PayFlex Debit Card

The PayFlex Debit Card makes your Health Care Flexible Spending Account (Health FSA) easier to use. The Card may also be used by participants in the Limited Use FSA for health care expenses after the Value PPO plan annual deductible has been met. It may also be used for out of pocket dental and vision expenses.

The PayFlex Debit Card is a special MasterCard® that draws on the value of your annual FSA election amount regardless of the amount of contributions or balance in the Account. Use of the Debit Card is optional - plan participants are not required to use the Debit Card to pay for out of pocket expenses.

It may not be used for dependent care expenses.

The Benefits Division provides PayFlex with the annual pledge amount and monthly contributions. An individual may not submit or deposit contributions directly to PayFlex.

The Card is mailed by PayFlex to FSA Health Care Account participants at their home address in a plain, white and nondiscrete envelope. Upon receipt, the Card should be signed on the back of the Card. By signing the Card, you agree to the provisions of the cardholder agreement which was included with the Card. That is, you agreed to use the card for qualifying expenses only, and to provide documentation upon request. Please read this agreement carefully. There is no added cost such as monthly fees or transaction fees to use the Card.

Using the PayFlex Debit Card is simple because...

• It's automatic - the funds are immediately deducted from your Health Care Spending Account at the time you incur the expense.
• It's fast & easy - simply swipe, press "Credit," sign for the transaction and save your receipts. No PIN is required.
• It improves your cash flow - it is not necessary to pay cash at the time of purchase and then wait for reimbursement.
• It's easy to track - your current balance and record of account transactions are available around the clock by accessing your account online. A monthy account statement is not issued.

The PayFlex Debit Card helps with qualifying Health Care Spending Account expenses such as:

• Prescription drug co-pays including retail and mail order pharmacies.
• Physician office visit and emergency room co-pays.
• Over-the-counter medications and eligible other items such as Band Aids, gauze and cotton balls.
• Health plan deductibles and coinsurance.

To view a listing of IRS eligible expenses, please click here. To view an informational brochure about the Debit Card, please click here ( PDF) . Please remember that the quantity of over-the-counter drugs and other items purchased and submitted for reimbursement must be reasonably able to be consumed during the current plan year. “Stockpiling” of drugs and medicines in anticipation of a medical condition or at plan year-end and then submitting for reimbursement would be an ineligible request based on IRS regulations.

When your Debit Card is activated. The Card is activated when first used. The Card is valid for three years though will be deactivated at termination of NU employment or if a participant does not re-enroll in the Health Care FSA for the next year. Each year when a participant re-enrolls, the Card will reflect that plan year's annual pledge amount.

Using the Debit Card. Each time you incur a qualified or eligible health care expense (such as a copay) at a health care provider or pharmacy that accepts MasterCard®, you simply use your PayFlex Debit Card. The amount of your qualified purchase will be deducted from your Health Care Spending Account automatically. It is very important to save your pharmacy or provider receipts as you will receive a request from PayFlex for documentation to validate the expense is an IRS eligible expense. Such information includes merchant name, name of the item/product, date and amount.

If you order prescription drugs by mail order, simply provide your PayFlex Debit Card account number, which is accessible from the face of the card, to the mail order pharmacy.

You may also use the Debit Card to pay for the patient portion cost for services you receive from your doctor or other health care or dental care provider. Simply refer to the Explanation of Benefits (EOB) you receive from Blue Cross or other insurance company and provide your provider's office the Debit Card account number appearing on the front of the Card.

Please note: The PayFlex Debit Card is for health care and related expenses only. It is not for dependent care expenses.

- Health care related merchants. The Card may be used at health care related merchants such as physician offices, vision care providers, hospitals and pharmacies. It may also be used at pharmcies located inside a discount or grocery store, only if the merchant has changed their merchant code at the pharmacy counter to the pharmacy merchant category code. Over 98% of health care merchants accept MasterCard®.

- Non health care related merchants. The Card may be used at non-health care related merchants which have implemented an IRS approved "information inventory approval system - IIAS." Under the IIAS, all products at the merchant location have been identified as either eligible or ineligible per Internal Revenue Code 213(d). At the point of sale, each item purchased is checked for the inventory code assigned by the merchant. If you have a non-approved item in the transaction, you will be asked for a second form of payment for these remaining items. The Card may not be used at a grocery or discount store general checkout lanes nor may it be used at 7 Eleven stores. It is recommended that participants ask the merchant to ring up the prescription drug items separately so that the Debit Card may be effectively used.

To view information about IIAS, please click here. To view a listing of non-healthcare related merchants that have or will be implementing an IRS-approved inventory information approval system, please click here. Please note that while Walgreens shows a status of pending, the Debit Card is fully functional at any Walgreens pharmacy. Walgreens was one of the first merchants to enable the use of a debit card and prior to the adoption of IIAS data standards.

If the Card is used to pay for a non-healthcare item, the participant will have to write a personal check to PayFlex or the Card will be deactivated.

The Card may not be used at non-health related MasterCard® locations such as restaurants, gas stations, bookstores and ATM terminals or for non-health related items. In addition, the Debit Card may not be used to pay for dependent care expenses such as for child care.

Ordering a replacement or additional cards. You may order additional cards for your family members from PayFlex at no cost to you. You may request additional cards online or by contacting PayFlex at 800 284-4885. Your member number is your NU employee ID found on your Wildcard. Please be certain that the dependent fully understands how to appropriately use the Card for qualifying expenses, and that receipts are kept.

If a Card is lost or stolen, it should be reported to PayFlex as soon as possible. If the theft or loss is reported within 30 days, you are not liable for any fraudulent charges.

Deactivation of the Debit Card. The Card is deactivated at the time of termination of University employment. If there are qualifying expenses which occurred prior to termination, a claim form may be submitted to PayFlex. It is also deactivate if you do not respond to PayFlex requests for receipts to validate Debit Card transactions are IRS eligible expenses.

For more information. Please contact the University's Benefits Division at 847 491-7513 or email at benefits@northwestern.edu. You may also contact PayFlex at 800 284-4885 or visit their website at www.mypayflex.com. A number of helpful frequently asked questions (FAQs) are available.

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