Flexible Spending Accounts

If you’re currently contributing to a Health Savings Account and want to set aside even more pre-tax money for health expenses, the LPFSA is the account for you. You can contribute up to $3,300 per year through pre-tax paycheck contributions. The money is yours to pay for eligible vision and dental expenses. And after you meet your medical plan deductible, you can use your LPFSA to pay out-of-pocket medical expenses, too.

Contributing to Your LPFSA

• You can contribute from $260 to $3,300 per year.
• Your contributions are deducted from your paycheck pre-tax, in equal amounts throughout the year, and deposited in your LPFSA.
• Your annual contribution total is available for you to use on January 1.

Using Your LPFSA

• Your HSA Bank debit card can be used to pay for 2025 FSA expenses.
• You can access your HSA Bank accounts directly through HSA Bank’s member website at myaccounts.hsabank.com.
• Keep your receipts to submit with your claims for reimbursement and to confirm your expenses, if requested.
• You have until March 31 of the following year to file claims for expenses incurred in the current year.

What Your LPFSA Can Pay For

You can use the money in your LPFSA to cover qualified dental and vision expenses, including:

• Your share of expenses, for dental work, including orthodontia; prescription glasses, contact lenses and solution, LASIK or other eye surgery
• Your share of medical expenses after you meet your medical plan deductible

You can find a complete list of eligible LPFSA dental and vision expenses in IRS Publication 502, Medical and Dental Expenses.

How to Use Your LPFSA for Medical Expenses

Once you have met your medical plan’s deductible, you can use your LPFSA to reimburse yourself for eligible medical expenses (incurred on or after January 1, 2025), in addition to dental and vision expenses. This is known as a Post-Deductible LPFSA. Here’s how to file a claim for medical expenses:

• Notify HSA Bank that you have met your annual medical plan deductible by submitting a Post-Deductible Expense Reimbursement Certification Form along with a copy of an Anthem Explanation of Benefits (EOB). Only medical expenses incurred after you meet your deductible are eligible for reimbursement.
• HSA Bank will use the date Anthem processes your claim as the effective date of your Post-Deductible LPFSA. Example: You meet your deductible after a doctor visit on March 7, 2025. Anthem processes your claim on March 12, 2025, which becomes the effective date of your Post-Deductible LPFSA.
• If you already have an HSA Bank debit card you won't receive a new one; your current card will be updated to cover out-of-pocket medical expenses, too.

You can contribute up to $5,000 for 2025 to pay for day care or elder care expenses for your IRS-qualified dependents.

Eligibility

To be eligible for a Dependent Daycare FSA:

• Both you and your spouse must work, or your spouse must be a full-time student.
• You must be the custodial parent or guardian.
• The dependent must live with you for the majority of the year while you (and your spouse, if applicable,)
  • Work or are seeking employment, or if
  • You and your spouse are disabled or a full-time student for at least five months during the year.

Contributing to Your Dependent Daycare FSA

• You can contribute up to $5,000 for 2025. The IRS does not allow Dependent Care FSA funds to carryover over to 2026.
• Your contributions are deducted from your paycheck pre-tax, in equal amounts throughout the year, and deposited in your account.

Using Your Dependent Daycare FSA

• Pay your day care provider, then submit an FSA Day Care Claim Form (available on myaccounts.hsabank.com). You will be reimbursed up to the amount deposited into your account. If your claim is more than your account balance, the remainder of your claim will be paid after additional funds are deposited into your account (during future pay periods).
• You have until March 31 of the following year to file claims for expenses incurred in the current year.

What Your Dependent Daycare FSA Can Pay For

Here are some of the expenses your Dependent Daycare FSA can reimburse you for:

• Care of your dependent child under age 13 or care of your disabled adult dependent who is unable to care for themselves
• Expenses you could claim as a dependent care deduction on your federal income tax return if you were not reimbursed through your account
• Care of a mentally or physically disabled dependent who regularly spends at least eight hours a day in your home
• Day care center fees, providing the center meets all state and local laws and provides paid care for more than six people
• Fees for an individual sitter who is not an immediate family member under 19 years old or any person you claim as a dependent on your federal tax return
• Nursery school or summer program for your dependent child under age 13 (excluding overnight camps)

You can find a complete list of eligible Dependent Daycare FSA expenses in IRS Publication 503, Child and Dependent Day Care Expenses.

If you’re not contributing to a Health Savings Account, you can set aside pre-tax dollars to help you pay for eligible medical, dental and vision expenses. When you enroll in a Health Care FSA (HCFSA), you can contribute up to $3,300 every year through paycheck deductions that reduce your taxable income.

Contributing to Your HCFSA

• You can contribute from $260 to $3,300 per year.
• Your contributions are deducted from your paycheck pre-tax, in equal amounts throughout the year, and deposited in your HCFSA.
• Your annual contribution total is available for you to use on January 1.

Using Your HCFSA

• You can access your HSA Bank accounts directly through HSA Bank’s member website at myaccounts.hsabank.com.
• Keep your receipts to submit with your claims for reimbursement and to confirm your expenses, if requested.
• If you pay for eligible expenses out of pocket, in most cases you can submit claims for reimbursement on HSA Bank’s member website at myaccounts.hsabank.com.
• In some cases you may wait for the doctor to file a claim to determine how much you owe and then use the money in your FSA to pay that amount.
• You have until March 31 of the following year to file claims for expenses incurred in the current year.

What Your HCFSA Can Pay For

Here are some of the expenses you can pay with your HCFSA:

• Copayments and deductibles
• Prescription drugs
• Hospital charges
• Medical equipment
• Lab fees
• Hearing exams and hearing aids
• Dental exams and dental work
• Orthodontia
• Eye exams
• Prescription glasses and sunglasses
• Contact lenses and contact lens solution
• LASIK or other eye surgery
• Insulin and diabetes testing supplies
• First-aid supplies
• Over-the-counter medications without a prescription
• Menstrual products

You can find a complete list of eligible Health Care FSA expenses in IRS Publication 502, Medical and Dental Expenses.