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Frequently Asked Questions
  • My PayFlex Card®
    • * Note:  These FAQs are designed to provide you with general information.  In the event of a conflict between the information here and your plan documents, the terms of your official plan documents will govern.

      What is a PayFlex Card?
      Your PayFlex Card is a debit card that is tied to your PayFlex account.  You can use this card to pay for health care products and services. This includes doctor and dentist visits, hospital stays, prescriptions and hearing and vision care. You may also use your card at some discount and grocery stores. These stores must have a system that can process a health care card. Note: The merchants and providers must accept MasterCard® in order for your card to work.
       
      What are the benefits of using a PayFlex Card?
      There are four key benefits to the PayFlex Card. 
      1. Immediate payment from your account – You can use your card at the point of service.
      2. Increased personal cash flow – When you use your card you do not have to pay out of pocket. 
      3. Reduced claim filing – You won’t have to submit a claim and wait for reimbursement.  Note: Be sure to keep all of your itemized receipts.  You may be requested to submit them.
      4. Ease of use – Using your card allows you easy access to your funds. 
       
      How does my PayFlex Card work for health care expenses?
      You can use your PayFlex Card to pay for an eligible expense. Swipe your card.  Select “debit” or “credit.”  If you use the card as “debit,” you’ll need a personal identification number (PIN) to complete the transaction. To create a PIN, call Card Services at 1-888-999-0121.  If you receive a new card, you’ll be assigned a PIN. If you order a card for your spouse or dependent, they will use the same PIN you use. 

      Note: The merchants and providers must accept MasterCard® for your card to work. They also must be a health care location (such as a doctor’s office or pharmacy). If they are not a health care location, they must have a system that can process a Health Care card. If you purchase eligible and non-eligible items, you can only use your card to pay for the eligible items. You will have to use another form of payment for the non-eligible items. 
       
      When you first receive your card, it is good for five years. Note for FSA: Each year that you enroll, the card will house the FSA plan year election amount. You can only use the card for expenses that you incur during that plan year.  You should always keep all of your itemized receipts to substantiate card transactions.
       
      Should I select “debit” or “credit” when using my PayFlex Card?
      You can use your card as "credit" or "debit."  When you choose "debit", you will need to enter a Personal Identification Number (PIN). To create a PIN, please call 1-888-999-0121.
                   
      I just received my PayFlex Card. Do I have to use the card for all of my health care expenses?
      No. You do not need to use your card for all health care expenses. You can always use another form of payment for your expenses and submit a claim for reimbursement.
       
      I have an HSA and a Limited Purpose FSA. When I use my PayFlex Card®, how do I know which account is being used?
      When you have an HSA and a Limited Purpose FSA (LPFSA), the type of charge determines which account pays. If you are paying for dental or vision care, PayFlex will first look to your LPFSA. If the LPFSA balance can cover the expense, then that account will pay. If the balance in your LPFSA cannot cover the entire expense, the funds will be taken from your HSA to pay for the rest of the expense. If you have no funds left in the LPFSA and the HSA balance can cover the expense, then the HSA will pay. For all other eligible health care expenses, the funds will come from your HSA.  
       
      Where can I use my PayFlex Card?
      You can use your card to pay for Health Care products and services. This includes doctor and dentist visits, hospital stays, prescriptions and hearing and vision care. You may also use your card at some discount and grocery stores. These stores must have a system that can process a Health Care card. Note: The merchants and providers must accept MasterCard® for your card to work.  
       
      What should I do if my PayFlex Card is not accepted?
      There is more than one reason why you may not be able to use your card. 
      • Some providers do not accept debit or credit cards.
      • A merchant or provider may not accept MasterCard®.
      • The merchant may not be able to accept health care cards.
      • Your account balance may not cover the expense.
      • Your account may be suspended. When your account is suspended PayFlex need more information regarding another card transaction.
      If you are unable to use your card, you will have to use another form of payment. You can then file a claim for reimbursement.
       
      Can I buy over-the-counter (OTC) items with the card?
      You can use your funds to pay for qualified Over-the-Counter (OTC) items and supplies.  These are items such as bandages or a home diagnostic test. You can also use the funds to pay for diabetic supplies and equipment such as crutches.  However, the rules are different for OTC medicines. To use your funds for OTC medicines, you need a written prescription.   A standard list of eligible expenses is available at mtb.payflexdirect.com within My Resources. Click on Planning Tools.
       
      Can I use my PayFlex Card to purchase eligible items online?
      Yes. You can use your card for online purchases of eligible items. Please remember to keep any and all receipts. 
       
      Do I also need to submit a claim form when I use my PayFlex Card?
      If you used your card, please do not submit a claim. However, there may be times when PayFlex needs more information about the card transaction. PayFlex may need you to show documentation that an expense was for qualified medical care. Refer to “What should I do if my account is in overpayment status?”
       
      How do I access my account information online?
      After logging in to mtb.payflexdirect.com, from My Dashboard, select Financial Center from the top navigation bar. Then use the drop down menu to select which account you want to view. You can see account information and card transactions.
       
      Why did I receive a Request for Documentation letter?
      You recently used your PayFlex Card. You received a letter because PayFlex needs more information on that card transaction. PayFlex needs proof that the expense was for qualified medical care. The amount you paid may not match your copay amount. The amount you paid may have been for an estimated amount. PayFlex needs to know how much you were supposed to pay out of pocket for the claim. Note: If you received this letter, your account may be suspended, if you do not respond by the date indicated. While your account is suspended, you cannot use your card for that account.  However, you may request reimbursement by submitting a completed claim.
      You can send one of the following items for the transaction in question.
      • The best form of proof is the Explanation of Benefits (EOB). You will receive this for any claim that first goes through your medical or dental plan.
      • If this is not for a claim that went through your medical plan (for example, an OTC expense), you can use an itemized receipt. The receipt must show the date of purchase or service; the amount you paid; a description of the item or service; and the name of the merchant or provider. Note: If the claim is for an OTC medicine, you must also include a written prescription from your health care provider.
      • If you are sending a prescription drug receipt, it must contain the pharmacy name; patient name; date of the prescription; and amount you paid.
      Please provide this information as soon as possible. You can upload the documentation online. If you are not able to do this, you can mail or fax it to PayFlex. The Request for Documentation letter gives you the instructions for getting that to PayFlex. Once PayFlex confirms that the amount you paid is an eligible expense, PayFlex will re-activate your card.
       
      Note: A cancelled check or credit card receipt alone is not acceptable documentation.
       
      What happens if I do not have enough money in my account to pay for an expense?
      If you do not have enough funds in your account, you PayFlex Card will be denied. You could ask the merchant to charge your card just for the amount that you have available. Then you would pay the balance with another form of payment. Depending on the type of account, you may or may not be able to submit a claim for reimbursement.
      • HSA – Once you contribute more funds to your account, you can submit a claim for reimbursement.
      • MRA and LPFSA – With a MRA or LPFSA, the full amount of your annual election was available on the first day of the plan year. Even though you may still be contributing to the FSA, if you have already been reimbursed up to your annual election amount, you will not be able to submit a claim for reimbursement.
       
      How do I report a lost or stolen card?
      As soon as you know your card is lost or stolen, please contact PayFlex at (888) 879-9280. Note: You should report the loss to us within 30 days. If you report it within 30 days, you will not have to pay for any fraudulent charges as outlined in your card holder agreement
                                                                                     
      What does overpayment status mean?
      An overpayment generally occurs when you pay for an expense with your PayFlex Card® and the documentation does not support the amount you paid.  For example, you used your card to pay for a dental bill. The amount that you paid is more than what your dental plan shows as the amount you owe. In another example, you submit an itemized statement from the health care provider that shows insurance is either estimated, pending or filed but not paid. 
       
      In both examples, your FSA has paid more than what your plan states that you should have paid. When this happens, your FSA will go into an overpayment status. Note: When your FSA is overpaid, PayFlex will suspend your card for that account. This means that you will not be able to use the card for other eligible expenses. If you have other accounts on the card, the card will continue to work for those accounts. For your card to be fully active again, PayFlex needs one of two things. You can send PayFlex the documentation that substantiates the transaction. (Substantiation is proof that an expense was for qualified care and was your financial responsibility.) You can send us a check for the overpayment amount to the following address:
       
      PayFlex Systems USA, Inc.
      Flex Claims Department
      P.O. Box 4000
      Richmond, KY 40476-4000
       
      You can view your card status online at mtb.payflexdirect.com at any time. After logging in, go to Quick Links. On the left side of the screen, click on Manage My Debit Cards.
       
      How do I know if my account is in overpayment status?
      If your account is overpaid, you will see an alert message when you log in to your account. It will appear under Alerts on My Dashboard. If you are enrolled in eNotify, PayFlex will e-mail an Explanation of Payment (EOP) to you. The EOP will explain the overpayment. (eNotify is PayFlex’s e-mail notification service.) If you do not have eNotify, PayFlex will mail the EOP to you. PayFlex store all documents online. You will be able to view the EOP online at any time. Note: If your account is overpaid, your card will be suspended for that account. 
      • View your PayFlex EOP online - You can view the EOP online. You can also download it. After logging in, go to My Dashboard. On the left side of the screen, select My Documents. From the drop down menu, select Coupon with EOP Report. If your account is overpaid, you will see the EOP that PayFlex has sent to you. 
         
