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HSA

Health Savings Account

A Nyhart Health Savings Account (HSA) is a pre-tax benefit used to pay for eligible medical, dental and vision expenses that works in combination with a qualified High-Deductible Health Plan. With an HSA, employees can invest their benefit dollars to help save for retirement.

Forms

Direct Deposit Authorization/Termination Form

Use this form to authorize Nyhart to initiate or cease deposits to your bank account.

Authorization to Disclose Information Form

This form authorizes Nyhart to disclose Personal Health Information and/or Transactional Information to an authorized person of your choice.

HSA Power of Attorney

Use this form to add a Power of Attorney designation or to revoke an existing one.

HSA Beneficiary Change and Spouse Consent Form

Use this form to designate or change your beneficiary. If you are married use this form to designate your spouse as Primary Beneficiary or get their signature of consent for another primary beneficiary.

HSA Distribution Request Form

Use this form to request a distribution from your HSA for Normal/Disability/Prohibited transaction distribution, excess contribution removal, rollover/transfer.

HSA Transfer Form

Use this form to initiate a direct transfer of HSA funds with another custodian to an HSA with Nyhart.

HSA Contribution Form

Use this form to make a normal, mistaken, or rollover contribution to your HSA.

Mileage Reimbursement Request

This form is used for requesting mileage reimbursement from your Flexible Spending Account.

HSA Death Distribution Request Form

This form authorizes a distribution from a deceased HSA holder’s account.

VEBA Claim Form

This form is used for requesting reimbursement from your VEBA account.

HRA Claim Form

This form is used to request reimbursement from your Health Reimbursement Arrangement.

Flexible Spending Claim Form

This form is used for requesting reimbursement from your Flexible Spending Account.

Commuter Flexible Benefit Program Reimbursement Claim Form

This form is used to request reimbursement from your Commuter Flexible Benefit Account.

Debit Card Substantiation

This form is used to verify a claim that has already been reimbursed by the use of your debit card. This document can be edited on screen for your convenience.


Frequently Asked Questions

What is a Flexible Spending Accounts (FSA)?

A Flexible Spending Account (FSA) is a benefit that allows you to use pre-tax money to pay for eligible health or dependent care expenses for you, your spouse, or your eligible dependents.

Who is eligible on my FSA?

Through the Health Care FSA, you can claim eligible expenses for yourself and any dependents you report on your income taxes, including college age dependents.

Through the Dependent Care FSA, you can claim eligible daycare and before/after school care expenses for a qualifying dependent. The IRS defines a qualifying dependent as:

  1. Your child who is under the age of 13.
  2. Your spouse who is not physically or mentally able to care for himself or herself and has lived with you more than half the year.
  3. A person who is not physically or mentally able to care for himself or herself and has lived with you more than half the year.

What is the FSA maximum contribution limit?

Each year, the IRS sets maximum contribution limits for FSAs.

For 2019, the maximum contribution limit is $2,700

When will my election be available?

You will have access to your entire Health Care FSA election on the first day of your period of coverage. Deductions for the plan will be evenly divided amongst your payrolls for the year.

However, the Dependent Care FSA is a pay-to-balance account. Therefore, you cannot be reimbursed until the funds have been contributed through your payroll deductions. If a claim is submitted for more than the available balance, the claim will remain in a pending status and funds will be released as they become available; until the entire claim or your annual election has been reimbursed. Prepayments are not eligible for reimbursement until the care has been provided.

Can I change or cancel my FSA after I have made my election?

Your election in the FSA is irrevocable. You cannot make a change in your election after your period of coverage begins. If you experience a qualifying Change in Status event, you may be permitted to change the election in your Health Care FSA or Dependent Care FSA. You will need to contact your HR department to process your Change in Status event. Your requested change must correspond to the event, and you must request the change within 30 days.

Qualifying Change in Status events that apply to Health Care FSAs and Dependent Care FSAs may include:

  • Change in your legal marital status - including the gain or loss of a spouse
  • Change in the number of your dependents - including gain or loss of taxable dependents
  • Change in your employment status or that of your spouse or dependents
  • Commencement of employment that triggers eligibility
  • Termination of employment that causes a loss of eligibility.

Qualifying Change in Status events that apply to Dependent Care FSAs may include:

  • Change in your dependent care provider
  • Change in your dependent care needs
  • Change in the cost of dependent care
  • If the dependent care provider is a relative, an increase in fees is not a qualifying Change in Status event.

What are the ways that I can access my account?

