Health Care Flexible Spending Account
The Health Care Flexible Spending Account (HCFSA) is an account from which you can request reimbursement for out-of-pocket health care expenses for you and/or eligible dependents not covered by your medical, dental or vision plans.
In most cases, an employee's flexible spending account money may not be used to reimburse health care expenses for a same sex domestic partner, even if the college provides other domestic partner health care benefits.
For the benefit plan year (June 1 through May 31) you may elect to contribute a maximum of $2,500 ($104.16 per pay period) to the HCFSA.
NOTE: It is important that you carefully estimate your HCFSA expenses. You will have to incur expenses by the end of the 2½-month “Grace Period” which will be August 15th each plan year or contributions will be forfeited. You have until September 30th to turn in eligible health care expenses that you incur during the June1 through May 31 benefit plan year plus the 2½-month Grace Period. Read a detailed description of the Grace Period.
First Trust of MidAmerica (First Trust) is the benefit administrator responsible for HCFSA claims processing and reimbursement.
Follow these instructions to set up a login on the First Trust website.
Eligible Medical Expense Information - see attached
Flexible Benefit Plan Forms
- Direct Deposit Authorization Form
- Claim Form - (save to your hard drive before using)
- Letter of Medical Necessity Submission Form
- Substantiation Form
You will need Acrobat Reader to open the above PDF files.
Debit Cards for HCFSA
The Benny© VISA debit card allows you to simply swipe the card at eligible locations for eligible expenses and have the amount deducted from your annual HCFSA election. There is no need for claim forms to be filed and no more having to pay out-of-pocket and await payment for those expenses.
- Participants have the option of using the debit card to pay for the healthcare expenses of medical providers, vision care retailers, dentists, pharmacies, etc. so long as the provider accepts debit cards at their location and there are remaining HCFSA funds available.
- First Trust will auto-substantiate all eligible healthcare expenses that equal your medical, dental, vision and RX insurance plan co-pays and multiples up to five.
- The debit card is available for use at most major grocery store and retail pharmacies.
- Auto-substantiation of all IIAS merchant locations. The current list can be found at: www.sig-is.org.
The first time you enroll in the HCFSA, First Trust will automatically issue and send to you, two debit cards in the name of the employee, for your use. After you enroll in the HCFSA, you can request additional debit cards from First Trust for additional family members at the following website: https://ftoma.lh1ondemand.com.
Receipts/Validating Debit Charges
Always keep your receipts because you may be asked to validate your debit charges. See the attached debit card substantiation information. You will receive an email from First Trust if validation is required and a follow up form in the mail. If you do not validate applicable debit card charges by the due date on the letter, your debit card will be suspended. You can email debit card receipts to email@example.com, fax them to 816-540-6462 or mail them to:
First Trust of MidAmerica
P.O. Box 30
Pleasant Hill, MO 64080
If you do not choose to use a debit card, you can complete a claim form and send it to First Trust along with copies of any applicable receipt(s) for reimbursement. You can fax, email or mail your claim form and other documentation to First Trust. Reimbursement requests received by First Trust prior to 11 a.m. will be processed that same business day. By signing up for direct deposit of your reimbursement requests, funds can be in your account within 1-2 business days. If you have the live check option, those checks are mailed out the morning after your claim form is processed.
Monitoring Your HCFSA
Another important resource for you is https://ftoma.lh1ondemand.com, the online resource center, which allows you to log in and monitor your HCFSA 24 hours a day, seven days a week. Follow these instructions to use the online service.
First Trust can be reached via email at firstname.lastname@example.org, by phone at 816-540-6463 or toll free at 888-221-6988, or by fax at 816-540-6462.