Debit Card Information (if applicable)
Card transactions occur daily and debits for total daily transactions will be made from the employer checking account each day. Employee communication of the substantiation process and employer understanding are critical to the success of the program. Cards will be ordered once we receiveonline authorization or upon receipt of a signed employer authorization form/agreement and the enrollment data has been loaded into the system. Allow a minimum of four (4) weeks after all data has been received for the delivery of cards. Indicate below if the card option is elected. If the card option is elected, we must receive a copy of the schedule of benefits clearly indicating the prescription drug and office co-pay amounts under the employer sponsored benefit plan(s).
(a) The Flex Convenience debit card service is not a paperless system for your employees. According to IRS Revenue Ruling 2003-43, all debit cards transactions require substantiation. Many types of transactions will be electronically substantiated while others will require the participant to submit paper documentation verifying that the expense is eligible.
(b) UnitedHealthcare’s debit card technology pre-screens all charges and only approves those originating from approximately 26 provider location categories. In doing so, however, a small percentage of ineligible claims may end up being paid through your Plan. If in the case a cardholder charges an ineligible item at an approved location, UnitedHealthcare will send a series of e-mails and/or letters asking the participant to either pay the plan back for the ineligible transaction or to submit a substitute claim. If the employee chooses to disregard those notices, according to IRS Revenue Ruling 2003-43, the employer is required to deduct the ineligible transaction amount(s) from the employee’s paycheck. If state payroll withholding laws prohibit involuntary deductions, the employer is required to contact the employee directly to recoup the amount of the ineligible transaction. It is important for the employer to contact UnitedHealthcare about any repayments made back to the Plan either by payroll deduction or repayment by the employee directly. UnitedHealthcare will provide a listing of these ineligible transaction amounts at the end of each plan year.
(c) UnitedHealthcare permanently deactivates cards for terminated employees within a reasonable time period after receiving notice of the termination from the employer. UnitedHealthcare further requires employers to collect and destroy the employee’s Flex Convenience card upon termination, much as they would collect keys to the office, security badges, and other corporate credit cards. The collection of cards from terminated employees eliminates any attempts to use the card for unauthorized or ineligible transactions.
By selecting ‘Yes’ below you agree that you have reviewed and agree to the terms listed above and authorize UnitedHealthcare to provide participants with the FSA Consumer Accounts Debit Card. If you select ‘No’ below, you may submit a paper application at a later date.
