Flexible Spending Accounts

Flexible Spending Accounts (FSAs) provide a tax-advantaged way to pay for eligible health care and dependent care (includes elder care) expenses. FSAs let you save for eligible health and dependent care expenses with dollars that are automatically withheld from your paycheck before taxes.

There are two types Flexible Spending Accounts:

1. Health Care Spending Account

2. Dependent Care Spending Account

Each year you choose to participate in one, both, or neither account; you are not automatically re-enrolled. You cannot transfer money between the accounts.

Health Care FSA

Set aside money to help pay eligible expenses not covered by your medical insurance. Your contributions will be deducted from your paycheck on a pre-tax basis in equal amounts throughout the year and put into your account.

After your benefit election in Dayforce becomes effective, Inspira Financial will mail you a Inspira Financial debit card along with account enrollment instructions and the Card Holder Agreement. If you enroll in a Health Care Inspira Financial FSA, you can use your debit card for your health care expenses such as Medical, Dental, Vision, and Prescriptions.

NOTE: If you are enrolled in a medical plan that offers an HSA, you are not eligible for the Health Care FSA.

Dependent Care FSA

With a dependent care flexible spending account, you set aside a portion of your paycheck to use for dependent care for:

Your dependent child(ren) younger than age 13 if they generally spend at least 8 hours/day in your home and you provide more than half of their financial support.

Any disabled dependent and/or spouse who cannot care for themselves if they live in your home for more than half the year and you provide more than half of their financial support.

After your benefit election in Dayforce becomes effective, Inspira Financial will mail you a welcome letter. No debit card is associated with the Dependent Care Inspira Financial FSA account. To be reimbursed, you will need to submit a claim online or through the Inspira Financial mobile app. You can also submit a claim by mail or fax.

How an FSA Works

1. Each year, you decide how much to set aside for FSA expenses. Your full contribution amount will be available for use on your benefit effective date.

2. Your contributions are then deducted from your paycheck on a pre-tax basis in equal installments throughout the calendar year for use on qualified expenses.

3. You can use your FSA debit card to pay for eligible expenses at the point of sale, or you can pay out-of-pocket and submit a claim form for reimbursement.

To view your Health Care FSA and Dependent Care FSA account information, you can set up an online account by clicking here. You are not required to set up an account to use your benefits.

You can reach out to Inspira Financial directly with questions regarding either account at 1-888-678-8242.

Contribution Limits

Eligible Expenses

Eligible health care expenses include:

Medical, dental, and vision care not covered by insurance
Health care plan copayments, deductibles, and coinsurance
Nursing home and in-home medical care
Over-the-counter drugs if prescribed by a doctor or psychologist/psychiatrist care
Transportation to and from medical care
Treatment for severe learning disabilities

Click here for a list of covered expenses.

Eligible dependent care expenses include:

Nursery schools, day camps and licensed day care centers (all day tuition costs for kindergarten and higher grades for children aged 5 and older are not eligible expenses)
Day care in your home, except if the provider is the child’s parent, your dependent or your child under age 19
Household services related to the care of an eligible dependent

You will be required to report the name, address, and tax identification number of the care provider on your federal tax return. For a complete list of qualified dependent care expenses, please refer to IRS Publication 503.

Submitting a Claim

After you incur an eligible expense, you can:

Submit a claim online by logging into InspiraFinancial.com. You can upload or fax your documentation of the claim.
Submit a claim using the Inspira Financial Mobile^® app. You can download it for free* from your mobile app store. You’ll use the same username and password that you use for our website.
Complete a paper claim form and mail or fax it with your documentation. Members can find this claim form by logging into InspiraFinancial.com.

What do I need to send with my FSA claim?

It depends on your expense type.

If your expense went through your medical or dental plan, you’ll need to send an Explanation of Benefits (EOB) from your plan. This is the best form of documentation.
If your expense didn’t go through your medical or dental plan, you can send an itemized bill or statement for the expense. It must show:

- Date of purchase or service

- Final amount you were required to pay

- Description of the item or service

- Name of the merchant or provider

- Patient name

For prescriptions, send your detailed receipt that includes the following:

- Pharmacy name

- Patient name

- Prescription name and fill date

- Amount you paid

For dependent care expenses, the dependent care provider must sign a PayFlex claim form or provide an itemized bill. The itemized bill and/or form must include the following:

- Date(s) of service

- Provider’s name

- Dependent’s name

- Amount charged for care

NOTE: If you don’t send an EOB, itemized receipt, or itemized statement with your claim, it will be denied. PayFlex cannot accept a cancelled check, credit card receipt or billing statement that shows “previous balance,” “balance forward,” “estimated,” “filed” or “pending insurance.”

FSA Store

Click here for the complete FSA eligibility list