There are two different Flexible Spending Accounts (FSAs). You can elect one or both during Open Enrollment.

You fund the accounts with your own money. Your contributions are deducted from your pay before taxes are calculated – reducing your taxable income and saving you money.

Health Care FSA This account is for eligible health care expenses — medical, dental, vision, mental health and substance abuse expenses the IRS considers eligible for reimbursement. You can use the account for yourself — and for your dependents’ health care expenses — even if they’re not enrolled in your plan. You can’t use this account for dependent day care expenses. It’s only for eligible health care expenses. Note: You cannot use your Health Care FSA to pay for health care coverage or gym memberships or for most cosmetic procedures. Health Care FSA Contribution Rules You can set aside up to $2,750 of your before-tax pay for 2022. The Health Care FSA has a "use it or lose it" rule. However, you can carry over unused balances up to $550 to the next year as long as you're eligible to participate in the Health Care FSA as of January 1 of the next year. You forfeit unused amounts over $550 at the end of the plan year (for example, if you have an unused balance of $551, you can carry over $550 and you’ll forfeit $1). You can be reimbursed even before you have money in your Health Care FSA to cover your claim, up to the annual amount you elected to contribute. Example You elect to contribute $1,200 for the year. You incur $1,000 in expenses in early February — but you’ve only contributed $200 to your account so far. You can be reimbursed for the full $1,000 right away. How the Health Care FSA Works To help you avoid forfeiting unused FSA dollars at the end of the year, your Health Care FSA will always pay claims first, before your Health Account pays claims. Then, when your Health Care FSA is used up, your Health Account will pay claims. No reimbursements will come out of your Health Account until your Health Care FSA is used up, and it’s all handled by your accounts’ administrator. Your FSA administrator depends on your medical coverage: If you're enrolled in the Anthem HAP–HealthEquity | WageWorks administers your FSA. If you're enrolled in the Kaiser HAP–Kaiser Permanente administers your FSA. If you waive medical coverage but you elect an FSA–HealthEquity | WageWorks administers your FSA. Estimate carefully If you have a Health Account, you can use it to help pay eligible health expenses, too. Your unused Health Account balance rolls over year after year but you can only carry over up to $550 in your Health Care FSA. You forfeit the rest. Log on to your myPlans Connect account and click Estimate Medical Plan Costs under Tools to help you decide how much to contribute to the FSA and see potential tax savings.

Dependent Care FSA This account is for eligible dependent care services for your dependent family members so you can work. The IRS allows you to use the account for child* and elder care while you work — such as day care or adult care, babysitters, at-home caregivers, preschool, before- or after-school programs and summer day camp. You can’t use this account for your dependents’ health care expenses. It’s only for dependent care services that allow you to work. Dependent Care FSA Contribution Rules You can contribute up to $5,000 per person or married couple filing a joint tax return — or $2,500 per person for employees with spouses filing separate returns — but your annual contributions can’t exceed your spouse's income. If your spouse is a full-time student or mentally or physically disabled, he or she is considered to have an annual income of $3,000 if you have one eligible child — or $6,000 if you have more than one eligible child. The contribution rules for married individuals do not apply to employees with registered domestic partners. How the Dependent Care FSA Works There are no debit cards for the Dependent Care FSA. You use your own money to pay expenses and then file claims for reimbursement. You can be reimbursed only when you have enough money in your Dependent Care FSA to cover your claim. Estimate carefully You forfeit unused amounts at the end of the plan year. You can’t carry over unused amounts. * Remember, the Dependent Care FSA is for child care service reimbursements for dependents generally under age 13, while the adult care reimbursements are for a dependent of any age who is physically or mentally incapable of self-care. Visit the IRS Website for eligibility details.

For details, visit the IRS website an view IRS Publication 502, Medical and Dental Expenses

• Anthem members: Click here for a list of eligible Health Care FSA expenses, and click here for a list of Dependent Care FSA expenses.
• Kaiser members: Click here for a list of eligible Health Care FSA and Dependent Care FSA expenses.

Be sure to keep your itemized receipts or explanation of benefits (EOBs) for purchases made using your FSA – you’ll need them if you have to verify your claims for the IRS.

For Anthem members or waived coverage employees with a Flexible Spending Account (FSA)

2021 expenses

File claims with HealthEquity | WageWorks through March 31, 2022, for 2021 health care expenses incurred through December 31, 2021.

2022 expenses

File claims with HealthEquity | WageWorks through March 31, 2023, for 2022 health care expenses incurred through December 31, 2022.

