0. Smart, simple savings Flexible Spending Accounts
Health Care
Dependent Care
The University of Tennessee
Plan Year: January 1 – December 31

1. What will be covered? PayFlex® and HealthHub®
Flexible Spending Accounts
Online Enrollment
PayFlex Card®
Getting reimbursed
HealthHub.com
PayFlex Mobile™
Transition to PayFlex
Your connection to HealthHub

2. About PayFlex® & HealthHub®
PayFlex is your administrator for Flexible Spending Accounts.
PayFlex processes your claims and provides you with customer service support.
More than 25 years of experience in administering reimbursement accounts.
HealthHub is PayFlex’s brand name for all our products and services.
HealthHub.com is your resource to:
View your account information
Submit claims for reimbursement
View claim and card transaction history
And more!

3. What is an FSA? Why should you enroll in an FSA?
An FSA is a Flexible Spending Account.
There are two types of FSAs:
Health Care account
Dependent Care account
Let’s you pay for eligible expenses with pre-tax dollars
You contribute to an FSA with pre-tax money from your paycheck
You do not pay Federal income or Social Security taxes on this money
Why should you enroll in an FSA?
You could save up to 30% in what you pay for taxes.
Annual Salary
Health Care FSA Annual Contribution
Dependent Care FSA Annual Contribution
Savings
$30,000
$1,500 $0
$310
$50,000
$1,750
$4,000
$1,188
$70,000
$2,000
$4,500
$1,343
At HealthHub.com, find out how much you can save by using the Savings Calculator and Dependent Care Tax Wizard!

4. Annual minimum contribution Annual maximum contribution
Health Care FSA
Annual minimum contribution
Annual maximum contribution
$120
$2,500
Helps you pay for eligible medical, dental, prescription, vision and/or hearing expenses that are not covered by insurance.
The individuals allowed to use your health care FSA contribution generally includes:
Your spouse
Your child to age 26 (dependent may turn 26 during plan year)
Your dependent who is permanently and totally disabled.
Your entire contribution is available at the beginning of the plan year.
The Health Care FSA maximum for 2013 will be $2,500, due to health care legislation.

5. View a detailed listing of eligible expenses at HealthHub.com
Health Care expenses
Eligible expenses:
Medical & dental deductibles, co-pays and co-insurance
Prescriptions
Over-the-counter items (OTC)
As of 1/1/ OTC drugs & medicines require Rx
Hospital expenses
Selected durable medical equipment
Orthopedic devices
LASIK surgery, eye glasses, contact lenses
Saline/clean solutions
Hearing aids and batteries
Bridges, dentures, crowns, orthodontic care
Chiropractic expenses/co-pays
Insulin, syringes for insulin
Ineligible expenses:
Anti-bacterial soaps
Dandruff or dry skin treatments
Teeth bleaching or mouthwash
Suntan/sunscreen lotion
Cosmetic surgery
Dietary & herbal supplements
Child birth classes
*A letter of medical necessity may allow some of these expenses to be eligible
View a detailed listing of eligible expenses at HealthHub.com

6. Annual minimum contribution Annual maximum contribution
Dependent Care FSA
Annual minimum contribution
Annual maximum contribution
$120
$5,000
Helps you pay for child or adult care costs.
You and your spouse, if married must be actively working, seeking employment, or full-time student, in order to get reimbursed.
The cost of care must be for your child under age 13 or for a spouse or dependent who is not able to take care of him or herself.
You can only be reimbursed up to the amount that is available in your account.
If married and both individuals are enrolled in a dependent care FSA, the combined IRS maximum contribution remains at $5,000.
For example: Each individual could elect $2,500 for their dependent care FSA.