      • Enroll in eNotify - To receive e-mails about your account, you will need to enroll in eNotify.  After logging in, go to My Settings. Click on Manage Notifications. Then, follow the online instructions. 

      What should I do if my account is in overpayment status?
      If your account is overpaid, you must do one of the following:  

      • If the claim that caused the overpayment has gone through your medical or dental plan, you should have received an Explanation of Benefits (EOB). Fax, mail or upload that EOB along with a copy of the letter notifying you. The EOB will show the date of service, a description of the service and the amount you have to pay for the claim. This will allow PayFlex to validate if the amount equals or exceeds the transaction amount. 
      • If the EOB shows that you did overpay, you can substitute another eligible expense for the overpayment amount. Fax, mail or upload the EOB along with a completed claim form for that other expense. If you do not have an EOB, you can use a detailed receipt. The receipt must show the date of purchase or service; the amount for which you were financially responsible; a description of the item or service; and the name of the merchant or provider. Note: You must have incurred this expense in the same plan year. The amount of this expense would have to be equal to or greater than the overpayment amount. You also must not have already received reimbursement for this expense.
      • If you do not have another expense to offset the overpayment, you will have to repay the account. You can mail a check for the amount of the overpayment. Make the check payable to PayFlex Systems USA, Inc. and mail to the address below.  Please do not send cash.
       
      PayFlex Systems USA, Inc.
      Flex Claims Department
      P.O. Box 4000
      Richmond, KY 40476-4000
       
      I used my PayFlex Card to pay for my dental expenses. My dentist overcharged me. How should I fix this?
      If your dentist overcharged you, you will have to work with your dentist to fix this. Your dentist will have to return the amount he or she overcharged you.  The dentist should credit the amount back to your PayFlex Card.  If the dentist will not credit your card, your account will remain in an overpayment status until other eligible expenses have been submitted, or you can send in a check made payable to PayFlex Systems USA, Inc. and mail to the address below to offset the overcharge. 
       
      PayFlex Systems USA, Inc.
      Flex Claims Department
      P.O. Box 4000
      Richmond, KY 40476-4000
       
      I received a bill for an estimated amount. Should I pay this amount?
      When you receive a bill for an estimated amount, that means that the amount you will actually owe is unknown. Therefore, you should wait until your insurance plan pays the claim and determines how much you owe before you use your PayFlex Card for payment. Your plan will send you an EOB showing the exact amount you owe. 
    • Note: This information is general in nature for informational purposes only. Please refer to your employer’s plan for specific information about your plan.

      What is a PayFlex Card?
      Your PayFlex Card is a debit card. You can use this card to pay for health care products and services. This includes doctor and dentist visits, hospital stays, prescriptions and hearing and vision care. You may also use your card at some discount and grocery stores. These stores must have a system that can process a health care card. Note: The merchants and providers must accept MasterCard® in order for your card to work.

      What are the benefits of using a PayFlex Card?
      There are four key benefits to the PayFlex Card.
      1. Immediate payment from your account – You can use your card at the point of service.
      2. Increased personal cash flow – When you use your card you do not have to pay out of pocket.
      3. Reduced claim filing – You won’t have to submit a claim and wait for reimbursement. Note: Be sure to keep all of your itemized receipts. You may be requested to submit them.
      4. Ease of use – Using your card allows you easy access to your funds.

      How does my PayFlex Card work for health care expenses?
      You can use your PayFlex Card to pay for an eligible expense. Swipe your card. Select “Credit.” (Though this is a debit card, you will not select “Debit.”) Your transaction will process like any other credit or debit card purchase. Note: The merchants and providers must accept MasterCard® for your card to work. They also must be a health care location (such as a doctor’s office or pharmacy). If they are not a health care location, they must have a system that can process a Health Care card. If you purchase eligible and non-eligible items, you can only use your card to pay for the eligible items. You will have to use another form of payment for the non-eligible items.

      When you first receive your card, it is good for five years. Note for FSA: Each year that you enroll, the card will house the FSA plan year election amount. You can only use the card for expenses that you incur during that plan year. This includes a grace period if your employer offers one on the FSA. You should always keep all of your itemized receipts to substantiate card transactions.

      Should I select “debit” or “credit” when using my PayFlex Card?
      You can use your card as "credit" or "debit."  When you choose "debit", you will need to enter a Personal Identification Number (PIN). To create a PIN, please call 1-888-999-0121.

      I just received my PayFlex Card. Do I have to use the card for all of my health care expenses?
      No. You do not need to use your card for all health care expenses. You can always use another form of payment for your expenses and submit a claim for reimbursement.

      Where can I use my PayFlex Card?
      You can use your card to pay for eligible health care products and services. This includes doctor and dentist visits, hospital stays, prescriptions and hearing and vision care. You may also use your card at some discount and grocery stores. These stores must have a system that can process a Health Care card. Note: The merchants and providers must accept MasterCard® for your card to work.

      What should I do if my PayFlex Card is not accepted?
      There is more than one reason why you may not be able to use your card.

      • Some providers do not accept debit or credit cards.
      • A merchant or provider may not accept MasterCard®.
      • The merchant may not be able to accept health care cards.
      • Your account balance may not cover the expense.
      • Your account may be suspended. When your account is suspended we need more information regarding another card transaction.

      If you are unable to use your card, you will have to use another form of payment. If your plan allows, you can then file a claim for reimbursement.

      Can I buy over-the-counter (OTC) items with the card?
      You can use your funds to pay for OTC items and supplies. These are items such as bandages or a home diagnostic test. You can also use the funds to pay for diabetic supplies and equipment such as crutches. However, the rules are different for OTC medicines. To use your funds for OTC medicines, you need a written prescription. A standard list of eligible expenses is available online. After logging in, go to My Resources. Click on Planning Tools.

      Can I use my PayFlex Card to purchase eligible items online?
      Yes. You can use your card for online purchases of eligible items. Please remember to keep any and all receipts.

      Do I also need to submit a claim form when I use my PayFlex Card?
      If you used your card, please do not submit a claim. However, there may be times when we need more information about the card transaction. We may need you to show documentation that an expense was for qualified medical care. Refer to “What should I do if my account is in overpayment status?”.

      How do I access my account information online?
      After logging in, from My Dashboard, select Financial Center from the top navigation bar. Then use the drop down menu to select which account you want to view. You can see account information and card transactions.

      Why did I receive a Request for Documentation letter?
      You recently used your PayFlex Card. You received a letter because we need more information on that card transaction. We need proof that the expense was for qualified medical care. The amount you paid may not match your copay amount. The amount you paid may have been for an estimated amount. We need to know how much you were supposed to pay out of pocket for the claim. Note: If you received this letter, your account may be suspended, if you do not respond by the date indicated. While your account is suspended, you cannot use your card for that account. However, you may request reimbursement by submitting a completed claim.

      You can send one of the following items for the transaction in question.

      • The best form of proof is the Explanation of Benefits (EOB). You will receive this for any claim that first goes through your medical or dental plan.
      • If this is not for a claim that went through your medical plan (for example, an OTC expense), you can use an itemized receipt. The receipt must show the date of purchase or service; the amount you paid; a description of the item or service; and the name of the merchant or provider. Note: If the claim is for an OTC medicine, you must also include a written prescription from your health care provider.
      • If you are sending a prescription drug receipt, it must contain the pharmacy name; patient name; date of the prescription; and amount you paid.

      Please provide this information as soon as possible. You can upload the documentation online. If you are not able to do this, you can mail or fax it to us. The Request for Documentation letter gives you the instructions for getting that to us. Once we confirm that the amount you paid is an eligible expense, we will re-activate your card.

      Note: A cancelled check or credit card receipt alone is not acceptable documentation.

      What is an Inventory Information Approval System (IIAS)?
      An Inventory Information Approval System (IIAS) is a system that marks a product or service as an eligible health care expense. Stores that sell eligible and non-eligible items must have an IIAS to accept health care cards. These include drug stores, discount stores and grocery stores. These types of stores sell more than just health care items. For example, a drug store also sells newspapers, food items and cosmetics. When you purchase a number of items, the IIAS marks the items that you can pay for with your PayFlex Card. You would then pay for the other items with another form of payment.

      What should I do if a store does not have an Inventory Information Approval System (IIAS)?
      If the store does not have an IIAS, you can still make your purchase. You will have to use another form of payment. You can then submit a claim for reimbursement.

      What happens if I do not have enough money in my account to pay for an expense?
      If you do not have enough funds in your account, you PayFlex Card will be denied. You could ask the merchant to charge your card just for the amount that you have available. Then you would pay the balance with another form of payment. Depending on the type of account, you may or may not be able to submit a claim for reimbursement.

