Charlotte Savings and Spending Accounts

Savings and Spending Accounts Overview 

On Friday, March 27, 2020, Congress passed the CARES Act (the Coronavirus Aid, Relief, and Economic Security Act), revising reimbursement rules for over-the-counter (OTC) drug costs regarding the use of savings and spending accounts:

Individuals can use an HSA, FSA or LiveWELL Incentive Account to purchase over the counter (OTC) medication without a prescription. Further, the CARES Act allows these accounts to be used to pay for certain menstrual care products, including tampons and pads, as eligible medical expenses. These are permanent changes and apply retroactively to purchases beginning on January 1, 2020. 

Health Savings Accounts (HSAs), Health Flexible Spending Accounts (FSAs) and the LiveWELL Incentive Accounts are all tax-advantaged, and the IRS defines the types of expenses that you can pay with these accounts. To see an overview of what expenses are covered, visit https://healthaccounts.bankofamerica.com/what-expenses-are-covered-by-an-hsa-fsa-hra.shtml

What happens to any remaining funds in my accounts at the end of the year?   
Different account types have different rules based on IRS guidelines.   

• Health Savings Account (HSA) – Unused funds roll over from year to year   
• Flexible Spending Account (FSA) and Limited Purpose FSA - Rollover up to $610 in unused funds to the next year  
• Dependent Care FSA (DCFSA) – Unused funds for 2023 can be spent up to 2 1/2 months after the end of the plan year
• LiveWELL Incentive Account – Unused funds roll over from year to year, if the teammate remains enrolled in the Co-Pay Plan. If the teammate is no longer enrolled in the Co-Pay Plan, any unused balance in their LiveWELL Incentive Account will be forfeited. Teammates will have until April 30 of the following year to have health care expenses from the previous year reimbursed 

Options Available with the Health Savings Plan

Health Savings Account (HSA): The HSA is yours to save for current and future healthcare-related expenses, such as your deductible, coinsurance, and prescription medications. Your HSA is an important component of retirement savings. Teammates can make direct contributions to this account from their paycheck. For participants in the Health Savings Plan with an active HSA, LiveWELL Incentives will be deposited into the HSA. Without an active HSA, earned LiveWELL Incentives will be paid as taxable earnings in your paycheck. (Typical reasons for not having an active HSA include coverage on a governmental plan such as Medicare or TRICARE).   

_{The maximum IRS contribution for the year includes the sum of all teammate and employer contributions, including incentives. Teammates age 55 or older are allowed an additional “catch-up” contribution of $1,000.}

Here’s what you need to know:  
Remember, preventive care, labs and most preventive medications are covered 100% – you do not pay for preventive care.  
(Note: No coverage provided for out of network).   

Your Health Savings Account (HSA) is the key to the Health Savings Plan – you can build your savings. 

• It is important for you to save in your HSA by putting in enough to meet your deductible and maximize your savings.  
• Dollars in your HSA are not taxed when you put them in or take them out for medical purposes.  
• Your HSA is a great savings vehicle for medical expenses now and in retirement.  
• HSA Contributions may be changed throughout the year in totalrewards.org. The amount entered at totalrewards.org is the contribution that will be made per pay period. To make updates to your HSA, follow the steps below:  
• Log in to totalrewards.org
• Select Review Now on the Review Your Benefits tile 
• Select Update Benefits Coverage  
• Select Update My HSA  
• Answer each of the HSA Eligibility Questions 
• Check the box for verification of eligibility and select Next 
• You will see the following options: 
  • Do Not Contribute: Stops your contributions, or  
  • Future Contributions: Change the amount in the Per-Pay Period Contributions box or Remaining Pay Periods Total box. 
    • If you choose to change Remaining Pay Periods Total, the system will then automatically change the Per-Pay-Period Contribution amount allowed. 
• Select Next  
• Review your update and click on Continue to Review and follow the prompts to save your change  
• Your changes are final once you click Finish Enrollment.  

Eligibility

• Teammates enrolled in the Health Savings Plan may contribute to an HSA pretax until they enroll in Medicare. For help in understanding how Medicare and your healthcare costs fit into your retirement goals, call N.C. Seniors’ Health Insurance Information Program (SHIIP) at 855-408-1212 (or a similar program if you live in another state)
• To participate in an HSA, you must be enrolled in a consumer-directed health plan – not covered by other health insurance, such as Medicare or TRICARE – and you cannot be claimed as a dependent on someone else’s tax return
• The maximum IRS contribution for the year includes the sum of all teammate and employer contributions, including incentives. Teammates age 55 or older are allowed an additional “catch-up” contribution $1,000

Limited Purpose Flexible Spending Account (LPFSA): Allows teammates to set aside additional pretax dollars to help pay for planned qualified dental and vision expenses that occur during a 12-month period. This account is known as "use it or lose it", however a rollover of up to $610 in unused funds to the next year is allowed. The IRS maximum contribution in 2024 is $3,050. 

Teammate Contributions to Meet IRS Maximum

Medicare and Your Health Savings Account (HSA)

LiveWELL Health Plan participants should contact Medicare 6-12 months prior to turning age 65 to learn about options for health care coverage and rules for contributing to a Health Savings Account when Medicare eligible.