Don’t use your card for prior year expenses

Don’t use your health payment card in 2022 to pay for 2021 expenses. Instead, you’ll need to file a claim to reimburse yourself or to pay your provider.

There are three ways to get reimbursed:

Pay My Provider	Pay Me Back	Manually file claims
Log in to your HealthEquity | WageWorks account and use Pay My Provider if you get a bill and you don’t want to use your card. Pay My Provider sends money to your provider for amounts not paid by insurance.	Log in to your HealthEquity | WageWorks account and use Pay Me Back if you already paid an eligible expense out of your own pocket. Download the free HealthEquity | WageWorks app—EZ Receipts®—for an easy way to use Pay Me Back.	Use the Health Account and Health Care Flexible Spending Account Claim Form or the Dependent Care Claim Form to file claims with HealthEquity | WageWorks.
HealthEquity | WageWorks automatically debits your Health Care FSA, if you elected it, and then your Health Account. Don’t have enough in your Health Account or Health Care FSA to cover the charge? You’ll need to pay with your own money. Watch the Reimbursements with Anthem video to learn more about filing a claim.

Tip: Don’t wait!

Send your explanation of benefits (EOB) to HealthEquity | WageWorks when you get it—even if you paid with your HealthEquity | WageWorks card. Sending the EOB right away will help avoid having your payment delayed.

If you need help filing a claim or reimbursement, call the PG&E Benefits Service Center at 1-866-271-8144, and select option 1 and then option 1 for HealthEquity | WageWorks.

Set up your HealthEquity | WageWorks account
To set up your account, log on to your myPlans Connect account and click on HealthEquity | WageWorks link. You’ll be able to go straight to your HealthEquity | WageWorks account without creating a username and password.

For Kaiser members

File claims with kp.org through March 31, 2022, for 2021 FSA expenses incurred through December 31, 2021. Log into your medical account at kp.org and select My coverage & costs and to file a claim.

If you have questions about the FSA accounts, contact your Health Account and Health Care/Dependent Care Flexible Spending Account (FSA) claims administrator.

Watch the Reimbursements with Kaiser video to learn more about filing a claim.

Track your Health Account balance

Log in to your HealthEquity | WageWorks account through your myPlans Connect account.

Ways to get reimbursed

If you elected the Health Care Flexible Spending Account (FSA), the money in your FSA will be used first to reimburse you for any out-of-pocket health care expenses—since the FSA has a "use-it or lose-it" rule. HealthEquity | WageWorks administers your FSA and will automatically debit your FSA first to pay for any out-of-pocket medical expenses. If you don’t have enough in your FSA to cover the expenses, HealthEquity | WageWorks will then debit your Health Account. Once you receive your Explanation of Benefits (EOB) from Anthem, Delta Dental or VSP, you can use your HealthEquity | WageWorks health care card to pay your health care provider the amount you owe him or her, as long as you have enough in your Health Account or Health Care FSA. You should always save your receipts and EOBs for IRS purposes.

There are three things you need to know about getting reimbursed through HealthEquity | WageWorks

• Claims filing deadline
• When you can use the HealthEquity | WageWorks health payment debit card
• Deadline for verifying expenses if you use the HealthEquity | WageWorks health payment debit card

	Getting reimbursed		Health Care Flexible Spending Account (FSA)		Health Account
	What's the latest you can file a claim?		March 31 for expenses incurred through December 31 of the prior year		No deadline for active participants
	Can you use your HealthEquity | WageWorks health payment debit card?		Yes for current-year expenses No for prior-year expenses		Yes for current-year expenses No for prior-year expenses
	If HealthEquity | WageWorks requests more information—what's the latest you can verify your expense?		March 31 for expenses incurred through December 31 of the prior year		No deadline*

*If you haven’t verified your expense within 90 days from the date of the card transaction, HealthEquity | WageWorks will deduct the amount of the transaction from any future claims you submit through Pay Me Back.

There are three ways to get reimbursed:

Pay My Provider	Pay Me Back	Manually file claims
Log in to your HealthEquity | WageWorks account and use Pay My Provider if you get a bill and you don’t want to use your card. Pay My Provider sends money to your provider for amounts not paid by insurance.	Log in to your HealthEquity | WageWorks account and use Pay Me Back if you already paid an eligible expense out of your own pocket. Download the free HealthEquity | WageWorks app—EZ Receipts®—for an easy way to use Pay Me Back.	Use the Health Account and Health Care Flexible Spending Account Claim Form or the Dependent Care Claim Form to file claims with HealthEquity | WageWorks.
HealthEquity | WageWorks automatically debits your Health Care FSA, if you elected it, and then your Health Account. Don’t have enough in your Health Account or Health Care FSA to cover the charge? You’ll need to pay with your own money. Watch the Reimbursements with Anthem video to learn more about filing a claim.

