Flexible Spending Accounts Internal Revenue Code (IRC) Requirements IRC guidelines are strict where tax breaks are made available. As your plan provider, we are required to follow IRC rules. ! First, the money you set aside operates under a “use or lose” system. That means you’ll want to use all of your funds prior to the next plan year or you will lose whatever amount is left. Ask if your employer’s plan includes a Runoff Period and Carryover Provision or Grace Period. • Runoff Period A period typically up to 90 days after the plan year ends when you can submit claims that you incurred during the previous plan year, but have not been submitted for reimbursement. • Carryover Provision This provision allows you to carry over up to $500 of unused contributions from one plan year to the next. • Grace Period An additional two and a half months following the end of the plan year in which you can incur claims and receive reimbursement. ! Second, the IRC requires proof for eligible expenses. For expenses that aren’t validated at the time of debit card swipe, an itemized receipt or Explanation of Benefits (EOB) must be submitted to prove eligibility of the expense. Submitting documentation through AFmobile® or online is the fastest way to validate a claim. Using your Benefits Debit Card A Benefits Debit Card allows you to pay for Documentation should include: eligible medical expenses using the funds RECEIPT OR EOB in your Healthcare FSA. The card may be 1. Provider Name Provider Name used at locations who accept Mastercard® Reciepient Name 2. Recipient Name Date of and have been identified as an authorized Service Description of Services Charges 3. Date of Service medical merchant. 4. Description of Service 5. Charges To verify transactions, submit an EOB or itemized receipt after your transaction or if Debit you receive a documentation request letter. Learn more about your debit card at americanfidelity.com/debit-card American Fidelity Assurance Company americanfidelity.com SB-32911-0220