Prepared for 

Piedmont Health Services

Piedmont Health Services 2020 FSA & HSA Plan Overview

What to Expect with Flores

• Who is Flores? 

Piedmont Health Services FSA and HSA Plans

• FSA basics
• HSA basics
• Flores Benefits Card
• Next steps

Overview

 Dedicated Customer Service

• No phone tree! When you call Flores, a live voice will answer your call.
• Each employer is assigned a dedicated account manager.  Your dedicated account manager is Kathryn Rizzo.

We are committed to:

Innovative Technology

• Participant website, www.flores247.com
• Downloadable app, Flores Mobile
• SMS/IVR communication tools

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 2020 FSA Plan Details

A Flexible Spending Account (FSA) allows you save between 25 and 40 percent on eligible health care and dependent care  expenses. 

Each pay period, your contribution to your account is deducted from your paycheck before taxes and deposited into your FSA.

Eligible expenses* include:

• Medical Services
• Prescriptions
• Vision 
• Orthodontia payments
• Dental
• Prescribed OTC medications
• Medical supplies

Health Care FSA Plan Basics

*If you enroll in FSA after 1/1/2020, your Health Care FSA balance will be available on your benefit effective date. 

FSA Plan Year:  

1/1/2020 -12/31/2020*

Max. Contribution: 

 $2,750   

*If you or a spouse enroll in a High Deductible Health Plan  with an HSA, your Health Care FSA is limited to dental and vision expenses.

For a full list of eligible expenses, visit our resource library at www.flores247.com.

Eligible expenses* include:

• Vision Services
• Orthodontia payments
• Dental Services

Limited Health Care FSA Plan Basics

*If you enroll in FSA after 1/1/2020, your Limited Health Care FSA balance will be available on your benefit effective date. Expenses must be incurred in the Plan Year while you are participating in the plan to be eligible for reimbursement.

FSA Plan Year:  

1/1/2020 -12/31/2020*

Max. Contribution: 

 $2,750   

*You can enroll in a Limited Health Care FSA only if you are enrolled in an HSA Qualified Health Plan with a Health Savings Account (HSA).

For a full list of eligible expenses, visit our resource library at www.flores247.com.

Use your Limited FSA instead of your HSA to cover these expenses and watch your

HSA grow!

File a claim and receive a check or direct deposit OR use your Flores Benefits Card. 

The entire Health Care FSA balance is available on 1/1/2020.

The FSA is a use-it-or-lose-it account. All claims for services incurred during your plan year must be submitted by March 31, 2021 in order to be processed.

Access your balance

Claims deadline

Claims Filing Deadline: 

 March 31, 2021

Family Maximum:

 $5,000 (per family) 

Dependent Care Basics

Eligible expenses:  

• Daycare or preschool
• Before and after school care
• Day camps

Ineligible expenses:  

• Overnight camps
• Tuition for kindergarten and above
• Educational expenses
• Fees not applied toward the care of the child

Claims Filing Deadline: 

March 31, 2021

Plan Year:

 1/1/2020-12/31/2020 

1. Download

Go to the "Document Library" at  www.flores247.com to download a Dependent Care claim form or obtain this form from your HR department.

2. Complete

Complete the claim form with the service dates, dependent name(s), the service provider's name and nine digit Tax-ID number.

3. Substantiate

Submit an itemized statement or have your provider sign in the "Provider Signature" box on the form.

4. Submit

Upload your claim at  www.flores247.com or the

Flores Mobile app. You can also fax or mail your claim.  

Easy Dependent Care Claim Process

Enroll in FSA during Open Enrollment.

Prior to 1/1/2020, you will receive a Participant ID Notice via email or mail if you enroll in a Flores plan for the first time. Use this to create a login to our web portal, www.flores247.com. Existing participants will continue to use their current log-in.

If you enroll in the Health Care FSA, you will also receive a Flores Benefits Card.

Cards will be loaded with your entire Health Care FSA election and you can begin using it on your benefit eligibility date. Your card will be valid for several years, so save your card after your balance is spent. If you re-enroll in FSA the next year, the same card will be reloaded. If you need extra cards, you can order them at www.flores247.com. If you already have a current Flores Benefits Card, it will be reloaded with your new election.

Please save receipts for services purchased with the Flores Benefits Card in case you receive a request for documentation.

After you enroll

 2020 HSA Plan Details

A Health Savings Account (HSA) allows you to save, invest, and spend funds on a tax-free basis.  Unused funds rollover from year to year and continue to grow,

tax-free.  

Each pay period, your contribution to your account is deducted from your paycheck before taxes and deposited into your HSA.  You can access the funds 2 business days after your pay period.

HSAs have a triple-tax advantage:

Money goes in tax-free

Money comes out tax-free

Money earns interest tax-free 

You can participate in an HSA if you are enrolled in a qualified high deductible health plan and not covered by another non-qualified healthcare plan, like your spouse's employer, Medicare, or Tricare. 

