Horizon MyWay® FSA

Learn how an FSA can help you plan and pay for health care and dependent care costs throughout the year.

	HEALTH CARE FSA	DEPENDENT CARE FSA
Availability of Funds	With a Health Care FSA, your full contribution is available from day one, even if you have not yet contributed the full annual amount.	With a Dependent Care FSA, your funds are available as you contribute from each paycheck (as soon as administratively possible).
Examples of Eligible Expenses	Deductible and coinsurance for covered health care services Copays for covered prescription drugs Over-the-counter medicines Out-of-pocket dental, vision, orthodontic or other provider fees Feminine hygiene products	Dependent care (including wages and related taxes) provided in your home by a babysitter, housekeeper or relative who is not your dependent Dependent care provided outside your home, including qualified day care facility, day camp or other outside dependent/child care services, such as before- and after-school programs Payment made for dependent care services outside your home for a dependent who spends an average of eight hours a day in your home Preschool/nursery school

Know How to Access Your Funds

To be reimbursed from your FSA, you will need to submit a claim form, a copy of your itemized receipt(s) and/or your Explanation of Benefits (EOB) statements to Horizon BCBS.

Please remember to retain copies of your claims forms, receipts and, when applicable, fax confirmations.

There are three ways to submit your claims.

ONLINE	FAX	MAIL
Sign in to securely submit claims online without a claim form. Securely submit claims through the Horizon Blue app without a claim form. Email your claim form and supporting documents to HorizonMyWay.Documents@hellofurther.com	Fax your claims to 1-866-231-0214.	Send claims to: Horizon BCBS FSA P. O. Box 982814 El Paso, TX 79998-2814

Tips for Faster Reimbursement

When completing a claim form, do so carefully to avoid a delay in processing and be sure to include a copy of your itemized receipt(s) and/or EOBs. You can combine claims from the same provider for several dates of service. Incomplete forms will be returned to you.
If you need more claim forms, you can download them.

Regardless of how you submit your claim, the fastest way to be reimbursed from your FSA is to set up direct deposit. With direct deposit, your reimbursement will be deposited into your designated account after your claim is processed. If you are not enrolled in direct deposit, your reimbursement will be mailed to you in the form of a check.

Know What Happens to Unused Funds

What happens to remaining balances at the end of the plan year depends on which FSA you have.

HEALTH CARE FSA	DEPENDENT CARE FSA
If you have funds remaining in your account on December 31, 2021, those funds will roll over to your 2022 account, and can be used to pay for eligible expenses incurred in 2022 regardless of whether or not you make an election to participate in the plan for 2022. Rollover funds will be added to your 2022 account and Horizon MyWay debit card on January 1, 2022, although you can still submit 2021 claims until April 15, 2022.	If you have funds remaining in your account on December 31, 2021, those funds will roll over to your 2022 account and can be used to pay for eligible expenses incurred in 2022 regardless of whether or not you make an election to participate in the plan for 2022. Rollover funds will be added to your 2022 account on January 1, 2022, although you can still submit 2021 claims until April 15, 2022.

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Horizon MyWay® FSA