      • HSA – Once you contribute more funds to your account, you can submit a claim for reimbursement.
      • Health Care FSA – With a Health Care FSA, the full amount of your annual election was available on the first day of the plan year. Even though you may still be contributing to the FSA, you will not be able to submit a claim for reimbursement.

      What should I do if my card is lost or stolen?
      Contact us as soon as possible to report a lost or stolen card to help limit any potential loss or liability as outlined in your cardholder agreement. We can then cancel your card and send you a new one.

      If you’re still worried about identity theft after cancelling your card, you can use MasterCard’s Identity Theft Resolution Services at no cost. They can assist you with the process of restoring your identity. Identity Theft Resolution Services include:

      • 24/7 access to MasterCard’s certified resolution specialists
      • Internet monitoring to proactively detect stolen personally identifiable information and compromised confidential data online
      • Assistance from a specialist with notification to all three major credit reporting agencies to place blocks on cardholders’ records and obtain free credit reports
      • Assistance with completing paperwork to alert various parties of the potential fraud
      • Education about how identity theft can occur and protective measures to avoid further occurrences
      To learn more about the Identity Theft Resolution Services, call the MasterCard Assistance Center at 1-800-MC-ASSIST (1-800-622-7747).

      MasterCard® is a registered trademark of MasterCard International Incorporated.
  • Health Care Flexible Spending Account (FSA)
    • *Note: This information is general in nature for informational purposes only. Please refer to your employer’s plan for specific information about your plan.
      Do I have to enroll in my employer’s medical or dental plan to participate in the health care FSA?
      Your plan will determine this. Although your employer can require that you take the medical or dental plan in order to have a health care FSA, not all plans are designed this way. You should check your plan documents to confirm this. 
       
      I have a health care FSA. If I’m contributing throughout the year, how much will my FSA cover for a claim in the beginning of the year?
      With a health care FSA, your full election amount is available on the first day of the plan year. This means that you can use your entire election on day one of the plan year.
       
      Example: You elect to contribute $1,200 for the plan year. In January, you have contributed $100. ($100 x 12 months = $1,200) In that same month, you receive health care services that cost you $1,000. At this point, you haven’t submitted any other claims. This means, you’ll receive the full amount of the claim from your FSA. You don’t have to wait until you actually contribute this amount to your health care FSA.
       
      What expenses are eligible under a health care FSA? 
      Generally, expenses that are medically necessary are considered eligible. This means if you need the service or product for your health it may be an eligible expense. This includes co-payments, co-insurance and deductibles. You can view a list of common eligible expenses on this website. You can also find more information at www.irs.gov. Refer to IRS Publications 969 and 502. You should also check your plan documents for eligible expenses under your plan.
       
      Can I use my FSA to pay for over-the-counter (OTC) items, supplies, drugs and medicines?
      Yes. However, there are different rules on how you can use your FSA to pay OTC items, supplies, drugs and medicines. You can use your PayFlex Card® to pay for OTC items and supplies. These include items such as bandages, hot/cold packs, thermometers, first aid kits, home diagnostic tests and diabetic supplies. You can also pay for these items out of pocket and then submit a claim to us. 
       
      For OTC drugs and medicines, you can’t use your PayFlex Card. First, you’ll need a written prescription from your doctor. Then you’ll have to pay for the OTC drug or medicine out of pocket and then submit a claim to us. You’ll need to include your written prescription and the detailed receipt with your claim.
       
      May I submit eligible health care expenses incurred by my spouse and dependents?
      Yes. You can be reimbursed for eligible health care expenses that you, your spouse and eligible tax dependents incur during the plan year. This is true even if you don’t cover your spouse and dependents on your health plan.
       
      Why do I have to show that an expense was medically necessary?
      There are some products or services that aren’t always used for medical care. Some products may be used for general health reasons. Two examples are massage therapy and weight loss programs. If you use the product or service to treat a medical condition, you’ll need to show that. This is “evidence of medical necessity.” You can submit a prescription or letter from your health care provider. You can also have your health care provider complete and sign a Letter of Medical Necessity form. You can find this form in the Resource Center.
       
      Can I pay my spouse’s health insurance premiums through my health care FSA?
      No. Premiums aren’t an eligible expense for the health care FSA. You can view a list of common eligible expenses on this website. For more information, visit www.irs.gov. There you can view IRS Publications 969 and 502.
  • Managing My Settings
    • What is the web address for PayFlex?
      The web address is: mtb.PayFlexDirect.com.

      How do I enroll in direct deposit?
      You can enroll in Direct Deposit online or with a paper form. Once you enroll, you can receive your reimbursements directly into your checking or savings account. To get started, from the top navigation select the Financial Center. Click on Enroll in Direct Deposit from the left navigation bar and follow the steps.
      To use paper enrollment, you can download the form. The form is available in the Resource Center under Administrative Forms. Complete the form. Mail it to us at the address on the form.

      How do I change my username and password?
      You can change your user name or password at any time. Go to My Dashboard. From the left navigation bar, select My Settings. Follow the instructions to make your changes.

      How do I change my e-mail address?
      You can change your e-mail at any time. Go to My Dashboard. From the left navigation bar, select My Settings. Follow the instructions to make your changes. Note: This is the e-mail address that we will use for all account communications.

      What is eNotify? How do I enroll?
      eNotify is our electronic notification service. When you enroll in eNotify, you will receive alerts and updates on your account. Depending on your plan, you can choose which notifications you want to receive. These include balance reminders and claim status. To get started, go to My Dashboard. From the left navigation select My Settings. Click on Notifications / E-mail Address and follow the steps.
  • Filing A Claim
    • How do I file a MRA or LPFSA claim?
      After you incur an eligible expense, you have two options for filing a claim.
      • You can submit a claim online at mtb.payflexdirect.com. You can then upload, mail or fax your documentation along with the fax cover sheet. Once logged in, from the left navigation bar select File a Claim.
      • You can complete a paper claim form. You can download a claim form. Once logged into mtb.payflexdirect.com, from the Quick Links in the left navigation, select My Resources. Click on Administrative Forms. You would mail or fax the completed claim form along with your documentation.

      What type of documentation do I need to include with my MRA or LPFSA claim?
      Acceptable documentation is one of the following.

      • If the claim first goes through your medical or dental plan, you will receive an Explanation of Benefits (EOB) from the insurance plan. This is the best form of documentation.
      • If the claim is not run through your medical or dental plan (for example, an Over-the-Counter (OTC) expense), you can use the itemized receipt or statement. The receipt must show the date the purchase or service is incurred; the amount for which you are financially responsible; a description of the item or service; and the name of the merchant or provider. Note: If the claim is for an OTC medicine, you must also include a written prescription.
      • If you are sending in a prescription drug receipt, it must contain the pharmacy name; patient name; drug name (if listed); date the prescription was filled; and amount you paid.
      • If the claim is for dependent care, the dependent care provider must sign the claim form or provide an itemized receipt.
      Note: A cancelled check,  credit card receipt or balance due statement are not acceptable forms of documentation.
       
      I have a MRA or an LPFSA. If I am contributing throughout the year, how much will my FSA cover for a claim in the beginning of the year?
      With a MRA or LPFSA your full election amount is available on the first day of the plan year. This means that you can use your entire election on day one of the plan year. This is true even though you have not yet made all of your contributions for the year.

      Why do I have to show that an expense was medically necessary?
      There are some products or services that are not always used for medical care. Two examples are massage therapy and a weight loss program. If you use the item or service to treat a medical condition, you will need to show that. This is “evidence of medical necessity.” You can submit a prescription or letter from your health care provider. You can also download a Letter of Medical Necessity form. Your Health Care provider can fill it out and sign it. Once logged in, go to My Resources on the left hand navigation.  The form is in Administrative Forms.

      Can I pay my spouse's health insurance premiums through my MRA or LPFSA?
      No. Premiums are not an eligible expense for the MRA or LPFSA. You can view a standard list of eligible expenses online. Once logged in, go to My Resources on the left hand navigation. Click on Planning Tools, then Eligible Expense Items. For additional information on eligible expenses, please refer to IRS Resources within My Resources.  Here you will find links to IRS Publication 502 and IRS Publication 969

      How does the MRA or LPFSA reimburse orthodontia?                                          
      The IRS recognizes that orthodontia is different from any other type of health care. For reimbursement of orthodontia, you may request your reimbursement under any of the three options available, depending on your arrangement with your provider.  Please remember to submit to your dental insurance carrier prior to submitting to PayFlex.
      1. Coupon Payment Option –this option works best when the orthodontist provided you either a coupon book or a monthly reminder statement of expenses. You must submit the coupon or itemized statement with a completed claim form. You will do this as the service is provided. 
         
      2. Monthly Payment Option –the Auto Pay option allows you to set up recurring monthly reimbursements.  To do this, you must submit a copy of the contract or agreement* that you have with the orthodontist along with the completed claim form and the box on the claim form checked indicating you wish to establish automatic monthly reimbursements. Once we process the first claim, we will automatically reimburse you each month. You do not have to submit a claim form for each visit. We use the agreement to set the monthly amount that you will receive from the FSA for the length of the agreement. Note: You must be enrolled in the FSA and have funds available. You will receive the monthly payments on or about the due date stated in your agreement.
       
