IQVIA Benefits Handbook
THE HEALTH CARE FSA AND COMBINATION FSA
Your Health Care FSA can be used to pay for IRS-approved health care expenses not covered by any other health plan.
The Combination FSA is available to HSA participants. You cannot participate in both an HSA and a regular Health Care FSA. The Combination FSA can be used only on eligible dental and vision expenses (and medical expenses after the medical plan deductible is met).
Annual Contributions
Each year, you may elect to have between $60 and $2,850 deducted from your pay on a pre-tax basis to fund a Health Care or Combination FSA. Annual contributions are deducted evenly from each of your paychecks throughout the year.
Your Dependents
You may submit expenses for dependents up to age 26 who are eligible to participate in the IQVIA Medical Plan, with the exception of domestic partners and their children who you are not able to claim on your tax return. For dependent eligibility requirements, see the Participating in the Health Care Plans section.
Eligible Expenses
In order to be eligible for reimbursement from your Health Care or Combination FSA, expenses must not be covered by another health plan and must qualify as eligible expenses by the IRS. Keep in mind, that the Combination FSA can only be used on eligible dental and vision expenses (and medical expenses after the medical plan deductible is met). For IRS guidelines regarding eligibility, you may log on to the IRS website at www.irs.gov or call 800-829-3676 and request Publication 502.
The following are examples of expenses that may be eligible for reimbursement:
- Acupuncture treatments.
- Birth control items.
- Childbirth classes.
- Copays and coinsurance payments.
- Deductibles.
- Hearing exams and hearing aids.
- Home modifications for medical reasons, e.g., wheelchair ramp.
- Inpatient treatment at a center for alcohol or drug addiction.
- Medically necessary fees paid to doctors, dentists, surgeons, chiropractors, psychiatrists, psychologists and Christian Science practitioners not covered by another plan.
- Prescription drugs not covered by another plan.
- Prescription eyeglasses or contact lenses.
- Qualified long-term care services.
- Smoking-cessation programs and drugs prescribed to alleviate nicotine withdrawal (nicotine gum and nicotine patches, which do not require a prescription, are not eligible).
- Special schooling for physically or mentally handicapped children.
- Speech therapy.
- Transportation costs primarily for and essential to medical care.
- Vision services, including laser vision correction.
- Weight-loss programs associated with a specific disease.
- Wheelchairs and crutches.
Ineligible Expenses
The following are examples of expenses that are not eligible for reimbursement:
- A trip or program for the general improvement of your health.
- Dental bleaching.
- Expenses paid by an insurance company or reimbursed to you from another source.
- Expenses you plan to claim as a deduction on your federal income tax return.
- Expenses reimbursed through your spouse's health care account.
- Health club dues.
- Most cosmetic surgery.
- Nicotine gum and patches that do not require a prescription.
- Premiums for a medical, dental or vision plan.
- Weight-loss programs for general health and appearance.
Accessing Health Care FSA Funds
The FSA debit card gives you direct access to your Health Care or Combination FSA. When you enroll in the Health Care or Combination FSA, you will automatically receive an FSA debit card (Benefits Debit Card). The FSA debit card helps eliminate the need to file claims every time you incur an eligible expense.
Note that if you participate in both the HSA and Combination FSA, you will receive one Benefits Debit Card to use for both accounts.
Automatic Orthodontia Reimbursement
If you or a covered dependent is scheduled for regular orthodontia expenses not covered by a dental plan, you may sign up for automatic orthodontia reimbursement. Fill out the Automatic Orthodontia Request Form available from the Mercer Marketplace website at www.yourflexbenefits.mercermarketplace365.com. You'll need to attach a copy of the contract or letter from your orthodontist outlining your payment plan.
Filing a Traditional Claim
If you need to submit a traditional claim, you may do so via:
For details on claims filing, go to the Mercer Marketplace website at www.yourflexbenefits.mercermarketplace365.com.
You have until March 31 of the following year or 90 days after coverage ends, whichever comes first, to submit expenses incurred during the current calendar year. If you think that your claim will be delivered after March 31, you should send it "Certified" in order to confirm that you mailed it by March 31. If you do not submit claims by March 31, you will forfeit any money remaining in your accounts.
For the Health Care or Combination FSA, you will be reimbursed up to the total amount of your annual contributions, even if the full amount has not yet been credited to your account.
Assume you have $1,000 deducted from your pay to fund your Health Care FSA for the year ($83.33/month). In March, you incur an eligible health care expense of $500. You may be reimbursed for the entire $500, even though you only have about $250 in your account. Once you reach your $1,000 limit, you may not submit any more claims for the year.
Continuing Your Health Care FSA through COBRA
If you terminate employment during the year, you can elect to continue your participation in the Health Care or Combination FSA for the remainder of the year under certain conditions under COBRA. You may only continue to participate in the Health Care or Combination FSA if you have elected to contribute more money than you have taken out in claims. For example, if you elected to contribute an annual amount of $500 and, at the time you terminate employment, you have contributed $300 but only claimed $150, you may elect to continue coverage under the Health Care or Combination FSA. If you elect to continue coverage, then you would be able to continue to receive your health reimbursements up to the $500. However, you must continue to pay for the coverage just as the money has been taken out of your paycheck, but on an after-tax basis. You may also be charged a 2% administrative fee to provide this benefit.
See the COBRA section for more information.
Discontinuing Your Health Care or Combination FSA
If you discontinue your Health Care or Combination FSA as a result of a life status change, you may not submit expenses incurred after that date. You may continue to submit claims for expenses incurred before the change in coverage for 90 days after your contributions end. According to IRS regulations, if there is money remaining in your account after you have been reimbursed for expenses incurred before the change, it will be forfeited.