To access your account, we have two user-friendly options; Nyhart FSA/HRA/HSA Mobile App and our website.

The Nyhart FSA/HRA/HSA Mobile App can be used on smartphones and tablets. Instructions for accessing the Nyhart FSA/HRA/HSA Mobile App are available under Forms & Resources at my.nyhart.com. You will use the following login credentials for the Nyhart FSA/HRA/HSA Mobile App:

Username: Social Security number
Password: Social Security number and your ZIP code together with no spaces or dashes.
Example: 12345678946250

Please note that this is a different login than you would use to log in to our website.

The Nyhart Mobile App will allow you to: view your balances, view account activity, view notification history, file claims, and submit receipts for outstanding debit card transactions.

If you are logging in for the first time or have not previously changed your login credentials, you may log in to our website at my.nyhart.com by using the following login credentials:

Username: Social Security number
Password: ZIP code

Your account is automatically created when you are enrolled. You will not need to register your account on our website. You may change your login credentials after initial login. If you forget your password, you may reset it by clicking on “Forgot Your Password?”

Will my spouse or dependent be able to obtain account information?

Due to the HIPAA Privacy Rule, Nyhart is requiring participants to have an Authorization to Disclose Protected Health Information (PHI) Form on file if a participant would like PHI disclosed to an individual other than the account holder. By signing this form, you are authorizing the disclosure of your PHI in connection with this plan. Nyhart will be unable to disclose any information to individuals except the account holder without a signed form on file.

The Authorization to Disclose PHI Form is available on our website my.nyhart.com under Forms & Resources. You can also request a form through support@nyhart.com or our customer service line at (800) 284-8412.

Where can I find a list of eligible expenses?

Nyhart provides a list of eligible expenses for reference on our website at my.nyhart.com. The Expense Eligibility Table is available in the left column, after you log in. The table will give you detailed descriptions of eligible expenses. If you are still unsure after reviewing the table, you may pre-qualify expenses by submitting documentation to support@nyhart.com or by calling (800) 284-8412.

Are insurance premiums eligible for reimbursement?

Insurance premiums are not eligible for reimbursement through the FSA.

Are prepayments eligible for reimbursement?

Prepayments are not eligible for reimbursement. You are eligible to be reimbursed once the service or care has rendered. Documentation submitted for prepayment will be entered as a claim and put on hold until service or care has rendered. Once the service or care has rendered, reimbursement will occur.

Can I claim the fees I pay to my family member through the Dependent Care FSA?

The dependent care fees you pay to your relatives may be eligible for reimbursement through the Dependent Care FSA. The child care provider must have a Tax ID number or a valid Social Security number, and they must claim the fees as income on their taxes.

Child care provided by a parent or another dependent of the household will not be eligible for reimbursement per IRS guidelines.

Can I use my FSA to pay for Over-the-Counter (OTC) products?

Over-the-counter (OTC) medicines, other than insulin, are no longer eligible for reimbursement from the FSA unless you have a prescription. Medical devices, such as eyeglasses and braces, which are purchased over-the-counter may still be considered eligible for reimbursement from the plan.

What type of documentation is required for reimbursement?

According to IRS Guidelines, all claims submitted through Flexible Spending Accounts (FSA) must be substantiated to verify the eligibility of the expenses. All expenses must be substantiated by independent third-party providers. The third-party information must describe the following:

  1. Patient's Name: The name of the person who received the service or for whom the item was purchased. For retail store purchases, this information may be excluded.
  2. Provider's Name: The provider that delivered the service or the merchant where the item was purchased.
  3. Date of Service: The date when services were provided or the item was purchased.
  4. Type of Service: A detailed description of the service provided or item purchased.
  5. Cost: The amount paid for the service or product and/or the portion that is not reimbursed through your insurance carrier.
Health Care Expenses

If the expense was submitted to your insurance for payment, you will need to submit an Explanation of Benefits (EOB) to establish the amount that was not paid by the insurance plan. If the expense was not submitted to your insurance, you will need to submit itemized bills from the provider. If the expense was a prescription, submit the tag from the RX bag or a pharmacy summary. Please be aware that cancelled checks alone are not sufficient documentation to verify an expense. Keep the original receipts for your records and send copies to Nyhart.

For most medical expenses, proof of a payment is not required. For orthodontia expenses; however, you must include documentation to indicate when payment was made along with the above information.

If over-the-counter (OTC) products were purchased, you will need to submit a copy of the receipt clearly indicating the name of the OTC products purchased along with a copy of the prescription from your physician.

