How to Pay with FSA Funds

Medical Plan Options A and B:

If you are enrolled in Medical Plan Option A or Option B for medical coverage, there are two ways to pay for eligible out-of-pocket medical expenses from your Health Care FSA administered by UnitedHealthcare (UHC):

  1. If you participate in the Firm’s Medical, Dental or Vision Plans, you may elect automatic reimbursement for your eligible out-of-pocket health care expenses for in-network services. Elect this feature on the Benefit Center website when you make your elections. Note: Automatic reimbursement is not available for out-of-network services, HMSA or Kaiser HMO participants or for expenses relating to your domestic partner.
  2. To submit expenses for out-of-network services, complete an FSA Claim Form (available on the Benefit Center website) and attach an itemized bill or receipt, or the Explanation of Benefits from your medical, dental or vision Plan administrator.

You may elect to roll over up to $550 of your unused Health Care FSA balance to the following year. If you enroll in Medical Plan Option C in a subsequent year, your rollover amount will be forfeited.

Medical Plan Option C:

To pay for eligible Limited Purpose FSA expenses, use the Smart YSA debit card to pay at the time of service or purchase. Eligible expenses will automatically be debited from the correct account—either the HSA or the Limited Purpose FSA—depending on which account the purchase is eligible for.

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