Claims submission and reimbursement
Note: Effective September 1, Vanguard's FSA will be administered by PayFlex®, now part of the Aetna family. As Aetna transitions your balance to PayFlex, your account will be placed on hold from September 1-8. Any claims submitted during this period will be processed and reimbursed after September 8.
How can I access the money in my flexible spending account (FSA)?
You can access your general purpose health care FSA funds by:
- Mailing or faxing the FSA claim form in Take Action.
- Submitting claims online.
- Accessing the free PayFlex Mobile™ app to submit claims and receipts on the go.
- Using the Auto Pay process.
- Using an FSA debit card for prescription copays, coinsurance, and eligible over-the-counter expenses.
Note: The Auto Payprocess and debit card cannot be used if you elect the Limited health care FSA.
What is the deadline for incurring expenses that can be reimbursed through an FSA?
If you are enrolled in the FSA as of December 31 of the plan year, you can incur expenses to be reimbursed from each year's FSA until March 15 of the subsequent year. Funds not used by this date will be forfeited. For example, if you have an FSA for 2015, you will have until March 15, 2016, to incur expenses as long as your FSA benefit was still active on December 31, 2015.
What is the deadline for submitting a health care claim for reimbursement?
The deadline for submitting a claim for reimbursement of each year's FSA-eligible expenses is May 31 of the subsequent year. Note: May 31 is the date by which the request must be received, not the postmark date.
What if there are funds remaining in my 2015 FSA and I begin contributions to a 2016 account?
At the beginning of the year, any funds remaining in your 2015 account will be used first to reimburse expenses incurred prior to March 15, 2016, until the funds are exhausted or the deadline to make a claim has passed. Eligible expenses incurred after March 15 will be reimbursed with funds from your 2016 account.
If you enroll in the HDHP for 2016, you must deplete the balance in your 2015 general purpose health care FSA by December 31, 2015, to be eligible for HSA contributions on January 1, 2016. See Limited health care FSA for more information.
How can I check the account status for claims processed by PayFlex?
You can access all your FSA account activity through the Aetna Navigator or PayFlex website in Take Action.
What happens to the money in my FSA if I waive coverage during a permitted election change?
You can continue to use the funds remaining in your FSA to pay for eligible expenses incurred prior to the effective date you waived coverage. However, you will not be reimbursed for any expenses incurred after the effective date for which the FSA benefit was waived. You would still have until May 31 of the following year to submit claims for eligible expenses incurred prior to the effective date you waived coverage.
What happens to the money in my FSA if I no longer work for Vanguard?
You can continue to use the funds remaining in your FSA after leaving Vanguard to pay for eligible expenses incurred prior to your termination date. For the health care FSA, you can elect to continue coverage through COBRA and incur expenses through the end of the year. To access the funds, you must first pay for the expense out of pocket, and then you must submit a claim form and receipt for reimbursement. You may submit claims for expenses incurred prior to the termination date until May 31 of the following year.
How do I submit the FSA claim form?
After making an out-of-pocket purchase for an eligible health care expense, mail or fax the completed FSA claim form in Take Action to PayFlex along with an itemized receipt, statement, or Explanation of Benefits (EOB). Once the request for reimbursement is approved, the money will be issued by check or direct deposit to your authorized bank account.
How do I submit a claim online?
Access the PayFlex or Aetna Navigator website in Take Action.
Under Financial Center, choose File a Claim. You can request reimbursement and upload an itemized receipt, statement, or Explanation of Benefits (EOB). Once the reimbursement request is approved, the money will be issued by check or direct deposit to your authorized bank account
Can I submit claims through a mobile app?
Yes, you can submit claims through the free PayFlex mobile app. The app is available for iPhone and iPad mobile digital devices, as well as Android and BlackBerry smartphones.
How do I enroll in or change my direct deposit information?
To enroll in or change your direct deposit information, complete the Direct deposit authorization form in Take Action. Or log on to the PayFlex website in Take Action, click Financial Center, and select Enroll in Direct Deposit.
How does PayFlex Auto Pay feature work?
The Auto Pay feature automatically passes medical and dental claims to PayFlex, eliminating the need to submit a reimbursement request.
For example, when you go for a regular office visit, present your Aetna ID card and pay the required deductible or coinsurance. Once the claim is processed, you will be automatically reimbursed (the deductible or coinsurance amount) by check or direct deposit to your authorized bank account.
Note: Orthodontia and vision claims will not be processed through Auto Pay.
The Auto Pay feature is not available if you elect the Limited health care FSA.
Can I opt out of Auto Pay reimbursements?
Yes. You can turn off and turn on Auto Pay reimbursements at any time during the year through the Aetna Navigator or PayFlex website in Take Action or by calling Aetna. Once Auto Pay is turned off, claim submissions must be made using the FSA claim form in Take Action. The Auto Pay feature will automatically turn on at the beginning of each new plan year.
Follow these steps for changing Auto Pay reimbursements:
- Log on to the Aetna Navigator or PayFlex website using the links in Take Action.
- Click the Financial Center tab.
- From the dropdown menu, select Health Plan Activity.
- Click Health Plan Activity Options on the left side.
- Review and update your current automatic reimbursement settings, then click Save.
I am in the Aetna HealthFund with the health reimbursement arrangement (HRA). If I contribute to an FSA, which account is used first when paying medical claims?
For all medical claims, the money in your HRA will always be depleted first, even if you have a remaining balance in your FSA from the prior year. Once your HRA funds are exhausted, reimbursements will be processed from your general purpose health care FSA.
How do I submit a claim for orthodontia expenses?
You must submit the FSA claim form in Take Action, along with receipt of payment to PayFlex. Orthodontia claims will not be reimbursed through Auto Pay.
If I'm a U.S. citizen working outside of the United States, can I receive reimbursement from my health care FSA?
Yes, your eligible health care expenses are reimbursable. Simply submit the FSA claim form in Take Action. If you pay in foreign currency, please indicate the currency so PayFlex can complete the conversion.