Dependent Care Expenses

In addition to the above requirements, Dependent Care FSA claims require additional information including:

  • Name and age of dependent
  • Provider information including name, address, and Tax ID number or Social Security number
  • Proof of payment.

Does Nyhart contact my provider for documentation?

Due to HIPAA regulations, providers should only speak to the account holder. Nyhart does not contact your provider for any information on your account. The provider or your insurance carrier should provide you with documentation that can be used to substantiate your expenses. If an itemized statement is needed, it is your responsibility to contact the provider to request it.

When do I need to submit my claims?

Throughout the plan year, you may submit claims as often as you like. To verify your submission deadline date, you will need to log in to the website at my.nyhart.com. Click on Your Balances in the left-hand column. Click on the Accounts tab, and click on the plan you would like to see. This will open a pop-up box with the plan details. The Final Filing Date will be listed on the right-hand side of the first box. Submissions received after that time will not be accepted.

Online claims can be submitted at my.nyhart.com.

You can also submit claims by filling out a claim form and include documentation for email, mail, and fax submissions. The form is available at my.nyhart.com under Forms & Resources. Claims are processed in the order they are received.

Submissions can be sent via email to support@nyhart.com, by fax to 1-888-887-9961, or by mail to:

Nyhart
c/o FSA
8415 Allison Pointe Blvd, Suite 300
Indianapolis, IN 46250

When looking online, it says that I have a pending payment. What does that mean?

A pending payment means that a claim is waiting for the next reimbursement date to be paid out. Reimbursement dates are specific to your employer. Direct deposits are generally available within 24 hours but can take up to 72 hours to settle. Checks should be received within 5 business days depending on your distance from Indianapolis, Indiana.

How do I change or add my banking account information?

You can change your banking account information at my.nyhart.com. After you log in, click on Your Balances from the column on the left. Go to the Profile tab. Click on Banking/Cards in the left-hand column. In the middle, you will have the option to Add Bank Account or View/Update current bank account on file. Click on Add Bank Account to add your banking information. Click on View/Update to change your current bank account information. You will be asked to confirm the answer to your security question before your banking information will be updated. If you cancel this action, your banking information will not be updated. Please note, that adding a bank account will not automatically change your reimbursement method.

If you are currently being reimbursed by check, you will need to update your reimbursement method to direct deposit. To update your reimbursement method, click on Your Balances. Go to the Tools & Support tab. Click on Change Payment Method. This will give you the option to select direct deposit. After clicking the Change Payment Method button, your account will be updated.

How can I appeal a claim that was denied?

If you do not agree with a denial, your recourse is to submit an appeal of denial to support@nyhart.com. All appeals must be in writing. The appeal will need to include the reason for your appeal and any additional documentation that is needed to support your appeal.

Nyhart
c/o FSA
8415 Allison Pointe Blvd, Suite 300
Indianapolis, IN 46250

Do I need to re-enroll in the FSA each plan year?

Yes, you must make a new election to the Health Care FSA and/or Dependent Care FSA each plan year.

What happens to the money deducted from my paycheck if I terminate employment?

Health Care FSA and Dependent Care FSA

You may only be reimbursed for eligible services that rendered on or before your date of termination. For example, if you terminated on June 1st, you may be reimbursed for eligible expenses that incurred on or after your effective date and prior to June 2nd.

If you have been reimbursed less than you have contributed to the plan, you will be notified of how to continue the Health Care FSA plan coverage through COBRA. If you choose COBRA continuation coverage, you must make after-tax contributions to the account in order to be reimbursed for expenses that incurred after your termination of employment.

COBRA does not apply to Dependent Care FSA.

How often are the debit cards reissued?

Your debit cards will be reissued every three years for security purposes. The two original cards you were issued will be replaced with no additional cost to you. The replacement cards will arrive before the expiration of your current cards. If you need cards reissued prior to expiration, you can request cards through my.nyhart.com. After you log in, click on Your Balances from the column on the left. Click on the Profile tab, and then click on Banking/Cards in the left-hand column. From this screen, you will click on Order Replacement. A confirmation screen will appear that asks to verify your address before issuing new cards. Click on Submit after you have verified and/or updated your home address. Please note, each time you order replacement cards you will receive two cards and be charged $10.00.

How do I report my debit cards as lost or stolen?

