Two of the most important areas of a Health Spending Account include claims and dependants.
Take a look at what you need to know.
Dependants
Dependants are defined as your legal spouse and unmarried, unemployed dependent children, including natural, adopted and step-children. Children of your common law spouse may also be considered an eligible dependant if living with the plan holder. In order to be considered an eligible dependant you must be claiming them on your personal income tax return.
Dependent children are eligible for benefits until the age of 21. Exceptions may be made in the case of full time students. If you declare a disabled or dependent adult on your personal income tax return, they may also be considered for eligibility.
You and your dependants can claim up to the amount designated in your Health Spending Account. This amount is for the entire family. Under exceptional circumstances where an unusually large medical expense is required, a one-time adjustment can be made to accommodate the expense.
If you have spousal insurance, the Health Spending Account is the last payer. In other words, if there is a spousal plan or another health and dental plan in place, any premiums paid to that plan is an eligible medical expense. Likewise, any co-pays or items not covered under those plans can be included when submitting a claim through your Health Spending Account. Submit all claims, if eligible, to other providers first and any co-pay would be included in your HSA claim.
Claims FAQ
Here's a quick list of common questions we hear about Health Spending Account claims:
How long after I join can I make a claim?
You are eligible to make a claim immediately after you receive your account information – typically within minutes. You can make a claim for eligible medical expenses that occur on or after the effective date of your plan. Before you make your first claim, you will need to setup a direct deposit with Olympia.
What is needed to make a claim?
Making a claim is fast, convenient, and secure. Login to your online account submit the details of your medical expense to Olympia.
How much can I claim?
Claims amounts are by classification and are determined by the employer.
How long will it take to get my money back?
Your claim will be reviewed and processed within 24-48 hours. Reimbursement to your personal bank account will take 1-2 business days.
What is the claim process?
- Pay for your medical expense (let’s say with your personal credit card). (Pay provider $100)
- Submit a completed claim online to Olympia
- Olympia will adjudicate the claim and debit the employer's account for the cost of the expense plus 8% ($108).
- Olympia reimburses your personal banking account for the original expense ($100)*
The employee receives their reimbursement from the employer funded account.
Is there a deadline for filing claims?
Typically, all expenses that occur during a plan year must also be claimed during this period. Employers have the option of extending a grace period beyond the end of the plan year to allow employees to submit claims.
How far back can I claim?
You can claim an expense that occurred on or after your effective date.
What is the plan year end?
Your plan year is a 12 month period based on the day you sign up.
How does coordination of benefits work with this type of plan?
The HSA administrator is the last payer. In other words, if there is a spousal plan or another health and dental plan in place, any premiums paid to that plan is an eligible as a medical expense. Likewise, any co-pays or items not covered under those plans can be included when submitting a claim through your HSA administrator. Submit all claims, if eligible, to other providers first and any co-pay would be included in your HSA claim.
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