Flexible Spending Account (FSA) Resources

A Health FSA is an account where you set aside pre-tax dollars to cover eligible medical expenses that are not covered by any other type of insurance. The account helps you budget for planned expenses such as deductibles, co-payments and prescriptions. You can find a complete list of eligible expenses in IRS Publication 502.

 To enroll in a health and/or dependent daycare FSA, you must elect the plan through your employer during your open enrollment period. Check with your employer’s benefit department for more details on the process.

Unless you have a qualifying event, you can only change your elections during open enrollment for the following plan year. During open enrollment, you will have the opportunity to evaluate the need to participate in the plan, as well as budget for all health care and/or dependent care expenses.

Your annual election amount will be deducted from your paycheck in equal amounts throughout the plan year. These deductions are made before taxes are taken out.

Health FSA funds cannot be used for over-the-counter drugs and medicines (other than insulin) without a prescription or a letter of medical necessity from a medical provider.

You can submit claims incurred prior to your termination date before the end of the run-out period (defined in your Summary Plan Description). Any remaining funds will be forfeited.

For example: Your plan may have a 90-day run-out period following termination. Your termination date is September 13. Your physician sees you on September 12, but you do not receive the Explanation of Benefits from your insurance carrier until October 31. You can still submit this expense as it was incurred prior to your termination date, and prior to the end of the 90-day run-out period following your date of termination. Any expenses incurred after September 13 are not eligible.

In order to be considered an eligible expense, the expense must be incurred prior to your termination date. However, you may be able to continue your health FSA coverage under COBRA, if applicable.

You can use pre-tax dollars to cover eligible work-related dependent daycare expenses for qualified dependents. If you are married, it would cover dependent daycare expenses while you and your spouse work, or your spouse attends school full-time.

• Your dependent child under the age of 13
• Or your spouse or dependent child, who is physically or mentally unable to care for him or herself

NOTE: Refer to IRS Publication 503 on where you can find a qualifying person test to help determine if your dependent meets the definition. 

Yes, an adult may qualify as a dependent provided that:

• The employee is providing more than half of that individual’s support for the year
• The dependent lives with the employee
• And the dependent is physically and/or mentally incapable of caring for him/herself

NOTE: Refer to IRS Publication 503 on where you can find a qualifying person test to help determine if your dependent meets the definition.  

You can be reimbursed for expenses for an individual providing care for your dependent, as long as the daycare expenses are incurred so you and your spouse (if married) can go to work, look for work or attend school full-time. You are required to submit his/her Tax Identification Number or Social Security Number when filing your Federal Income Tax Return.

If the camp is day camp and your dependent attends so that you and your spouse (if married) can go to work, look for work or attend school full-time, this would be an eligible expense. Overnight camps are specifically excluded.

Expenses are eligible for reimbursement when they have been incurred (date of service), not when you are billed or when you pay for the services. As soon as your account is funded, you can use your balance to pay for eligible expenses.

The claim will be processed and approved up to your election maximum, if eligible. The amount that is currently available will be reimbursed, and the remaining portion will be pending reimbursement until you make another contribution. You will not need to resubmit the claim if your amount exceeds your current balance. You will automatically be reimbursed the remaining portion as funds become available, until the full claim has been paid.

You may not change your election unless you have a “Qualifying Life Event,” such as marriage, adoption, divorce, etc. Your election change must be consistent with the change-in-status event. For example, if you adopt a child, then you may increase your dependent daycare FSA election due to the newly eligible dependent.

A “Qualifying Life Event” covers:

• Change in legal marital status (marriage, death of spouse, divorce, legal separation, annulment)
• Change in number of tax dependents (birth, death of dependent, adoption or placement for adoption)
• Change in dependent’s eligibility
• Change in employment status of employee, spouse or dependents
• Other changes that may permit an election change under the dependent daycare FSA are:
  • Change of dependent care provider
  • Change of rate charged by unrelated dependent care provider
  • Child attaining age 13

If you experience a Qualifying LIfe Event, please review your employer’s Summary Plan Description, as it will provide you with important information including the deadline for reporting this event.

Health and dependent daycare FSA elections are separate. You cannot move contributions from one account to another.

NOTE: The elections you make are for the entire year. Your elections cannot be changed unless you experience a Qualifying Life Event as noted above.

If all of your Health FSA funds are not used during the plan year, they will be forfeited. Your employer may allow for a carryover of unused funds. Check with your employer or customer service (888-350-5353) to see if your Health FSA program supports carryover of unused funds, and whether or not any maximum or minimum carryover amounts are associated with your plan.   

If all of your dependent daycare FSA funds are not used during the plan year, they will be forfeited. Some plans may offer a grace period to submit expenses. Check with your employer or customer service (888-350-5353) to see if your dependent daycare FSA program supports a grace period.