      * You can get a payment contract or agreement from your orthodontist. That agreement must include the patient’s name; date that the service began; the length of service; cost of the initial banding work; and the amount you must pay each month.
       
      Note: If you use the Auto Pay option, you cannot also use the PayFlex Card® for these expenses. 
      1. Total Payment Option – you may have the option to pay the full amount when the treatment begins. If your plan allows and you did pay the full amount, you can receive reimbursement for the amount you paid out-of-pocket. We will reimburse you up to your FSA election amount, minus any previous FSA payments. Note: If you have sent in other claims, make sure to check your FSA balance. You can do this online. This will let you know how much you have available to cover your orthodontia treatment. 
       
      With this option, you must include a copy of your paid receipt. You also need to include an itemized statement. This must include the provider’s name; the patient’s name; date that the service began; the amount you paid; and the amount insurance will pay. Note: You can only submit this once for reimbursement.
       
      I have a Dependent Care FSA.  If I am contributing throughout the year, how much will my FSA cover for a claim in the beginning of the year?
      A Dependent Care FSA reimburses only eligible incurred expenses up to the amount you have contributed, minus any previous payments.  A Dependent Care FSA reimburses up to the balance in the account. 

      I have a Dependent Care expense that I want to submit for reimbursement. However, I don’t have enough in the account right now to cover the full amount.  How should I submit this claim?
      You can file your claim for the actual amount. However, the FSA will only reimburse you up to the balance in your account. The remaining amount will not be reimbursed to you until your scheduled contributions are available.  Once the additional funds are available, the FSA will reimburse you for the remaining amount.

      I pay tuition for my child’s kindergarten. Is this an eligible Dependent Care expense?
      The cost of tuition is not an eligible expense. This includes kindergarten, as well as first grade and higher. If your child is in before- and after-school care those may be eligible expenses if the before- and after-school care is so you can work.

      I just had a baby and will be home for six weeks. I'm taking my older child to day care during this time. Will these day care expenses be eligible?
      This is not an eligible expense. The Dependent Care must be so you can work. Since you are not working during this period, the day care expense is not reimbursable.

      I pay my neighbor to watch my 13-year-old after school. Is this an eligible expense?
      No. Care must be for a qualifying person. A qualifying person includes your dependent child who is younger than age 13. Unless your child is mentally or physically incapable of caring for him or herself, this is not an eligible expense.   

      My 16-year-old daughter cares for my 8-year-old son after school. Will my Dependent Care FSA reimburse me for the amount I pay my daughter?
      No. This is not an eligible expense. If the care provider is your child, he or she cannot also be your tax dependent. He or she must be 19 or older by the end of the year. Refer to IRS Publication 503 for more information.   

      When can I submit a claim for my Dependent Care expenses?
      You would submit claims after the completed dates of service. For example, you pre-pay your care provider every Friday for the next week. You must wait until the end of the next week to submit your claim. 

      What type of documentation do I need to include with my Dependent Care claim?   
      When you submit a claim, PayFlex needs the detail for that expense. Include only one of the following for reimbursement:
      • You can submit a Dependent Care FSA Claim Form that your care provider has signed. The form must include dates of service; name of dependent; cost of care; and the care provider’s name. With your care provider’s signature, this claim form is an itemized statement of the expense:
      OR
      • If your care provider does not sign the claim form, he or she must provide an itemized statement. You would then include that statement with the completed claim form. The itemized statement must include the dates of service; name of dependent; cost of care; and the care provider’s name.
    • How do I file an FSA claim?
      After you incur an eligible expense, you can:
      • Submit a claim online. You can upload or fax your documentation to us.
      • Submit a claim using the PayFlex 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 this website.
      • Complete a paper claim form and mail or fax it with your documentation. You can find this form in the Resource Center.
      *Standard text messaging and other rates from your wireless carrier still apply.   

      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 receipt or statement for the expense. It must show the:
      • Date of service or purchase
      • Amount you were required to pay
      • Description of the item or service
      • Name of the merchant or provider
      If the claim is for an over the counter (OTC) drug or medicine, you must also include a written prescription from your doctor.

      For prescriptions, send your detailed receipt. It must include the pharmacy name, patient name, prescription name, date the prescription was filled, and amount you paid.

      For dependent care expenses, the dependent care provider must sign the claim form or provide an itemized receipt. It must include the date(s) of service.

      Note: If you don’t send an EOB, itemized receipt or statement with your claim, we’ll deny it. We can’t accept a cancelled check, credit card receipt, or billing statement that shows “previous balance,” “balance forward,” “estimated,” “filed,” or “pending insurance.”
  • Paying for Dental Expenses with your Reimbursement Account
    • How do I know if my account is in overpayment status?
      If your account is in overpayment status, you'll see a message under Alerts on My Dashboard.  If you sign up for the Explanation of Payment (EOP) notifications by e-mail, you'll also get EOPs for overpayment. They're sent from eNotify@payflex.com.  If you don't select the e-mail option for EOP notices, we'll mail the notices to your home address.  We store all documents online, in case you misplace one. 
       

      Access your Explanation of Payment online    
      To view and download notices, log in and select My Documents from the left hand navigation bar. Then select Coupon with EOP Report from the drop down menu. If your account is in overpayment, you'll see the Explanation of Payment notice(s) that have been sent to you.  If your account is in overpayment status, we'll deactivate your card.  You can view your card status online by clicking on Manage My Debit Cards under Quick Links on the left hand navigation bar.
       

      Sign up for account notifications
      Log in and select My Settings. Then click on the notifications link, enter your e-mail address twice and select the notifications you wish to receive either via email or web alert. To save your changes, click Submit.

  • Dependent Care Flexible Spending Account (FSA)
    • How does the Dependent Care FSA work?

      How does the Dependent Care FSA work?
      With a Dependent Care FSA, expenses must be work-related. This means that you need the care so that you can work.

      • If you are married, you must both be working. If just one of you is working, the other spouse must be actively looking for work; be a full-time student; or be unable to care for him or herself. Note: Unpaid or minimally paid volunteer work does not count as employment.
      • The expenses must be for a qualifying person. A qualifying person is your dependent child who is younger than age 13 or a spouse or tax dependent that is not physically or mentally able to care for him or herself.
      • You must receive these services from an eligible care provider. This can include providers such as a licensed child care facility, an adult day care center and possibly a summer day camp.  Check your specific plan for further details.
      • The care provider cannot be your tax dependent, your child who is under age 19 at the end of the year, a person who was your spouse any time during the year or the parent of your qualifying person. The expenses must be for a service you received during the plan year and while the qualifying person regularly spends at least 8 hours each day in your home. They cannot be for future services. For example, you prepay your child’s summer day camp. You cannot receive reimbursement until after your child attends the camp.
      • The annual reimbursement is limited to the lesser of your earned income for the year or the cost of care, up to $5,000. If you are married, this limit is based on the income of the lower paid spouse and whether you file separate tax returns.
      You must file Form 2441, Child and Dependent Care Expenses, with your tax return.

      What expenses are eligible under a Dependent Care FSA?
      You can view a standard list of eligible expenses online. Once logged into mtb.payflexdirect.com, go to My  Resources and click on Planning Tools. You can find more information at www.irs.gov. Please refer to IRS Publication 503, Child and Dependent Care Expenses.

      If I participate in the Dependent Care FSA, do I need to report this on my income tax return?
      Yes. When you have a Dependent Care FSA, you must include this information as part of your tax return. You will do this on IRS Form 2441: Child and Dependent Care Expenses. (See Instructions for IRS Form 2441 for more information.) If you have questions, please speak with your tax advisor.

      How much can I contribute to a Dependent Care FSA?
      The most that you can contribute to a Dependent Care FSA is $5,000. This is per household per year. This means that if you and your spouse each have a Dependent Care FSA, you are limited to $5,000 between you. Keep in mind, this amount may be less based on earned income and tax filing status.

      What does "work-related" mean?
      Work-related means that you pay for dependent care so that you can work and earn an income. If you are married, your spouse must also work. If just one of you is working, then the other one must be actively looking for work; be a full-time student; or be unable to care for him or herself. Note: Unpaid or minimally paid volunteer work does not count. For the IRS definition of work-related expenses, please refer to IRS Publication 503.

      If I have the Dependent Care FSA, can I also use the Child and Dependent Care Tax Credit?
      Generally, if you have a Dependent Care FSA you cannot also take the full tax credit.  Please consult your tax advisor for specific information based on several variables such as tax filing status, number of dependents, earned income, tax bracket, etc. to learn which option is most beneficial for your unique situation.

      Note: These FAQs are designed to provide you with general information. In the event of a conflict between the information here and your summary plan description/plan document, the terms of your official summary plan description/plan documents will govern.
  • All About Flexible Spending Account (FSAs)
    • What is a Flexible Spending Account?

      Flexible Spending Accounts (FSAs) let you pay for eligible expenses with tax-free money. You contribute to an FSA with pre-tax money from your paycheck. This, in turn, lowers your taxable income.