Tip: Don’t wait!

Send your explanation of benefits (EOB) to HealthEquity | WageWorks when you get it—even if you paid with your HealthEquity | WageWorks card. Sending the EOB right away will help avoid having your payment delayed.

If you need help filing a claim or reimbursement, call the PG&E Benefits Service Center at 1-866-271-8144, and select option 1 and then option 1 for HealthEquity | WageWorks.

To set up your account, log on to your myPlans Connect account and click on HealthEquity | WageWorks link to submit your reimbursement.

For medical expenses
If you use an in-network provider, you don’t need to file a claim — your doctor will file one with Anthem. Anthem will then pay your doctor the amount covered under the Health Account Plan (HAP) and send you an Explanation of Benefits (EOB). Once you receive your EOB from Anthem, you can use your HealthEquity | WageWorks health care card to pay your doctor the amount you owe him or her, as long as you have enough in your Health Account or Health Care FSA.

If you use an out-of-network provider, you may need to pay your doctor up front and then file a claim with Anthem. Anthem will then pay your doctor amounts it covers under the HAP and send you an EOB. Once you receive your EOB from Anthem, you can use your HealthEquity | WageWorks health care card to pay your doctor the amount you owe him or her, as long as you have enough in your Health Account or Health Care FSA.

You should always save your receipts and EOBs for IRS purposes.

For prescriptions
When you visit the pharmacy, you'll need two cards:

• Your Express Scripts ID card tells your pharmacy you're eligible for prescription drug benefits
• Your HealthEquity | WageWorks health care card is loaded with your Health Account credits and — if you elected the Health Care FSA — your annual FSA contribution. However, not all small independent pharmacies have the correct computer system to validate your transaction, in which case you'll need to pay for the prescription using another form of payment

For mental health and preventive substance abuse expenses
After you receive mental health or substance abuse care from a Beacon Health Options provider, you’ll need to wait a few weeks for Beacon Health to process your claim, determine what you owe, and mail you an Explanation of Benefits (EOB) form. Once you receive your EOB from Beacon Health, you can use your HealthEquity | WageWorks health care card to pay your health care provider the amount you owe them, as long as you have enough in your Health Account or Health Care FSA. You should always save your receipts and EOBs for IRS purposes.

For dental and vision expenses

You can use the Health Account – or your Flexible Spending Account (FSA) if you elected it – to pay for your dental and vision expenses:

You can use your HealthEquity | WageWorks health care card to pay at the time of service, but you may have to submit documentation to HealthEquity | WageWorks such as copies of your receipts or Explanation of Benefits (EOB) forms at a later date. You should always save your receipts and EOBs for IRS purposes.

Deadline for filing Flexible Spending Account (FSA) claims

2021 expenses

File claims with HealthEquity | WageWorks through March 31, 2022, for 2021 health care expenses incurred through December 31, 2021.

2022 expenses

File claims with HealthEquity | WageWorks through March 31, 2023, for 2022 health care expenses incurred through December 31, 2022.

Don’t use your card for prior year expenses

Don’t use your health payment card in 2022 to pay for 2021 expenses. Instead, you’ll need to file a claim to reimburse yourself or to pay your provider.

Set up your HealthEquity | WageWorks account

To set up your account, log on to your myPlans Connect account and click on HealthEquity | WageWorks link. You’ll be able to go straight to your HealthEquity | WageWorks account without creating a username and password.

Alternatively, you can log into HealthEquity | WageWorks.com/wageworks or use the EZ Receipts app.

HealthEquity | WageWorks won’t know who you are—so you’ll need to register your account the first time you visit HealthEquity | WageWorks outside of myPlans Connect. You’ll need to provide the last four digits of your Social Security number just once—when you register your account.

After you set up your HealthEquity | WageWorks account, you’ll be able to:

• Sign up for emails and text messages about your account activity
• Sign up for direct deposit for reimbursements
• See alerts and messages – like when you need to submit a receipt or explanation of benefits
• See all your claims activity
• View a dashboard, where you can see your account activity, submit a claim, look up an eligible expense or submit a receipt
• Order extra cards

For more information or assistance with your FSA, contact HealthEquity | WageWorks for at 1-866-271-8144, Monday–Friday, 5 a.m.–7 p.m. Pacific time or log on to your myPlans Connect account.

The Kaiser Visa Health Payment Card is loaded with your Health Account credits and — if you elected the Health Care FSA—your annual FSA contribution.

