Limited Purpose FSA

Benefit Overview

Who Can Participate? High Deductible Health Plan (HDHP) Enrollees Only

Maximum Annual Contribution: $3,050/calendar year per Household

Account Overview: If you or your spouse participate in an HDHP Health Savings Account (HSA) plan, you are eligible for the Limited Purpose FSA, which you can use for qualified dental and vision expenses only (not medical). 

What is a Limited Purpose FSA (LPFSA)?

A Limited Purpose FSA is a flexible spending account that allows you to set aside pre-tax dollars for dental and vision expenses for you and your dependents, even if they are not covered under your primary health plan. You are eligible to open a limited purpose FSA if you are enrolled in a health savings account (HSA). 

Understanding Eligible Expenses for Reimbursement

Your Limited Purpose FSA is meant to be utilized to assist with dental and vision expenses. See below for some examples of eligible and ineligible expenses.

Eligible and Ineligible Limited Purpose FSA Expenses

Eligible Expenses	Ineligible Expenses
Dental exams Dental x-rays, fillings, crowns, orthodontia Vision exams Eye glass frames Contact lenses, contact lens solution Laser vision correction	Expenses incurred in a prior plan year Dental products for general health Any medical expense

A comprehensive list of eligible expenses can be found at the My SmartCare portal. 

Using Your Limited Purpose FSA

The easiest way to pay for an FSA eligible expense is to use your FSA Benefits Debit Card. Simply swipe it at the register and keep your receipt should claim documentation be required. Visit the Debit Card Registration webpage for information on how to get started with your FSA Debit card. Otherwise, you can file a claim through the MySmartCare online portal or mobile app, or by mail, fax, or e-mail (including the receipt documenting the service type, amount, and date). Once approved, your reimbursement check will be mailed or you will receive a direct deposit into your designated bank account. For instructions on how to file a claim, visit the Submit a Claim webpage. 

Important Limited Purpose FSA Information​

• With the HDHP and HSA, you are not eligible to enroll in the Healthcare FSA. If you had a Healthcare FSA the previous year, any roll over funds will be rolled over into a Limited Purpose FSA.
• Your full election amount is available on the first day of the plan year
• You cannot change your election amount during the plan year, unless you experience a change in status or qualifying event
• Keep you receipts, you will need an itemized invoice for all reimbursement requests.
• Any unused funds that remain in your account at the end of the year will be forfeited. Plan carefully and use all the money in your Limited Purpose FSA by the end of the plan year.  

Contact Information

BCC is the third-party administrator for all FSA accounts

Phone: (800) 685-6100

Email: [email protected]

Website: mywealthcareonline.com/bccsmartcare/

Customer Service Center Hours

Monday - Thursday: 5:00am - 5:00pm PT

Friday: 5:00am - 3:00pm PT

The Call Center can assist with questions regarding account balance, claim status, substantiation, debit cards, check reimbursement, eligible expenses, My SmartCare registration, and other general FSA questions. 

Reference

Healthcare Flexible Spending Account (FSA)

Dependent Care FSA (DCFSA)

Health Savings Account (HSA)