You can report your debit cards as lost or stolen at my.nyhart.com. This will immediately suspend your cards from use. New cards will be mailed to you within 7 to 10 business days. In order to report your cards as lost or stolen online, you must log in. Click on Your Balances from the column on the left. Click on the Profile tab, and then click on Banking/Cards in the left-hand column. From this screen, you will click on Report Lost/Stolen. A confirmation screen will appear that asks to verify your address before updating the card status. Click on Submit after you have verified and/or updated your home address.

You can also report your card as lost or stolen by emailing us at support@nyhart.com or by calling us at (800) 284-8412. Our hours of operation are Monday through Friday from 7:30 a.m. to 5 p.m. Eastern Standard Time.

What is a Health Savings Plan (HSA)?

A Health Savings Account (HSA) allows you to pay for qualified dental, medical, and vision expenses as well as save for future qualified expenses on a tax-free basis. An HSA is similar to an Individual Retirement Account (IRA) established for the benefit of you, owned by you, and is portable. If you change employers, the HSA stays with you.

Any unused money in your HSA at the end of the year rolls to the next year. You may also choose to invest your HSA money. Any interest or dividends generated by investments are added to your HSA account tax-free.

Who is eligible for an HSA?

You are eligible for an HSA if you:

  • Are covered under a high-deductible health plan (HDHP).
  • Have no other medical coverage. You cannot be covered by a family member’s non-HDHP or a medical FSA/HRA.
  • Are not enrolled in Medicare.
  • Cannot be claimed as a dependent on someone else’s tax return.
  • Have a valid Social Security number.

Can my spouse and I have other types of health plans in combination with my HSA?

You or your spouse may have a Limited-Use FSA or HRA in combination with your HSA. A Limited-Use FSA/HRA is limited to dental and vision expenses only.

Can I have a joint HSA with my spouse?

No. HSAs are individual accounts that are opened in one person’s name. While your HSA will cover expenses for the family, the account itself remains in your name.

How will I receive monthly HSA statements?

Monthly HSA statements are available through our website, my.nyhart.com. We recommend that you review them periodically. You may also sign up for paper statements to be mailed to your home for $1.50/month.

How do I start an HSA?

During your employer’s open enrollment, you may enroll in an HSA by filling out the enrollment forms and returning them to your HR.

Can I have more than one HSA?

Yes, but your contributions may not exceed the maximum contribution amount between all your HSAs.

How do I check my HSA balance?

You may check your HSA balance at any time by logging in to my.nyhart.com. After you log in, click Your Balances on the left side. Your HSA balance will be listed in the left column with your HSA investment balance listed below it.

The amount listed in your HSA balance is the amount available on your debit card. Any amount shown in your investment balance is accessible to you by creating a distribution through our website.

Where can I find a report with all my account activity?

Your account activity is available in real-time by accessing our website at my.nyhart.com. After you log in, you will click Your Balances on the left side, and then click Accounts in the top menu bar. Next, click Account Activity to view all contributions and distributions processed on your HSA.

You may export your account activity to an Excel spreadsheet by clicking the Export button.

Do I need to submit documentation to use my HSA?

No. You do not need to submit documentation to create distributions or use your debit card on your HSA. We recommend that you keep HSA documentation in a folder near your tax documents. Documentation may be requested if you would like a debit card transaction to be moved from your HSA to a Limited-Use FSA/HRA.

Where can I find my HSA tax documents?

Your HSA tax documents are available on our website at my.nyhart.com. Once logged in, click on Your Balances, and then hover on Accounts in the top menu bar. You will then select Statements on the left hand side. The 1099-SA Distribution Statement will be available by the end of January and the 5498-SA Contribution Statement will be available by mid-February.

What happens to my HSA if I terminate or resign?

If your employment ends with your current employer, your HSA will remain active and will convert to a Nyhart Individual HSA. We will send you notification via the mail that explains the changes that will occur to your account and the move date.

As of the move date, your current debit card will stop working. You will also experience a blackout period of 2 to 4 business days where you will not be able to create contributions or distributions on your HSA.

New cards will be issued and will arrive within 10 to 14 business days of your HSA conversion. All features that you are accustomed to are offered on our Nyhart Individual HSAs. A monthly administration will be applied directly to your account. (Previously, this was paid by your employer.)

What happens to my HSA after my death?

If you have a beneficiary on your HSA, your beneficiary will be able to submit an HSA Death Distribution Form and request the HSA be sent to the estate, or converted to an HSA in the surviving spouse’s name.

