addition, the IRS requires you to retain proof for up to seven (7) years, in the event you are audited.

    How do I file a medical FSA claim?

    The claim form can easily be completed by logging into your account online and clicking the “submit a claim” button. Once you have completed your claim, print it, sign the form, and fax or mail it to SelectAccount with supporting documentation.

    What documentation should I submit with my claim?

    Documentation must contain the provider’s name, patient name, date of service, type of service, and total patient responsibility. This information is most commonly found on your explanation of benefits from your insurance carrier or an itemized statement from your provider.

    What happens if I use the debit card for a non-eligible expense?

    There are three options:

    • You can return the funds to the account by submitting the Reimbursement Return Form within the same tax year of the non-eligible expense.
    • You can offset the amount with future expenses that are qualified during the same tax year. You must keep your documentation for your own tax purposes.
    • You can declare the amount as a prohibited transaction. You may be subject to income taxes on the amount as well as an IRS penalty.
    What happens to my FSA if I don’t use all of the funds deposited?

    Unused money in your FSA will be forfeited at the end of your plan year unless your plan has a rollover option. In this case, up to $500 of the balance can be rolled forward into the next plan year.

    What happens to my medical FSA when I terminate employment?

    When your employment ends, your participation in the plan also ends. The entire amount you elected to contribute to the plan can be accessed if you have qualifying medical expenses during the plan year prior to your termination date. Medical expenses incurred after the termination date are not eligible for reimbursement unless you elect COBRA and continue to contribute to your account. Be sure to check your Summary Plan Description for your claims deadline as the deadline can change when you leave employment. Any funds you have contributed to the account will be returned to your employer after the claims deadline.

    What is crossover?

    SelectAccount allows employees to eliminate the need to file paper claims by creating an electronic connection between a health plan and SelectAccount. This feature is only currently available if the health plan is Blue Cross and Blue Shield of Minnesota, Blue Cross and Blue Shield of Kansas, CCStpa or BlueLink TPA.

    What is the medical FSA contribution limit?

    Prior to the 2013 plan year, the employer could set minimums and maximums for contributions (there were no IRS limits). Effective with the 2013 plan year, the IRS limits the employee contribution to $2,500. This limit is per plan. If someone changes employers mid-year, they can elect another $2,500.

    What should I do if I lose my SelectAccount debit card?

    Contact SelectAccount as soon as possible at 1-800-859-2144.

    What types of expenses are eligible to be reimbursed from my medical FSA?

    Eligible expenses are defined by Internal Revenue Code Section 213(d). Click here to view a listing of eligible expenses. Please note your employer can limit the types of expenses that can be reimbursed from the account, so please review your Summary Plan Description for any exclusions before incurring the expense.

    When will I receive my debit card?

    You will receive your card within 10-14 business days of SelectAccount processing your enrollment.

    Will I be able to change the amount of money I set aside in my medical FSA during the plan year?

    Yes. However, you must have a qualifying lifestyle change in order to change your election mid-year. Check your Summary Plan Description for additional requirements.

    FSA Calculator

    Understand your tax savings when using an FSA to reimburse yourself for out-of-pocket medical expenses.

    Orthodontia Worksheet

    Worksheet to help determine the amount of orthodontia expenses that can be claimed from a medical FSA