7. Dependent Care expenses
Eligible expenses:
Licensed day care provider
In-home provider as long as the provider is not your child under age 19, or someone you claim as a tax dependent
Summer camps (not overnight)
Tuition through preschool
Before and after school care (under age 13)
Ineligible expenses:
Tuition expenses for kindergarten and beyond
Overnight camps
Child care expenses for a child 13 or older (unless disabled)
Child care expenses for night-time babysitting
Child care expenses while you are on an extended leave of absence
Care provided by an older dependent or sibling
View a detailed listing of eligible expenses at HealthHub.com

8. Things to remember…
You can enroll in an FSA during the annual enrollment period.
You can also enroll when you first become eligible.
Once you enroll, you may only change your election if you have a change in status (i.e., birth, death, marriage, divorce, change in day care provider).
You and/or your spouse do not need to be covered by your employers health plan to participate in an FSA.
Expenses must be for services received, not for services to be provided in the future.
Your employer offers the grace period, which allows you additional time to spend your money. (2 ½ months)
Your employer also offers a run-out period, which allows you additional time to submit claims for reimbursement. (90 days)
FSAs have a use-it-or-lose-it rule. If you have funds left in your FSA at the end of the plan year you will lose them.
Expenses incurred during the grace period will be paid out of “prior” plan year, reducing the available balance first.
After your prior plan year balance is exhausted, the remaining claims will be applied toward the current plan year.
Participants can still used the PayFlex Card for expenses during the grace period.
Plan Year
Grace Period - last day to spend FSA dollars
Run-out period - last day to submit claims
1/1/2013 – 12/31/2013
March 15, 2014
March 31, 2014

9. Getting started is easy with HealthHub®
Getting started is easy with HealthHub®! Review your expenses from the prior plan year. Use our online planning & education tools.
My HealthHub resources – education materials, planning tools, forms and IRS publications
Eligible expense items – general list of eligible health care and dependent care expenses
Savings calculator – estimate your health care and dependent care expenses
Frequently asked questions – helps you understand your FSA
Digital library – helps you understand FSAs and the PayFlex Card®
Once you know how much you want to contribute for the year, you can figure out how much will be deducted each pay period. Divide your annual contribution by the number of pay periods you have (e.g., 12, 24, or 26).
A change in status may include:
- Legal marital status (marriage, divorce, legal separation, annulment or death of a spouse)
Number of tax dependents (birth, adoption or death)
Employment status that affects eligibility
Dependent satisfying or ceasing to satisfy coverage requirements (reaching limiting age, gain/loss of student status, marriage)

10. FSA Online Enrollment: 10/1 – 11/1
Login to HealthHub.com, click on Online Enrollment under Quick Links.

11. Select account
The accounts available to you will be displayed. Check the box for the account(s) you wish to enroll in. If you do not wish to enroll in a particular account, do not check the box.

12. Enter per-pay deduction amount
Enter the amount you want to deduct from your paycheck each pay period. Your annual election will calculate automatically. Click on Save My Elections.

13. Confirm Enrollment This page will show:
The account(s) you have selected to enroll in
Your per pay deduction(s)
Your annual election(s)
Terms and Conditions
To complete the enrollment process, you’ll need to review and accept these Terms and Conditions. If you agree, click Submit.

14. Enrollment confirmation page
A confirmation screen will show the account(s) you have enrolled in. You will also receive an if you have signed up to receive electronic notifications from PayFlex.

15. Using your FSA dollars

16. PayFlex Card® Spending made simple. Select. Swipe. Save.
What is the PayFlex Card?
It is similar to a debit card. You use it to pay for eligible expenses. Generally all you need to is swipe your card and save your receipt.
Benefits of using the card
Immediate payment from your account
Increases your personal cash flow
No claim filing
Ease of use
Where can I use the card?
Physician and dentist offices, vision care providers, and hospitals
Grocery stores, discount stores, web-based merchants
Drug stores and retail pharmacies who have implemented an IRS-approved system
Dependent care providers accepting MasterCard®
*Merchants must accept MasterCard® in order for the card to work