You cannot be claimed as a dependent on someone else's tax return and you (and/or your spouse) cannot be enrolled in a Health Care FSA plan that is not limited to dental, vision, or post-deductible medical expenses.

Who is involved with my HSA?

You

You are the account holder. You own your HSA, just like any other personal bank account you may have.

You can save, invest and use funds when you need them. If you change employment, you will continue to own your HSA.

Your Employer 

Your employer partners with Flores to administer your HSA. They work with Flores to open and fund your HSA via pre-tax contributions that you elect to make.

Your employer also covers some of the administration fees associated with your account.

Flores

We administer your HSA. We work with the bank to open your account and process your pre-tax payroll contributions. You will access your HSA using a Flores-provided benefits card or our Flores247 Web Portal. You can call our team of dedicated account managers if you need assistance with your account.  We also provide resources to help you better understand your HSA.

Avidia Bank

Your HSA funds are held by Avidia Bank. They are a federally approved HSA custodian. Avidia ensures your account is opened and maintained per federal regulations. Funds in your HSA cash account are FDIC insured. 

Avidia will send annual tax forms to you, as well as quarterly statements. Avidia provides the investment platform and defines your account holder fees. To learn more, see HSA Features and Fees.

You can contribute up to $3,550 for single coverage and $7,100 for family coverage (including employer contributions). Participants age 55 and older may make an additional catch-up contribution of $1,000. Piedmont Health Services will contribute to your HSA $750 for single coverage and $1,500 for family coverage. 

Contributing is easy! 

Direct Deposit - Contributions are deducted from your paycheck pre-tax and deposited into your account.

Funds Transfer - Transfer funds from another financial institution (like your bank) electronically at www.flores247.com.

HSA Plan Contributions

*If you enroll in FSA after 4/1/2018, your medical FSA balance will be available on your benefit effective date.

**If you choose to enroll in a qualified High Deductible Health Plan with an HSA, your FSA funds must be limited for use toward dental and vision services.

Accessing funds in your account is simple and tax-free.  You have four options for accessing your funds:

Flores Benefits Card - Simply swipe your card while at the doctor's office or pharmacy and you're done.  Additionally, if you are paying by mail, phone, or online, you can provide your Flores benefits card number to complete your transaction.  Funds are available on your card 2 business days following your pay date.  Funds can be used for your spouse and dependents, even if they are not on your health plan!

Checks - You can order checks when you open your account. A nominal charge may apply.

Bill Pay - Enroll in Bill Pay at flores247.com.  Once enrolled, you can add your payees and start sending payments directly from your account.

Reimbursing yourself - If you pay out-of-pocket for qualified medical expenses, you can reimburse yourself from your HSA.

How do I use my funds?

Keep Great Records!

HSA funds that are used for qualified medical expenses (including medical care, dental, vision, prescriptions, medical equipment, and certain healthcare premiums) are tax-free.  If you use your HSA for non-qualified medical expenses and are under age 65, you may incur a 20% penalty and owe income tax on the amount used.  Keep track of your expenses at www.flores247.com where you can view balances and reports on your spending.

Go Green with e-Statements!

The HSA account will default to paper statements. Since there is a small quarterly fee for paper statements, we strongly recommend that you log in to flores247.com and opt into electronic statements.

After You Enroll in a HSA

Prior to 1/1/2020, you will receive a Participant ID Notice from Flores. Use this to create a login to our web portal, flores247.com.  If you already have a Participant ID, you will continue to use your existing log-in. You will also be contacted by Avidia Bank by email. It is important that you read and take the appropriate action requested in this communication promptly to establish your account. 

You will also receive a Flores Benefits Card.

Cards will be loaded with your HSA contributions as you make contributions to the account. Your card will be valid for several years, so save your card after your balance is spent. If you need to order additional cards, you may order them at www.flores247.com (after logging in).

If you currently have a Flores Benefits Card, you will not receive a new debit card. Funds will be loaded to your existing Flores Benefits Card.

Please save receipts for services purchased with the Flores Benefits Card in case you receive a request for documentation.

After you enroll

Enroll in FSA or HSA during Open Enrollment

• Look for your PID notice to arrive in the mail, or email, and create your login for www.flores247.com. Existing participants will continue to use the same log-in information.
• Look for your Flores Benefits Card to arrive prior to 1/1/2020 and order additional cards at www.flores247.com (after you log-in). Existing participants will have funds loaded to their existing card.
• If you enroll in HSA, look for a communication from Avidia Bank and take the requested action to complete your account establishment.
• Download our free Flores Mobile app from the Apple or Android device stores.
• If you enroll in the dependent care FSA, complete and return your no-wait Dependent Care claim form and direct deposit form to receive automatic reimbursements each pay period.

Your dedicated account manager is Kathryn Rizzo.

Next steps

Kathryn Rizzo

[email protected]

(800) 532-3327