Payment Features WageWorks Healthcare Card Pay My Provider What payment features are available under this plan? Pay Me Back Automatic Health Plan Claims Reimbursement Eligible Expenses Standard FSA (according to current IRS Regulations) Custom Expense List (if custom expenses are needed, What expenses are payable as benefits under this plan? please clearly define requirements to your Relationship Management contact to ensure support can be provided.) Note: Custom expenses cannot be supported on the WageWorks Healthcare Card. Qualified Changes Standard List (according to IRS Regulations) Custom List (if custom qualified changes are needed, please What life events do you allow for participants to add, remove, or change coverage? clearly define requirements to your Relationship Management contact to ensure support can be provided.) Plan does not allow mid-year changes in enrollments following qualified life events HSA-COMPATIBLE FSA OPTION
Payment Features What payment features are available under this plan? WageWorks Healthcare Card Pay My Provider Pay Me Back Automatic Health Plan Claims Reimbursement Eligible Expenses What expenses are payable as benefits under this plan? Standard FSA (according to current IRS Regulations) Custom Expense List (if custom expenses are needed, please clearly define requirements to your Relationship Management contact to ensure support can be provided.) Note: Custom expenses cannot be supported on the WageWorks Healthcare Card. Qualified Changes What life events do you allow for participants to add, remove, or change coverage? Standard List (according to IRS Regulations) Custom List (if custom qualified changes are needed, please clearly define requirements to your Relationship Management contact to ensure support can be provided.) Plan does not allow mid-year changes in enrollments following qualified life events HSA-COMPATIBLE FSA OPTION
3880-fsa-er-oe-conf-frm_11_2016.docx