17. PayFlex Card® Spending made simple. Select. Swipe. Save.
What can I purchase with the card?
Eligible health care expenses such as co-pays, prescriptions, vision and hearing products and certain over-the-counter (OTC) items.
Eligible dependent care expenses such as before- and after-school programs, day care, summer day camps, adult care, etc.
Things to remember…
Save all receipts and Explanation of Benefits in case documentation is requested by PayFlex or the IRS.
If you enroll in an FSA, you will receive a PayFlex Card via mail in a plain, white envelope before the beginning of the plan year.
Select “credit” when you use your card. There is no PIN number.
View your account balance, card transaction history and any outstanding card transactions requiring documentation online at HealthHub.com

18. Substantiating your card transactions According to IRS guidelines, PayFlex is required to verify that all purchases made with your PayFlex Card® are eligible expenses.
During the plan year, you may receive a Request for Documentation letter OR see an alert on HealthHub.com that states you have a claim requiring substantiation.
If you receive a letter, you must respond to keep your PayFlex Card ACTIVE.
If you see an alert on HealthHub.com, click on “Learn More” and upload your documentation
Common reasons when documentation may be required:
The amount of the expense does not match your co-pay.
The merchant description provided to PayFlex from the card swipe does not clarify the type of expense. This generally occurs with dental or hospital expenses.

19. How to keep your card active If you see an alert message or receive a Request for Documentation letter, you have three options for substantiating your card transactions.
Option 1: Send us the documentation for the expense.
Upload, fax or mail an Explanation of Benefits (EOB) or itemized receipt for the expense(s) listed in the letter or displayed online.
Option 2: Send us another expense.
Upload, fax or mail an EOB or receipt for another eligible expense. The amount must be equal to or great than the amount in question.
Option 3: Pay back your account for the amount in question.
Send a personal check or money order to PayFlex to cover the amount.
Note:
If you do not respond, we will suspend your card.
Once we receive and process your documentation or payment, your card will be active again.

20. Getting reimbursed If you choose not to use your PayFlex Card®, you can:
Submit a claim online at HealthHub.com (Pay Me or Pay Them)
Pay Me – reimburse yourself for out-of-pocket expenses
Pay Them – pay your provider directly
Submit a claim through the PayFlex Mobile app
Complete a claim form and fax to PayFlex
Complete a claim form and mail to PayFlex
Quick Tips:
An Explanation of Benefits (EOB) or itemized receipt must be sent with your claim form
Your EOB or receipt must include:
the amount you owe
name of merchant/service provider
date of service
service/item received
name of patient (if applicable)
Receive quick reimbursements by enrolling in direct deposit online.
Download a claim form online in My HealthHub Resources.
View your claim history and payments online at HealthHub.com.

21. How to file a claim
To fax or mail a claim, download & print a claim form
via My HealthHub Resources.
Log in to HealthHub.com. Click on File a Claim under Quick Links. Enter your expense type, date of purchase and amount. UPLOAD or FAX or your documentation.

22. HealthHub Participant Website
Go to HealthHub.com. Click on Employee Account Login. Click on Register Now.
Note: You do not need to login to access the top navigation links.
Top Navigation Links
Legislative news – important legislative updates regarding your account
My HealthHub resources – education materials, planning tools, forms and IRS publications
Eligible expense items – listing of eligible health care and dependent day care expenses
Savings calculator – A calculator to help you estimate your annual expenses and potential savings
Frequently asked questions – key information to help you understand your PayFlex account(s)
Digital library – engaging videos to learn more about FSAs and the PayFlex Card®

23. Registering your account
Enter your personnel number (without leading zeros) and enter your home zip code.
Enter your personnel number (without leading zeros) as the Member ID.