      What are the different types of FSAs, and how do I know what I qualify for?
      A Medical Reimbursement Account (MRA), also referred to as a traditional Health Care FSA, helps you pay for eligible out-of-pocket medical, dental, vision and hearing expenses. Out-of-pocket expenses are those that your insurance does not cover. These include deductibles, coinsurance and co-pays and certain over-the-counter (OTC) items. If you enroll in M&T’s medical plan and open an HSA, you are not eligible for an MRA.

      A Limited Purpose FSA (LPFSA) helps you pay for eligible out-of-pocket dental and vision expenses. Out-of-pocket dental and vision expenses are those that your insurance does not cover. These include deductibles, coinsurance and co-pays and certain over-the-counter (OTC) items. If you are enrolled in M&T’s medical plan and open an HSA, you only qualify for a LPFSA (you are not eligible for a MRA).

      A Dependent Care FSA helps you pay for eligible child or adult day care expenses. These expenses are so that you and, if you are married, your spouse can work, look for work or attend school full-time. These include day care, before- and after-school care programs, nursery school or preschool, summer day camp and adult day care. The cost of care must be for your child under age 13, or for a spouse or tax dependent who is not able to take care of him or herself and regularly spends at least eight hours a day in your home.

      How much money can I expect to save in taxes with an FSA?
      You will gain the most savings from your FSA if you plan carefully. When you contribute to an FSA, that money is deducted from your pay on a pre-tax basis and deposited into your FSA over the length of a year. This means that you pay less in Federal and Social Security and (in most cases) state and local payroll taxes. Generally, federal taxes range from 15% to 28% and Social Security taxes are 7.65% of your pay with state and local taxes varying.

      How does an FSA work?

      Managing your FSA is as easy as 1-2-3.

      Estimate how much you will spend on eligible health care expenses, dependent care expenses or both during the plan year. This is what you pay out-of-pocket. Be sure to take into account whether you qualify for a MRA or a LPFSA and the eligible expenses associated with those types of accounts. (See Question "What expenses are eligible for reimbursement under a MRA and LPFSA?" for more detail.)

      1. Decide how much you wish to set aside into your Medical Reimbursement Account (MRA), Limited Purpose FSA (LPFSA), and your Dependent Care FSA, up to the plan limits. M&T will deduct that amount from your paycheck in equal amounts each pay period. These deductions are pre-tax. Note: These are separate FSAs. The MRA and LPFSA cannot pay for dependent care expenses. The Dependent Care FSA cannot pay for health care expenses.
      2. As you incur eligible expenses throughout the year, you have two ways to use your funds. You can use your PayFlex Card® to pay for your services. If you do not have or do not want to use the card, you can submit a claim form for reimbursement.

      Can I change my election during the plan year, and if so how do I make that change?
      Your FSA election remains in effect for the plan year. This is an IRS rule. The only way to change your FSA election during the plan year is if you have a qualified change in status. If you have a status change, the change you wish to make to your FSA must be consistent with the status change event. Here is a list of status change events. Note: Your plan determines which of these are allowed under the plan. Please refer to your plan documents for more information.

      • Change in legal marital status (marriage, divorce, legal separation, annulment, death of a spouse)
      • Change in number of tax dependents (birth, adoption, death)
      • Change in employment status that affects benefit eligibility or change in spouse’s employment
      • Dependent becomes or is no longer eligible under the plan (reaches limiting age)

      Keep in mind that the election change must be consistent with the event. If you experience a qualified change in status, please go to the MyBenefits enrollment website to submit the change within 30 days of the date your change in status occured.

      How do I get reimbursed?
      As you incur eligible expenses throughout the plan year, you have two ways to use your funds. You can use your PayFlex Card® to pay at the point of service for your health care expenses, or if you do not have or do not want to use the card, you can submit a claim form for reimbursement. You can find the claim form on the mtb.payflexdirect.com website under My Resources.

      What does the term "incurred expense" mean?
      The IRS considers an expense to be "incurred" at the time you receive the care, not when you are billed or pay for the expense. The expense must be incurred within the FSA plan year and while you have coverage for you to receive reimbursement.

      Here are some examples.

      • Your FSA coverage is effective January 1 through December 31 of this year. Expenses that you incur during this period can be reimbursed.
      • You received Health Care services in December of last year. You paid for those services in February of this year. This expense cannot be reimbursed. In this example, you incurred the expense before the start of the FSA plan year.
      • You had dental work done this year, in January. However, you prepaid for the work last December. Though you paid for the work last year, you incurred the expense this year. This expense can be reimbursed from your FSA.

      What happens if I have funds left in my account at the end of the plan year?
      If you have funds left in your account at the end of the year and after the claims filing deadline has been exhausted, they are forfeited under the IRS "use-it-or-lose-it" rule. You can avoid losing money at the end of the year. Review your current and prior years’ expenses. This will help you estimate what you may spend in the next year. Make sure to be conservative while planning for predictable expenses.

      What is the claims filing deadline period?
      Eligible claims incurred from January 1 – December 31 can be submitted until March 31st of the following year in which the services were incurred.

      The one exception to this deadline is if you terminate employment mid-year, you will have 90 days from your date of termination (unless you qualify and elect COBRA) to file claims. (See Question "What happens if I leave my company?" for more detail).

      What happens if I leave my company?
      Your FSA coverage (MRA, LPFSA, and Dependent Care FSA) ends on your last day of employment. Reimbursement can only be requested on eligible expenses incurred before the date of your termination, unless you qualify and elect continuation of coverage under COBRA. You will have 90 days from your termination date to submit eligible claims

      If my spouse and I each have an FSA, can we claim each other's expenses?
      For health care expenses, you cannot claim the same expense for both accounts. In other words, you cannot "double-dip." If you claim your spouse’s expenses on your FSA then your spouse cannot claim those same expenses on his or her FSA. If your spouse claims your expenses under his or her FSA, then you cannot also claim them under your FSA.

      For Dependent Care expenses, you and your spouse can each have a Dependent Care FSA. However, between the two of you, you are limited to a maximum reimbursement of $5,000 per household or $2,500 per spouse if filing separate tax returns in day care costs which may be reduced based on earned income and tax filing status.

      Medical Reimbursement Account (MRA) and Limited Purpose Flexible Spending Account (LPFSA)

      Do I have to enroll in my employer’s medical or dental plan to participate in the MRA or LPFSA?
      No, you do not need to enroll in M&T’s medical or dental plan to participate in the MRA or LPFSA; however, your enrollment will determine which type of account you qualify for. If you are enrolled in M&T’s medical plan and open an HSA, you are only eligible for the LPFSA. If you do not enroll in M&T medical coverage, or you choose not to open an HSA, you are eligible for a Medical Reimbursement Account.

      Is there a limit to the amount I can contribute to my MRA or LPFSA for each plan year?
      The IRS allows a contribution of up to $2,500 regardless of which type of account you are enrolled in, a MRA, or LPFSA. As a reminder, you cannot have both types of accounts.

      What expenses can be reimbursed by a MRA and LPFSA?
      In a MRA, you can be reimbursed for eligible medical, dental, vision and hearing expenses. In a LPFSA, you can be reimbursed for eligible dental and vision expenses. Expenses that are medically necessary and not reimbursed by insurance or any other type of reimbursement are generally eligible. You can view a standard list of eligible expenses online at mtb.payflexdirect.com under My Resources within Planning Tools. In addition, under IRS Resources you will find helpful information in IRS Publications 502 and 969.

      Can I use my MRA for over-the-counter (OTC) medications and supplies?
      The IRS allows reimbursement for certain OTC items. To confirm whether or not an item is allowable before purchase, please visit www.irs.gov or contact Payflex toll free at (888) 678-7742. Eligible OTC items that contain a medication or drug will require a written prescription. In order to request reimbursement, you will have to include the prescription with your claim.

      You can continue to use your MRA funds to purchase OTC items that do not contain a medicine or drug without a prescription (for example: bandages without antibiotic ointments, splints, cold/hot packs, rubbing alcohol, thermometers, etc.). Insulin may continue to be reimbursed with or without a prescription.

      May I submit expenses incurred by my spouse and dependents?
      You can be reimbursed for eligible medical expenses incurred by you, your spouse and eligible dependents. This is true even if your spouse and dependents are not on your health plan.

      Note: These FAQs are designed to provide you with general information. In the event of a conflict between the information here and your summary plan description/plan document, the terms of your official summary plan description/plan documents will govern.

  • Health Savings Account (HSAs) Simplified
    • What is a Health Savings Account?

      A Health Savings Account (HSA) is a tax-advantaged health care account that you own. You contribute to it with tax-free or tax-deductible funds. You can then use those funds to pay for qualified medical expenses now and in the future. You can use these funds for your own expenses and for those of your spouse and dependents. This is true even if your spouse and dependents are not on you health plan. To contribute to an HSA you must have a qualified High Deductible Health Plan (HDHP) and not be enrolled in any type of non-HDHP coverage.  (see the question, “What is a qualified HDHP?”).

