What qualifies for FSA expenses?

Allowed expenses include insurance copayments and deductibles, qualified prescription drugs, , and medical devices. You decide how much to put in an FSA, up to a limit set by your employer. You aren't taxed on this money.

What can I buy with my FSA card?

You can spend FSA funds to pay deductibles and copayments, but not for insurance premiums. You can spend FSA funds on prescription medications, as well as over-the-counter medicines with a doctor's prescription. Reimbursements for are allowed without a prescription.

Can I use my FSA card for gas?

Fuel is eligible for transportation to and from medical care, up to the allowed mileage rate. Fuel, gasoline for medical care reimbursement is eligible with a flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA).

What does an FSA pay for?

Flexible spending account (FSA): A benefit plan that lets people put money aside in special accounts, pre-tax, to help pay for certain medical costs, child care, and other health services. Insurance coverage provided by or through UnitedHealthcare Insurance Company or its affiliates.

What can I use my Cbiz card for?

The CBIZ Debit Card is only accepted at qualified locations where Visa debit cards are accepted. Qualified locations may include hospitals, doctor's offices, pharmacies, online drug stores, and day care centers. Card swipes are processed as credit card transactions.

How do I file a claim with Cbiz?

Log in to the consumer portal at myplans.cbiz.com and select File a Claim under the Accounts link. Download the Mobile App through the AppStore or Google Play and search for My Plans by CBIZ.

Get Cbiz Flex Login 2008-2024

CBIZ Flex Flexible Benefits Plan Claim Form Version 11. 01. 08 Employer Email SSN Phone - Un-reimbursed Medical Expense Claims Date Expense Incurred Name of Service Provider Expense Description Person for Whom Expense Incurred Net Amount Attach appropriate receipt s and submit with this claim form. Total Medical Care Expense Claim Dependent Care Expense Claims Name of Dependents Period Covered From To Name and Taxpayer Identification Number of Service Provider Amount Incurred Total Dependent Care Expense Claim Provider s Signature Read Carefully The undersigned participant in the Plan certifies that all expenses for which reimbursement or payment is claimed by submission of this form were incurred during a period while or are not reimbursable under any other health plan coverage and that they were incurred by the participant or a legal dependent of the participant. The expenses qualify as valid Medical Care Expenses under Code 213 d as defined in the Flexible Spending Account Summary Plan Description Document the plan. The undersigned certifies that their family member has received the services described above on the dates indicated and the expenses qualify as valid Dependent Care Expenses as defined in the FSA Summary Plan Description Document. The undersigned fully understands that he or she is fully responsible for the sufficiency accuracy and veracity of all information relating to this claim which is provided by the undersigned and that unless an expense for which payment or reimbursement is claimed is a proper expense under the Plan the undersigned may be liable for payment of all related taxes including federal state and or local income tax on amounts paid from the Plan which relate to such expense. Employee Signature Date Claim Forms can be mailed or faxed to CBIZ Payroll Attn Flex 310 First St* Ste 600 Roanoke VA 24011 Please keep a copy for your records Fax 800-584-4185 Phone 800-815-3023 option 4 Email cbizflex cbiz. The expenses qualify as valid Medical Care Expenses under Code 213 d as defined in the Flexible Spending Account Summary Plan Description Document the plan. The undersigned certifies that their family member has received the services described above on the dates indicated and the expenses qualify as valid Dependent Care Expenses as defined in the FSA Summary Plan Description Document. The undersigned certifies that their family member has received the services described above on the dates indicated and the expenses qualify as valid Dependent Care Expenses as defined in the FSA Summary Plan Description Document. The undersigned fully understands that he or she is fully responsible for the sufficiency accuracy and veracity of all information relating to this claim which is provided by the undersigned and that unless an expense for which payment or reimbursement is claimed is a proper expense under the Plan the undersigned may be liable for payment of all related taxes including federal state and or local income tax on amounts paid from the Plan which relate to such expense. .

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