If you do not use your Fifth Third Bank Multi-Benefit Debit card, you may submit your claim data in any of the below methods:

• Log into your account at 53hsa.com and click on “File a Claim”
• Log into your account on the Fifth Third Bank Mobile App and click on “File a Claim”
• Complete the Flexible Spending Account Claim Form and include the appropriate documentation and send to Chard Snyder:
  • Via Email:  [email protected]
  • Via Fax: 888-245-8452
  • Via US Mail:
    Chard Snyder
    ATTN: Claims Department
    6867 Cintas Blvd
    Mason, OH  45040

For a Health FSA Reimbursement, two types of documentation can be submitted:

• Explanation of Benefits (EOB)
  Every time a claim is submitted to your health insurance carrier, you will receive an EOB statement detailing what the health plan will pay in addition to what you are responsible for paying. For any expense that is partially covered by another insurance carrier, you must attach a copy of both EOBs.

• Itemized Receipts
  For expenses that are not submitted to another insurance plan, you must attach a copy of the itemized receipt that contains all the information listed below:
  • Name of patient
  • Name and address of provider
  • Description of service
  • Date of service
  • Amount of service

For a Dependent Daycare Reimbursement, you will need to complete the Dependent Daycare portion of the Flexible Spending Account Claim Form and you can either:

• Have your daycare provider sign and date
• Include a receipt that includes the name, address and Tax Identification Number of provider as well as dates of service (from/through) and amount of charge.

The Health FSA does not require that your dependents be covered under your health insurance plan. You can use your account to pay for eligible health care expenses for your family, regardless of their health insurance plan, as long as they are an IRS qualified tax dependent.

You will receive an email or letter indicating the reason for the denial, along with instructions for submitting the requested documentation, if applicable.

We will need a copy of the contract with your orthodontist that includes the patient name, start/end date of the contract, in addition to the terms of the contract (i.e. monthly payments, quarterly payments, paid in full). Claims should be submitted for reimbursement in accordance with your orthodontic contract’s payment schedule.

There are a few reasons why your Fifth Third Bank Multi-Benefit Card may not work. Before contacting Chard Snyder for additional assistance, there are a few actions we recommend you take:

• Verify that you have activated your Fifth Third Multi-Benefit Card
  • If you have never activated your debit card, you may activate it by calling 866-898-9795
• Verify that your debit card is not suspended due to a request for additional documentation
  • Log in to your account online or the mobile app to view any pending documentation requests
• Verify that you have funds an Available Balance in your account
  • Log in to your account online or the mobile app to view your account summary
• Verify the expense you are trying to purchase is eligible
  • Visit www.53hsa.com
  • Under the tab labeled “Resources”, select “FSA Resources”, then “FSA Expense Eligibility”
  • Enter the expense you are trying to purchase under “Search Expenses” and select “Search”

If you have activated your Fifth Third Bank Multi-Benefit Card, you do not have any outstanding documentation requests, you have an Available Balance in your account, and the expense you are trying to purchase is eligible, please contact Chard Snyder for additional assistance.

• Call: 888-350-5353
• Email: [email protected]

Your Fifth Third Bank Multi-Benefit Card is smarter than the average card and recognizes many eligible expenses such as doctor’s office visits, prescriptions, and emergency room visits. Your card helps you stay within IRS rules by allowing purchases only at locations that provide eligible services or merchandise. Because your Flexible Spending Account dollars are tax-free, IRS regulations will sometimes require us to ask you for a copy of an itemized receipt or an Explanation of Benefits (EOB) as proof that your expense was eligible.

For example: The IRS requires us to confirm that you went to the dentist for a checkup instead of teeth whitening, or to the hospital for gallbladder surgery, not a tummy tuck.

You may submit your debit card substantiation documents via any of the below methods:

• Log into your account at 53hsa.com and upload the documentation by clicking on the request listed under “Tasks”
• Log into your account on the Fifth Third Bank Mobile App and upload the documentation
• Along with a copy of the debit card substantiation letter emailed or mailed to you, send the requested documentation to Chard Snyder:
  • Via Email:  [email protected]
  • Via Fax: 888-245-8452
  • Via US Mail:
    Chard Snyder
    ATTN: Claims Department
    6867 Cintas Blvd
    Mason, OH  45040

There are multiple reasons why you may be asked to repay your account, including but not limited to:

• When additional documentation was received, it was determined that the date of service was not during the plan year
• When additional documentation was received, it was determined that the service provided was not an eligible service
• We did not receive the additional documentation

There are multiple ways to repay:

• Log into your online portal, link a bank account, and repay via direct deposit
• Log into the Fifth Third HSA Mobile App, link a bank account, and repay via direct deposit
• Send a repayment check to Chard Snyder and include the letter you received
• If your plan-year account balance is not negative, you may submit additional claims incurred during that plan year that total equal to, or greater than, the amount of the repayment requested. (Please note: any claim submitted for reimbursement for a plan year that has a pending repayment request will automatically be applied towards that repayment.)

• Visit www.53hsa.com in your web browser
• Select the link labeled “Existing User Log in” in the middle of the home page
• A message stating you are leaving a Fifth Third website will appear. Select “Continue”
• Enter the username and password for your account and select “Login”. If you have not logged into your account previously, check a notification that was sent immediately after your enrollment in our system to the email address we have on file for you. That email notification contains your default username and password. Once you have logged in for the first time, you will be asked to change the default password to a password of your choice.

On your iPhone or Android device, visit the App Store or Google Play and search for 53hsa or Fifth Third Bank HSA and select “GET” to download the mobile app.