      Each year, the IRS sets the maximum amount you can contribute to the HSA. The funds that you contribute but do not use will roll over year to year. In addition, an HSA is portable. This means that if you change employers or leave the work force, the HSA stays with you. Finally, with an HSA you do not have to submit documentation for the funds you use. However, you should keep all your receipts as validation that you used the funds for qualified expenses. You should also keep your receipts in the event of an IRS audit. 

      What is the tax advantage of an HSA?
      The HSA is “triple tax advantaged”, which means that it’s tax-advantaged in the following ways:

      • Tax-free contributions. The contributions you make to your HSA and that M&T contributes on your behalf (if you are eligible for an account seed) are not taxed when they’re deposited into your account.  Note: You must be eligible to contribute the money to your HSA (as defined by the IRS).  You should consult a tax advisor.  Tax references are at the federal level.  State taxes may vary.
      • Tax-free growth. None of the interest or investment earnings in the HSA are taxed. Investment products are not FDIC insured, have no bank guarantee, and may lose value.
      • Tax-free withdrawals. If you withdraw money from your HSA to help pay for qualified health care expenses, your money comes out of the HSA tax-free.

      Will I ever have to pay taxes when I use my HSA funds?
      When you use your funds for qualified health care expenses, you do not pay taxes on that amount. If you use your HSA funds for a non-qualified expense, then you will have to pay income taxes. You may also have to pay a 20% penalty tax. There are times when the penalty tax does not apply. If you are disabled or age 65 or older at the time you use the funds, you do not have to pay the penalty. Upon the death of the account owner, the account becomes the property of the named beneficiary. If the beneficiary is the surviving spouse, the account remains an HSA and typical HSA rules apply (for ex., distributions not used for qualified medical expenses are subject to ordinary income tax). If the beneficiary is a person other than the surviving spouse, the HSA is no longer an HSA as of the date of the account holder's death.  The beneficiary must include in gross income the fair market value of the HSA as of the date of death.

      Who is eligible for an HSA?
      You're eligible to enroll in an HSA, if you have a qualified High Deductible Health Plan (HDHP), such as M&T’s medical plan. (See the question: “What is a qualified HDHP”?).

      You and your employer are eligible to contribute to an HSA, but there are a few rules:

      • You can't have any non-permitted coverage (for ex., a non-HDHP medical plan, such as a PPO or HMO, or a traditional Health Care FSA such as the M&T Medical Reimbursement Account (MRA)).
      • You can't be enrolled in Medicare or TRICARE.  
      • You can't have used Veterans Affairs (VA) medical benefits in the prior three months. Except in cases where the hospital care or medical services were for a service-connected disability. 
      • You can't be claimed as a dependent on another person’s tax return.

      What is a qualified High Deductible Health Plan (HDHP)?
      A qualified HDHP must have minimum deductible (the amount you pay out of your own funds before the plan begins to pay) of at least $1,300 for individual coverage and $2,600 for family. The plan must also limit the amount you potentially could pay out-of-pocket in a year to $6,550 for individual coverage and $13,100 for family. These minimum and maximum amounts are established by IRS and may change from year to year.

      The Plan is permitted to waive the deductible requirement for eligible preventative services and still be considered a qualified HDHP for HSA purposes.

      Does M&T’s Plan meet these qualifications?
      Yes, M&T’s Consumer Driven Health Plan is a qualified HDHP. See M&T’s specific plan design for your deductible and out-of-pocket maximum.

      Can I have a Medical Reimbursement Account  (MRA) with an HSA?
      If you are contributing to an HSA, you cannot have a MRA. However, you are permitted to have a Limited Purpose FSA (LPFSA) which reimburses you for eligible dental and vision expenses. It is important to note that if your spouse opens a MRA or Health Care FSA through his or her employer and you are eligible for reimbursement from that FSA, that is considered other non-HDHP coverage and therefore makes you ineligible to contribute to an HSA.

      What other types of health coverage can I have and still be eligible for an HSA?
      You can still be eligible for an HSA if you have certain other coverage. You can have other insurance that covers the items listed below. You may also have a discount card. A discount card gives you discounts on health care services or products.

      • Coverage relating to liabilities from workers’ compensation laws, torts, or ownership or use of property (such as automobile insurance)
      • Specified disease or illness
      • A fixed amount per day (or other period) for hospitalization
      • Accidents*
      • Disability*
      • Dental care*
      • Vision care*
      • Long-term care*
      • Most Employee Assistance Programs (EAP)

      * This coverage can be through insurance or some other form of coverage. 

      What expenses can I use my HSA for?
      You can use your HSA funds to pay for your out-of-pocket costs. You can use your HSA to pay for qualified medical, dental, vision and hearing expenses received on or after the effective date of your HSA. For more information, please refer to IRS Publications 969 and 502. The health care can be for you, your spouse and your dependents. This is true even if they are not on your HDHP.  

      You can use your HSA funds to pay for your out-of-pocket costs. To use your HSA funds, you must have received the care on or after the effective date of your HSA. For more information, please refer to IRS Publications 969 and 502. 

      Can I use my HSA to pay for my contributions or medical plan premiums?
      If you are under age 65, you generally cannot pay for contributions from an HSA, but there are a few exceptions. The only premiums that may be paid from an HSA prior to age 65 are:

      • COBRA coverage
      • Qualified long-term care insurance
      • Any health plan maintained while receiving unemployment compensation

      If you are age 65 or older, you can use your HSA to pay for the M&T sponsored post-65 retiree medical plan.  Medicare premiums (Part B and D), or a Medicare Advantage plan.  You cannot use your HSA to pay for premiums for Medicare Supplemental coverage (or “Medigap” plans). 

      If I no longer have a qualified HDHP in the future, can I still use my HSA to pay for health care expenses?
      Yes. You can continue to use your HSA funds to pay for out-of-pocket health care qualified medical expenses. However, you will not be eligible to make any further HSA contributions.

      Who may contribute to my HSA?
      Anyone can contribute to your HSA. This means that you, your spouse, your employer, a family member and any other person can contribute. Though anyone can contribute to your HSA, all of those contributions count toward your annual limit.

      How much can I contribute to my HSA?
      Each year, the IRS sets annual contribution limits for HSAs. For 2017, the limit for an individual enrolled in a self-only plan will be $3,400. The contribution limit for a family enrolled in a family HDHP will be $6,750. For 2016, the limits are $3,350 (self-only) and $6,750 (family).
       
      You can contribute up to these limits while you (or your family) are enrolled in a high-deductible health plan.You can contribute permitted amounts in a lump sum or on a scheduled contribution basis.You can change your scheduled contribution amount at any time during the year as long as you don’t exceed the annual limit.If you are age 55 or older, you can contribute another $1,000 per year. This is a “catch-up” contribution designed to allow additional savings for retirement health expenses.
       
      This means that the amount that you can contribute is based on a few things.

      1. Do you have self-only or family coverage? 
      2. Did you have coverage under the HDHP plan for the entire year? If not, the maximum contribution amounts may be limited or pro-rated based on the number of months you are enrolled in the plan.
      3. How old are you? Are you 55 or older? 

      You may want to speak to your tax advisor. He or she can help you understand how much you can contribute to your HSA.See also IRS Publication 969 at www.irs.gov.

      How much can I contribute if I do not have the HDHP for the entire year?
      How much you can contribute depends on when you had the HDHP.
       
      If you are covered under an HDHP on December 1, then the Last-month rule applies. This means that if you are covered on December 1 you can contribute to your HSA as if you were covered under the HDHP for the entire year. However, if you make this full-year contribution you must remain covered under the HDHP throughout the all of the next calendar year.  Otherwise, you will be taxed on contributions made for the months you were not covered in the first year and will be subject to an additional 10% tax penalty. 

      Example: You have an HDHP starting on May 1, 2016. You still have the HDHP coverage on December 1, 2016. You contribute the full contribution amount for 2016. However, at some point in 2017 you are no longer covered under a HDHP.  You will have to pay income taxes on the amount for those months in 2016 that you were not actually eligible. In this example that would be for the months of January through April 2016. You would also have to pay a 10% tax penalty on that amount. 
       
      If you have an HDHP for part of the year but not on December 1, then the Proration rule applies. Proration means that you can contribute just for the months that you are eligible. The amount you can contribute to your HSA is determined by dividing the annual contribution limit (e.g., In 2016; $3,350 for self-only, $6,750 for a family) by 12, and multiplying the result by the number of months you are covered under the HDHP during the year.    Note: Eligibility is based on being covered under the HDHP on the first day of each month.

      Example: On January 1, 2016, you enroll in a family HDHP, but your coverage under that plan ends on April 30, 2016. The most that you can contribute for the year is $2,250.00 ($6,750/12 = $562.50 x 4 months). 
       
      You may want to speak with your tax advisor. He or she can help you to figure out how much you can contribute.  
       
      How much can I contribute if I change my level of HDHP coverage during the year?
      How much you can contribute depends on the coverage that you have when you start and end the year. 
       
      If you have a self-only HDHP on January 1 and a family HDHP on December 1, the last-month rule applies. With the last-month rule, you can contribute as if you were eligible for the entire year. This means that you can contribute as if you had family coverage under the HDHP all year.