Questions about Medicare

For help in understanding how Medicare and your health care costs may fit into your overall retirement goals, call the Seniors’ Health Insurance Information Program (SHIIP) at 855-408-1212. Teammates can also call the Social Security Administration at 888-383-1598.

Seniors’ Health Insurance Information Program (SHIIP) Details

• SHIIP is available to anyone for FREE
• SHIIP has representatives in every NC county
• Teammates may make appointments for 1:1 phone calls or in-person meetings with a specialist
• Teammates may contact a representative Monday – Friday, 8 a.m. – 5 p.m., by calling the SHIIP consumer information line at 855-408-1212 or via email
• SHIIP can answer detailed questions about Medicare that Social Security Offices may not be able to answer 

Options Available with the Co-Pay Plan

Flexible Spending Account (FSA): Allows teammates to set aside pretax dollars to help pay for planned qualified medical, dental and vision expenses that occur during a 12-month period. This account is known as "use it or lose i", however a rollover of up to $610 in unused funds to the next year is allowed.

Teammate-Only and Family Plans IRS Maximum Contribution: $3,050 

LiveWELL Incentive Account: For teammates that are enrolled in the Co-Pay Plan, Atrium Health will deposit earned LiveWELL Incentives into this account during the year. Funds can be used to help pay for qualified medical, prescription, dental and vision expenses. Unused funds rollover from year to year.

Using Your Health Savings Account (HSA), Flexible Spending Account (FSA), LiveWELL Incentive Account and Limited Purpose Flexible Spending Account (LPFSA)

Atrium Health partners with Bank of America to administer the Health Savings Account (HSA), Flexible Spending Account (FSA), LiveWELL Incentive Account and Limited Purpose Flexible Spending Account (LPFSA), making it easy to access your account information in one place.  If you select the Co-Pay Plan or are enrolling in either health plan for the first time you will receive a new card for 2024.

If you enroll in the Co-Pay Plan and currently have a Health Savings account (HSA) you will have one card for all accounts. The funds will be accessed in the following order: Flexible Spending Account (FSA), LiveWELL Incentive Account then Health Savings Account (HSA).

2023 Flexible Spending Accounts (FSA) will be closed at 12:01 a.m., December 31, 2023 for teammates who enroll in either of the LiveWELL Health Plans.

The following provisions apply to FSA plans:

• Between January 1 and April 30, 2024, you can submit manual FSA claims for expenses incurred in 2023.
• If you were enrolled in the Health Savings Plan for 2023 and were enrolled in a Limited Purpose FSA in 2023, at the beginning of May 2024, any balance remaining up to $610 will be rolled into a Limited Purpose FSA for dental and vision-related expenses
• If you are enrolled in the Co-Pay Plan for 2024 at the beginning of May 2024, any balance remaining from a 2023 Limited Purpose FSA up to $610 will be rolled in an FSA for medical, dental and vision-related expenses

These funds will be accessible on a new Bank of America card that will arrive in your home sometime in late December.

In addition to the Savings and Spending Accounts associated with the LiveWELL Health Plans, eligible teammates have the opportunity to participate in a Dependent Care Flexible Spending Account (DCFSA). 

Dependent Care Flexible Spending Account (DCFSA)

You can use the DCFSA to pay for any eligible, work-related dependent daycare expenses you incur – such as licensed daycare centers for your dependent children or adults, summer day camps, nursery schools or after-school care. Unlike the HCFSA, your funds must be in your DCFSA before they can be reimbursed. Eligible dependents include: 

• Children under age 13
• Disabled dependents of any age who live with you more than eight hours per day, whom you claim on your tax return and who are enrolled in an eligible daycare program 

Important Information About DCFSA IRS Limit

You can contribute up to $5,000 ($2,500 if married, filing separately) to your DCFSA. This limit may change if: 

• You are considered a “highly compensated” teammate, the limit is subject to reductions based on IRS discrimination testing results
• Both you and your spouse contribute to a DCFSA (only $5,000 combined is allowed) based on IRS guidelines 
• The $5,000 limit includes DCFSA, the Dependent Back-up Care and Transitional Child Care benefits
• Both the DCFSA and the federal tax credit for child and dependent care offer you tax savings on dependent care expenses. It is important to determine which is right for you and which will provide the greatest tax benefit in 2024.

Based on your family's unique situation, it is recommended that you consult a qualified tax advisor to make your choice on an election and contribution amount for the DCFSA.

Healthcare Flexible Spending Account (HCFSA)

If you or your eligible dependents are not covered under the LiveWELL Health Plan or any other high-deductible plan, you are eligible to make contributions to the HCFSA. You can contribute up to $3,050 in 2024.

• Use the dollars in your HCFSA to pay for eligible expenses for yourself or anyone you claim as a dependent on your income tax return
• Eligible expenses are medical, prescriptions, dental and vision charges not fully covered by other benefits or insurance
• Your annual election is deducted from each paycheck in equal amounts
• Expenses must be incurred on or after your effective date of coverage during the plan year
• You decide how much you want to contribute to your HCFSA – up to the maximum contribution