24. Create your online profile
Once you click Confirm, you can access your account information.

25. My Dashboard
After successfully registering your account, you can do the following:
View your account balance(s)
Submit a claim for reimbursement
Enroll in direct deposit
View any upcoming payments for claims submitted
View your claim history & card transactions
View card status and order additional cards
View any outstanding card transactions requiring documentation
Print claim forms & educational materials
Enroll in eNotify to receive important account notifications
Shop online with your FSA dollars
View legislative updates and important HealthHub news
View frequently asked questions
Access wellness videos, tips & recipes

26. My Settings Stay up to date on your account
My Settings Stay up to date on your account. Click on My Settings and select Notifications / Address.
eNotify via
Reimbursement Account
Balance Reminder (weekly/monthly)
Claim Received
Explanation of Benefits
Debit Card
Card Declined
Card Documentation Processed
Card Inactivated
Receipt Request Letter
eNotify via web alerts

27. PayFlex Mobile™ Keeping you connected for FREE!
Available for iPhone®, BlackBerry® and Android™ smartphones
Getting Started with PayFlex Mobile
Register your account online at HealthHub.com to create a username and password.
To download the app, access your phone’s app store and select PayFlex Mobile.
To use the app, login to your account using your HealthHub username and password.
Features & Benefits
Account Alerts
Receive notifications related to account status and actions needed to keep your account active.
Account Activity
Access real-time account information including account balances, claims processed and transaction details.
Claims Submission
Submit claims for reimbursement and even substantiate a debit card transaction.
Benefit Plan Details
Store important health plan information and view a list of typical eligible expenses.
Who to contact for assistance
Downloading issues – contact your phone carrier directly for assistance.
All other issues – contact PayFlex Customer Service at

28. Transition to PayFlex 2012 claims 2013 claims Deadline
How it affects you
What you should do
1/2/2013
First day to submit 2013 plan year claims to PayFlex
You can use the PayFlex Card, submit claims online at HealthHub.com or submit paper claims to PayFlex.
3/15/2013
Last day to incur 2012 plan year expenses
No action necessary.
4/30/2013
Last day to submit 2012 plan year expenses
Submit all claims for the 2012 plan year to the University of Tennessee Payroll Office using current claim forms available at flexiblebenefits.tennessee.edu
5/14/2012 BW
5/31/2012 Monthly
Last payday to receive 2012 plan year reimbursements on University of Tennessee payroll.
No action necessary after you have turned in claims forms and supporting documentation to the University of Tennessee Payroll Office.
Q: Will my 2012 FSA payroll deductions continue to be made through the end of the plan year?
A: Yes, your payroll deductions will continue, without interruption, through the end of 2012.
Q: Will my 2013 FSA payroll deductions be made from my University paycheck?
A: Yes, your payroll deductions will continue to be made on each monthly check for monthly paid employees and on the first and second biweekly payrolls ending in a month for biweekly employees.
Q: How will I be reimbursed for my grace period expenses?
A: All grace period expenses must be turned in to the University of Tennessee using current procedures. They will be reimbursed on your University of Tennessee paycheck.
Q: How will I be reimbursed for 2013 plan year expenses?
A: PayFlex will reimburse your 2013 plan year expenses by the payment method you select or you may use your PayFlex Debit Card to pay for the expenses at the time of service. The University cannot provide reimbursement for these claims.
Q: How do I submit claims online using PayFlex’s Express Claims service?
A: Beginning 01/02/2013, you can start submitting claims online with PayFlex. PayFlex’s Express Claims service allows you to submit FSA claims online 24 hours a day, 7 days a week. To access this system for the first time, enter HealthHub.com into your web browser and click EMPLOYEE ACCOUNT LOGIN, then REGISTER. Enter your University Employee ID Number and Zip Code to set up your account.
Q: After the transition period is completed, how quickly will I receive my reimbursement(s) from PayFlex?
A: Claims are processed within 48 business hours of receipt so you can expect to receive reimbursement within 72 business hours of submitting your claim.
2012 claims
Complete the University’s claim form available at print, sign and submit with your supporting documentation to the UWA Payroll Office.
2013 claims
Submit a claim online at HealthHub.com or complete a paper claim a mail or fax to PayFlex

29. Your connection to HealthHub®
Customer Service
Phone:
Hours: Monday – Friday, 7am - 7pm CT
Saturday, 9am - 2pm CT
Submit a Claim
Online: Log in to > select File a Claim
Fax:
Mail: PayFlex Systems USA, Inc.
P.O. Box 3039
Omaha, NE 68103