      So, if you have family coverage under the HDHP on December 1 then you can contribute as if you had family coverage for the entire year.  However, if you do contribute up to the family limit for the full year you will have to maintain family coverage under the HDHP through the end of the following year.   If you do not maintain family coverage under the HDHP throughout the following year the contributions you made for the months you did not have the HDHP in the prior year are no longer tax-free.
       
      If you start the year with a family HDHP but have self-only HDHP coverage by December 1, the Proration rule applies.  Proration means that the maximum contribution amount allowed will be determined based on the number of months you had family and self-only coverage.  For each month of family coverage you can contribute 1/12 of the annual family contribution limit ($6,750), and for each month you have self-only coverage you can contribute 1/12 of the annual self-only contribution limit ($3,350).  

      Example: From January 1 through July 31, 2016, you have a family coverage under an HDHP. From August 1 through December 31, 2016, you have a self-only HDHP coverage. For January through July, you can contribute $3,937.50. ($6,750/12 = $562.50 x 7 months) For August through December, you can contribute $1,395.83. ($3,350/12 = $279.16 x 5 months) In this example, you can contribute $5,333.33. ($3,937.50 + $1,395.83) 
       
      You may want to speak with your tax advisor. He or she can help you to figure out how much you can contribute.

      I have Veterans (VA) benefits. Can I contribute to an HSA?
      Generally, you can’t contribute to an HSA if you’ve used your VA benefits during the prior three months. However, if you used your VA benefits for a service-connected disability and you meet all other HSA eligibility requirements, you can contribute to an HSA.

      What is a “catch-up” contribution?
      If you are enrolled in an HDHP and are age 55 or older, you can contribute another $1,000 annually to your HSA. This is a catch-up contribution. For example, you have a self-only HDHP. For 2016, the contribution limit is $3,350.  If you are 55 or older, you can contribute up to $4,350 for the year. ($3,350 + $1,000) Note: This is assuming that you are eligible for the full year. 
       
      If you have family HDHP coverage and your spouse is age 55 or older, he or she can also make a catch-up contribution of $1,000 annually. If your spouse wants to do this, he or she would have to open up his or her own HSA. Only one person can own an HSA. This means that your spouse cannot contribute his or her catch-up contribution to your HSA.
       
      If you would like to contribute the entire catch up contribution through payroll deduction, you must contribute funds every pay period.Otherwise, you’ll need to make a post-tax contribution online or send a check to PayFlex.
       
      Note: If you are eligible for benefits under Medicare you cannot make a contribution or catch-up contribution to an HSA.  

      Can I transfer funds from my IRA into my HSA?
      Yes. You can make a one-time transfer from your IRA into your HSA. You would do this as a trustee-to-trustee transfer. The transfer amount is tax-free. It also counts toward your HSA contribution limit for the year. You must stay in a qualified HDHP for 12 months after the transfer date. This is the testing period. If you do not keep HDHP coverage for the entire testing period, you will have to pay income taxes on the transfer amount. You may also have to pay a 10% penalty tax. If you have additional questions, you should talk to your tax advisor.

      When is the deadline for making contributions to an HSA?
      For any year that you have an HSA, you can contribute until April 15th  of the following year. If you make a prior year contribution between January 1 and April 15th,  please indicate this as a prior year contribution on both the contribution form and your check. If you do not let PayFlex know, PayFlex will post the contribution for the current year.

      Contributions can be made by either check or online through your HSA.  You are able to setup a one-time or recurring contribution to your HSA from a linked bank account via the PayFlex website.  You may also make one-time contributions via check with the appropriate contribution form.

      How can I keep track of my balance?
      You can view your account balance online. After logging in, go to on My Dashboard. If you want more detailed information, click on View My Account.

      Will I receive a statement of my account activity?
      Yes. You will receive statements for your account activity. You choose how you receive them. You may receive them online or via US Mail. Note: There may be a fee for paper statements.  For a listing of fees, please refer to the Fee Schedule located on the left hand navigation within the Financial Center.

      What happens if I contribute more than the allowable annual amount?
      The amount that you can contribute to your HSA each year is based on a number of factors. These include your level of HDHP coverage, how long you had the HDHP and your age. If you (or anyone else) contribute more than that amount, you have an “excess contribution.” You should remove the excess contribution from your HSA either by requesting a withdrawal online or in writing to us using the address below.  In either case, please note that you are requesting a withdrawal that is “a return of excess contribution”. You should do this by the tax filing deadline for that year. If you do not remove the excess contribution, that amount will be subject to income taxes and a 6% penalty tax. Please talk to your tax advisor if you have more questions. 

      PayFlex Systems USA, Inc.
      P.O.Box 3317
      Carol Stream, IL 60132-3317

      Do I need to keep my receipts?
      With an HSA you do not have to submit documentation for the funds you use.However, you should keep all your receipts as validation that you used the funds for qualified expenses, or in the event of an IRS audit.

      When can I receive distributions from my HSA?
      Once you have funds in your HSA, you can use the funds at any time. You can keep the funds there to save for future expenses. You can use the funds to pay for expenses you now have. You can go online to make a payment to your provider or pay yourself back. If you have a PayFlex Card®, you can use it at the point of service. If you paid out of your pocket, you can go online and reimburse yourself.  After logging in to mtb.payflexdirect.com, from the top navigation bar click on Financial Center. Under Health Savings Account, select Make a Withdrawal. Enter all the required fields and click Continue.

      If you linked your bank account, you will receive the reimbursement as a direct deposit to your personal account. This can take up to 48 hours for you to see the funds in your account. To do this, from the top navigation bar, click on Financial Center.  Under My Account on the left hand navigation, click on Link My Bank Accounts and following the instructions.

      Can I use my PayFlex Card with my HSA?
      Yes. You can use your PayFlex Card with your HSA. If you have more than one account with us, you will receive just one card. For example, you have an HSA and a Limited Purpose FSA.  You will receive one card for both accounts. The PayFlex Card is a MasterCard® that you can use at qualified merchants. Please remember to save all of your receipts.   

      I have an HSA and a Limited Purpose FSA. When I use my PayFlex Card®, how do I know which account is being used?
      When you have an HSA and a Limited Purpose FSA (LPFSA), the type of charge determines which account pays. If you are paying for dental or vision care, we will first look to your LPFSA. If the LPFSA balance can cover the expense, then that account will pay. If the balance in your LPFSA cannot cover the entire expense, then with any unpaid amount we will take the funds from your HSA.  If the HSA balance can cover the expense, then the HSA will pay. For all other eligible Health Care expenses, the funds will come from your HSA.  

      How do I get reimbursed if I did not use my PayFlex Card® for a HSA expense?
      You can go online to request a reimbursement.  After logging in to mtb.payflexdirect.com, from the top navigation bar click on Financial Center. Under Health Savings Account, select Make a Withdrawal. Enter all the required fields and click Continue.

      If you linked your bank account, you will receive the reimbursement as a direct deposit to your personal account. This can take up to 48 hours for you to see the funds in your account.  After logging in, from the top navigation bar, click on Financial Center.  Under My Account on the left hand navigation, click on Link My Bank Accounts and following the instructions.

      Can I name a beneficiary for my HSA?
      Yes. You can go online to name your beneficiaries. You may name up to four primary beneficiaries and up to four contingent beneficiaries. You most likely did this when you first registered your HSA online.  However, if you didn’t or you would like to make any changes, you can change your beneficiaries at any time online.  After logging in, click on the Financial Center, then select Health Savings Account from the “Select Account” drop down menu. In the left navigation, click on My Profile. Select Beneficiaries. Enter the required information.

      Who is responsible for determining whether HSA distributions are used for medical expenses?
      As the account owner, you have to make sure that you use your HSA funds for eligible medical expenses. You should keep all of your receipts. Also make sure to keep good records of your withdrawals. You should talk to your tax advisor if you have more questions. 

      What happens if I terminate employment?
      If you change employers or leave the work force, the HSA stays with you. It does not stay with your former employer. The account information will remain the same. This means that you will have the same PayFlex account and card. However, you may have to pay some new account fees. If applicable, these fees will be sent to you in writing from PayFlex.  

      What happens to my HSA upon my death?
      First, your estate can use the funds to pay any unpaid medical bills you may have at the time of your death. Your beneficiary will receive the remaining HSA funds. If that is your spouse, the HSA will remain an HSA. However, it will be in your spouse’s name. Your spouse will not have to pay any taxes on these funds.

      If the beneficiary is not your spouse, then the funds do not stay in an HSA. Your beneficiary will receive the funds as a withdrawal from your HSA. This means that the funds will be subject to income taxes. The funds will not be subject to the 20% penalty tax. Note: If you have a spouse and the beneficiary is not your spouse, some states require your spouse’s consent for you to have that beneficiary. You should speak to an attorney or tax consultant for more information.

      Is my HSA FDIC insured?
      Yes.  When you open an HSA, the funds are in a “cash” account.  This is similar to any other bank account.  Like with other bank accounts, the HSA funds are FDIC-insured.

