Pre-Tax Expense Accounts: Making a Claim

If you have a Pre-Tax Expense Account, remember that September 15, 2008 will be the final day on which you can incur eligible expenses for the 2007-2008 plan year, and you must submit claims for all expenses by September 30. More information about these deadlines is available here. For a list of eligible expenses, visit the Health Care and/or Dependent Care account pages. Instructions on filing a claim are provided below.

To draw on your pre-tax expense accounts, you must make claims for the eligible expenses you incur. The steps to follow are:

1. Save your original receipts for expenses.
2. For health care claims only: If any portion of the expense is covered under a medical, prescription, dental, or vision plan, submit the expense to the health plan carrier, and wait for the Explanation of Benefits (EOB).
3. For over-the-counter drugs only: You must provide appropriate documentation when submitting expenses for over-the-counter drugs.
4. Fill out a Request for Reimbursement Form, available from our forms section.

5. Send the completed Request for Reimbursement Form along with the original proof of expense and original EOBs (if applicable) to ADP at:
   

   ADP FSA Services
   P.O. Box 1853
   Alpharetta, GA 30023-1853

6. Upon approval of the expenses, you will receive a check for the approved amount.

Keep in mind that you are reimbursed only for eligible expenses that you incur during the same plan year in which you make contributions.

You can access your pre-tax expense account details, including balances and the status of claims you have submitted, securely online through Penn’s online benefits enrollment site. Just login with your PennKey and password, continue until you reach the “Enrollment Options” page, and click the link titled “Access Your Pre-Tax Expense Accounts”.

If you leave the University during the plan year, your contributions end with your final paycheck. After you leave, you have until three months after the end of the plan year in which you terminate to claim expenses that were incurred up to your date of termination (up to the balance remaining in your account). Your requests must be for eligible expenses incurred during the plan year up to your date of termination. NOTE: For the Health Care Account, you may claim expenses that occur after you leave the University - up to the end of the plan year in which you terminate - only if you elect to continue your contributions to the account under the Consolidated Omnibus Budget Reconciliation Act (COBRA). For the Dependent Care Account, however, you may continue to submit requests for reimbursements after you leave through the end of the three-month grace period. You may be reimbursed for expenses incurred through the end of the plan year, up to the balance in your account at the time you stopped participating.

For the 2007-2008 plan year, expenses for both the Health Care and Dependent Care Pre-Tax Expense Accounts must have been incurred between July 1, 2007 and September 15, 2008. All expenses must be submitted to ADP for reimbursement by September 30, 2008.