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.

Medical Plan Option C:

To pay for eligible Limited Purpose FSA expenses, use the Smart-Choice 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.

Deposit Funds Directly into Your Checking Account

Make it easy — elect direct deposit from UHC’s website to have your Health Care and Dependent Day Care FSA reimbursements deposited directly into your U.S. checking or savings account. This way, you will not have to wait for the reimbursement for each claim in the mail.
 

How to Pay with LPFSA Funds – Option C

You may pay for your dental and vision expense from your Limited Purpose FSA administered by AonHewitt. If you enroll in Option C, you cannot enroll in a Health Care FSA:

• Use the Smart-Choice debit card to pay at the time of service or purchase, like you would a debit or credit card. With the Smart-Choice debit card, you don’t have to fill out forms or wait for reimbursements. Eligible expenses will automatically be debited from the correct account.
• Or you may choose to submit an online or paper claim for your unreimbursed dental and vision expenses. You are required to provide the itemized bills, receipts and/or the Explanation of Benefits (EOB) from your dental or vision plan as proof of the unreimbursed eligible expenses.

You can elect direct deposit of your LPFSA reimbursements into your U.S. checking or savings account. To register for direct deposit, visit the Your Profile section on the Your Spending Account website at www.morganstanley.com/benefits.