      Can I invest my HSA funds?*
      You first need to have a minimum balance of $1,000 in your HSA.  Once you have more than $1,000 in your HSA, you can invest any amount over that minimum balance. You can find this minimum balance amount in the Financial Center of your online account.  From there, go to the investments page.
       
      If you do invest any of your HSA funds, those funds would be in an “investment” account.  Any funds in an investment account are not FDIC-insured.
       
      Once you open an investment account, a monthly investment fee will be taken out of your HSA cash account.  You can view your account fees in the Financial Center of your online account.  Select your Health Savings Account from the drop down menu.  Click on Fee Schedule on the left side.    
       
      What are my investment options?

      You'll be able to choose from a variety of mutual funds.  You can view these funds in the Financial Center of your online account.  Select your Health Savings Account from the drop down menu. Click on the investment link on the left side of the screen to get started.
       
      Note:
      You must have more than $1,000 in your HSA cash account to invest your funds.  You can invest any amount over this minimum balance.

      If I no longer have a qualified HDHP, can I still use my HSA to pay for health care expenses?
      Yes. When you have a qualified HDHP you can contribute to the HSA. When you no longer have the HDHP you cannot contribute to the HSA. However, you can continue to use your HSA funds to pay for out-of-pocket Health Care qualified medical expenses.

      I have an HSA with another bank. Can I also enroll in a PayFlex HSA?
      Yes. You can have more than one HSA. The amount that you contribute to all HSAs is still limited to the annual contribution limit for the year. 

      You may also close your old HSA and transfer the funds to your new HSA. You may be paying fees on your old HSA. If so, you may want to consider that in regards to having more than one HSA.

      When am I eligible for a Health Savings Account (HSA)?
      First, you must have a qualified High Deductible Health Plan (HDHP) to have an HSA.  The date that you are eligible for the HSA is based on the effective date of your HDHP. 

      • If your HDHP starts on the first day of the month then you are eligible for the HSA that same day.  For example, the HDHP starts on January 1.  You are eligible for the HSA on January 1. 
      • If your HDHP starts on any day after the first day of the month, you are eligible for the HSA on the first day of the next month.  Let’s look at an example.  Your HDHP is starts on January 15.  You are eligible for the HSA on February 1.

      Once you sign up for the HSA, you must go through a Customer Identification Process (CIP).  With the CIP, we verify your name, Social Security number, address and date of birth.  If we need more information from you, that could delay the opening of your HSA.  Once your HSA opens, that is the effective date.  So, your effective date may be later than the date you are eligible.

      When can I start to use my HSA?
      You can start to use your HSA once it is open and funded.  Your effective date determines which expenses you can pay with the HSA funds.  You can use your HSA funds for expenses that you incur on or after the HSA effective date.  You can’t use the HSA for expenses that you incurred before the HSA opened.

      I am over age 65 and enrolled in Medicare – can I contribute to an HSA?
      No, the IRS considers Medicare non-HDHP coverage, and therefore being enrolled in Medicare makes you ineligible to contribute to an HSA.

      I am currently over age 65 and enrolled in Medicare, however; I have HSA funds remaining from when I was under age 65. Can I still use my HSA?
      Yes, while you must be enrolled in a qualified HDHP (and no other form of non-HDHP medical coverage) to contribute to an HSA, you can use the funds for eligible health expenses regardless of what type of plan you are enrolled in.

      I am age 65 (or older) and I am enrolled in Medicare. I also still have coverage through my employer’s health plan. May I use my HSA funds to pay my contribution to my employer’s health coverage?
      The answer depends on how you pay for your employer’s health plan. If you pay those premiums with pre-tax money, then the answer is no. You cannot use your HSA funds to pay for premiums that you pay pre-tax.

      If you pay the premiums with after-tax money, then you can use the HSA funds for this expense. Once you reach age 65, this is an eligible expense for the HSA.

      I am enrolled in Medicare. Can I use my HSA funds for my Medicare premiums?
      If you are age 65 or older, you can use your HSA to pay for contributions for the M&T sponsored post-65 retiree medical plan, Medicare premiums (Part B and D), or a Medicare Advantage plan. Premiums for Medicare Supplemental coverage (or “Medigap” plans) cannot be paid for by the HSA.

      My spouse is enrolled in Medicare, but I am not. Am I eligible to make an HSA contribution?
      Yes. Your spouse’s Medicare status does not affect your ability to make an HSA contribution. You are eligible to make contributions to the HSA as long as you satisfy the HDHP requirements. For example, assume you enrolled yourself and your spouse in the HDHP, you have no other non-HDHP coverage (including Medicare) and your spouse is covered by Medicare. You would be eligible to make the family maximum contribution to your HSA. Note: You cannot use your HSA to reimburse yourself for your spouse’s Medicare premiums unless you are over age 65.

      I am an active employee under age 65. Can I use my HSA to help pay for expenses incurred by my spouse who is covered by Medicare Part A & B?
      Yes.  You can use your HSA to pay for eligible out-of-pocket expenses for any of your qualified dependents, regardless of whether or not the dependent is enrolled in a HDHP.  Please note that you cannot use your HSA to pay for your spouse’s Medicare premiums, because you are under age 65.

      I am an active employee over age 65 - can I open a HSA and receive M&T’s employer contribution?
      If you are age 65 or over, you are not eligible to contribute to an HSA. Based on your eligibility as it relates to M&T’s frozen salary bands, you may be eligible to receive the value of M&T’s contribution as taxable income through payroll in lieu of an HSA contribution from M&T.

      HSAs for Domestic Partners/Same Sex Spouses

      Can I enroll my domestic partner or same sex spouse in the HDHP?  Can I use my HSA for his or her eligible expenses?

      Under M&T’s medical plan, your domestic partner or same sex spouse may be enrolled as your dependent in your medical plan, however; unless your domestic partner is a “tax dependent” of yours under the IRS tax code, you may not reimburse their health care expenses from your HSA without incurring a income tax penalty of 20%. You should speak to an attorney or tax consultant for more information.  You are eligible to make pre-tax contributions to your HSA up to the family contribution maximum of $6,750.

      The rules are different for same-sex spouses. The IRS now recognizes same sex marriages for federal tax purposes.  This follows the U.S. Supreme Court ruling on the federal Defense of Marriage Act (“DOMA”).  In that ruling, the Court said that Section 3 of DOMA is unconstitutional.  This decision affects health savings accounts (HSAs).   If you and your spouse are legally married under state law you may now fund a joint HSA (rather than separate individual accounts), and you can use your HSA to pay for your own and your spouse’s eligible expenses.   This does not apply to domestic partnerships, civil unions or other non-marriage relationships recognized by state law.

      Can my domestic partner or same-sex spouse open his or her own HSA?
      Your domestic partner or same-sex spouse covered under M&T’s medical plan may open his or her own HSA at a financial institution of his or her choice, and be reimbursed for his or her qualified medical expenses from that HSA. Additionally, your domestic partner or same-sex spouse enrolled in the M&T medical plan can contribute up to the annual family HSA contribution maximum. That means that for 2016, you and your domestic partner or same-sex spouse can each contribute $6,750 to your respective HSA accounts.

      Note: If you and your same-sex spouse are legally married under state law you may now fund a joint HSA (rather than separate individual accounts), and you can use your HSA to pay for your own and your spouse’s eligible expenses. 

      You should speak to an attorney or tax consultant for more information , including questions about annual contribution maximums and how to take tax deductions for post-tax deposits. 

      HSAs for Veterans Affairs Benefits-Eligible Individuals

      Are employees and dependents covered under Veterans Affairs benefits eligible for the HSA?

      Merely being eligible for benefits through the Department of Veteran’s Affairs does not disqualify an individual from opening or contributing to an HSA. The IRS has indicated that an individual eligible for an HSA can make a tax-deductible contribution for any month if he or she has not received VA benefits during the preceding three months.

      Note that the IRS has indicated that preventive care received from the VA will not trigger the three month ineligibility provision.

      Note: These FAQs are designed to provide you with general information. In the event of a conflict between the information here and your summary plan description/plan document, the terms of your official summary plan description/plan documents will govern.
      _________________________________________________________________________________________________

      *Investment services are independently offered through a third party financial institution.

      By transferring funds into an HSA investment account you can potentially benefit from capital appreciation in the value of mutual fund holdings. However, you will also be exposed to a number of risks, including the loss of principal, and you should always read the prospectuses for the mutual funds you intend on purchasing to familiarize yourself with these risks.

      The HSA investment account is an optional, self-directed service. We do not provide investment advice for HSA investment account participants. You are solely responsible for any investment account decisions you make. Mutual funds and brokerage investments are not FDIC-insured and are subject to investment risk, including fluctuations in value and the possible loss of the principal amount invested. The prospectus describes the funds’ investment objectives and strategies, their fees and expenses, and the risks inherent to investing in each fund. Investors should always read the prospectus carefully before making any investment decision.

      System response and account access times may vary due to a variety of factors, including trading volumes, market conditions, system performance, and other factors.