	Getting reimbursed		Health Care Flexible Spending Account (FSA)		Health Account
	What's the latest you can file a claim and verify an expense?		March 31 for expenses incurred through December 31 of the prior year		No deadline for active participants
	Can you use your Kaiser Visa Health Payment card?		For prescription drugs—only at the Kaiser pharmacy You'll need to file a claim for most other expenses except medical claims, which are automatically processed by Kaiser

Track your Health Account balance

Log in to kp.org/healthpayment.

Ways to get reimbursed

If you elected to participate in the Health Care Flexible Spending Account (FSA), the money in your FSA will be used first to reimburse you for any out-of-pocket health care expenses—since the FSA has a “use it or lose it” rule. Kaiser will automatically debit your FSA first to pay for any out-of-pocket medical expenses, and then will debit your Health Account if you don’t have enough in your FSA to cover the expenses.

Kaiser will automatically pay your Kaiser provider; you do not have to file any claims or deposit any checks when you get care from Kaiser.

When you get care outside Kaiser—for example, dental and vision care—there are two ways to file claims for reimbursement from your Health Account or Health Care FSA:

• By logging on to Kaiser’s website and uploading, faxing, or mailing your supporting documents to Kaiser
• Through Kaiser’s smartphone app—KP HRA/HSA/FSA Balance Tracker—available through the iTunes app store and the Google Play Android store

Be sure to keep a copy of all your receipts before you submit them to Kaiser.

For medical expenses
Kaiser will automatically pay your Kaiser provider; you do not have to file any claims or deposit any checks when you get care from Kaiser.

After you receive care, Kaiser will process your claim, send you an Explanation of Benefits (EOB,) and then automatically debit your Health Account or Health Care FSA to pay any charges you owe for services. If you don’t have enough funds in your account(s), Kaiser will bill you, and you’ll be responsible for paying Kaiser what you owe with your own money.

For prescriptions
Your Kaiser Visa Health Payment Card is loaded with your Health Account credits and — if you elected the Health Care FSA — your annual FSA contribution.

You can use your Kaiser Visa Health Payment card only at the Kaiser pharmacy. You can’t use the card anywhere else. You shouldn’t have to submit an itemized receipt or Explanation of Benefits (EOB) to verify your expense. Kaiser automatically debits your Health Account or Health Care FSA when you use your Kaiser Visa Health Payment card.

For mental health and preventive substance abuse expenses
As a Kaiser member, you’ll need to file a claim when you use Beacon Health Options for inpatient substance abuse or for autism treatment. If you have enough in your Health Account or Health Care FSA to cover what you owe, you’ll be reimbursed. Otherwise, you’re responsible for paying your provider amounts you owe.

For dental and vision expenses

You can use the Health Account – or your Flexible Spending Account (FSA) if you elected it – to pay for your dental and vision expenses:

However, since you can’t use your Kaiser Visa Health Payment card to pay for dental and vision expenses, you’ll need to file a claim for reimbursement.

If you have to pay your provider at the time of service, you’ll need to spend your own money and then file a claim with Kaiser to be reimbursed from your Health Care FSA or Health Account.

If you don’t have to pay your provider at the time of service, you’ll need to wait for your Explanation of Benefits (EOB) and then – once you know how much you owe – you can pay using your own money and file a claim for reimbursement or file a claim to pay your provider directly. Either way, the funds will be debited from your Health Account or Health Care FSA if you elected it.

To file a claim for reimbursement or to pay your provider directly:

• Log in to kp.org with your Kaiser Permanente username and password
• Click on My Coverage and Costs
• Under Plan Ahead, click on Health Payment Accounts
• Click on File a Claim
• Select a payee (yourself or your health care provider
• Upload your itemized receipt or EOB
• Follow the prompts on the menu screen to submit your claim

Visit the BeneTV page to watch a short video about how to get reimbursed.

You may also file claims through Kaiser’s smartphone app—KP HRA/HSA/FSA Balance Tracker—available through the iTunes app store and the Google Play Android store.

You’ll need to enter the date of service, amount of service, provider’s name, patient’s name and service provided in order to verify your expense.

TIP: Upload both your credit card or cash payment receipt and the statement from your dentist or eye doctor that itemizes the services you received.

Deadline for filing Flexible Spending Account (FSA) claims

File claims with kp.org through March 31, 2022, for 2021 FSA expenses incurred through December 31, 2021. Log into your medical account at kp.org and select My coverage & costs and to file a claim.

For more information or assistance with your FSA, contact Kaiser Permanente at 1-877-750-3399 Monday–Friday, 5 a.m.–7 p.m. Pacific time.