If no beneficiary is listed on your HSA, the state of Indiana requires the HSA distribution to be made to the estate of the deceased. Extra documentation may be requested to process a death distribution to an estate.

How do I add a beneficiary?

You may add or update your beneficiaries at any time through our website, my.nyhart.com. Once logged in, click on Your Balances, and then click on Profile in the top menu bar. Click on Add Beneficiary on the right side. Please note that adding a beneficiary does require the beneficiary’s Social Security number.

Can an Estate or Living Trust be a beneficiary?

Yes. Both can be listed as a beneficiary. The tax ID number included on their legal documentation will need to be entered into our website. If you need assistance, please let us know via email at support@nyhart.com, or by phone at 800-284-8412.

What are the fees associated with my HSA?

Generally, your employer will pay your monthly administration fee.

The following fees are applicable:

HSA Check Distribution Fee: $10.00/each
Return Fee: $15.00/each
Stop Check Fee: $20.00/each
HSA Account Summary Fee: $1.50/month

How do I close my HSA?

You may close your HSA at any time by submitting an HSA Distribution Form to transfer or rollover your HSA balance.

If you do not have a balance in your HSA, you may send an email request to support@nyhart.com. Please include your name and the last 4 digits of your Social Security number to verify that you would like your account with Nyhart closed.

What is an HSA contribution?

An HSA contribution is a deposit made into your HSA.

What is the HSA maximum contribution limit?

Each year, the IRS sets maximum contribution limits for HSAs.

For 2019, the maximum contribution limits are:

Individual: $3,500
Family: $7,000

For 2020, the maximum contribution limits are:

Individual: 3,550
Family: $7,100

Who can contribute to my HSA?

A contribution can be made by you, your employer, family members, or anyone who would like to contribute to your HSA.

What is the allowable catch-up contribution?

The allowable catch-up contribution for participants over 55 is $1,000. This amount adds to the coverage maximum limits.

For 2019, the maximum contribution limits with catch-up are:

Individual: $4,500
Family: $8,000

For 2020, the maximum contribution limits with catch-up are:

Individual: $4,550
Family: $8,100

How can I contribute to my HSA?

You may contribute to your HSA through payroll deductions with your employer by signing up during open enrollment. You may contribute directly from a personal bank account into your HSA via our website, my.nyhart.com.

You may also contribute by sending a check written to Nyhart by mail at:

Nyhart
c/o HSA
8415 Allison Pointe Blvd, Suite 300
Indianapolis, IN 46250

Can HSA contributions be changed during the year?

Your payroll contributions may be changed per your employer’s HSA setup. To change your contribution amount, contact your HR department.

When is the last day of the year to contribute to my HSA?

You will have until tax day of the following year to contribute up to the maximum into your HSA.

Can I transfer or rollover HSA money from my current HSA custodian to Nyhart?

You may transfer or rollover HSA money from HSA custodian to Nyhart by completing the HSA Transfer Form and submitting the form to your current HSA custodian.

A transfer or rollover must be made to the same owner of the HSA; i.e. John Doe’s HSA at Chase to John Doe’s HSA at Nyhart. A spouse is not allowed to transfer or rollover into their spouse’s HSA account.

What is the difference between a transfer and a rollover?

Please note that transfers are unlimited from custodian to custodian. Rollovers may occur once per 12 months.

What happens when I exceed my HSA contribution maximum?

If a contribution is made over the HSA maximum for the year, Nyhart will send a notification to the HSA account holder. It is the account holder’s responsibility to decide whether to create an excess distribution or pay the tax penalty on the excess contribution by tax day of the next year.

How do I request an Excess Distribution?

You may request an excess distribution by completing the HSA Distribution Form and submitting it to us via email at support@nyhart.com, fax 888-887-9961, or by mail at:

Nyhart
c/o HSA
8415 Allison Pointe Blvd, Suite 300
Indianapolis, IN 46250

What is a Mistaken Distribution?

A mistaken distribution is a refund processed back to your HSA. You may pay your HSA back any refunds that you have received directly from your personal bank account and then send an email to support@nyhart.com with your name, the last 4 digits of your Social Security number, and the refund contribution you have submitted. We will manually adjust the transaction from a normal contribution to a mistaken distribution. (Without this adjustment, it could place your contributions over your HSA maximum contribution for the year.)

You may also complete the HSA Contribution Form and send a check written to Nyhart by mail to:

Nyhart
c/o HSA
8415 Allison Pointe Blvd, Suite 300
Indianapolis, IN 46250

All mistaken distributions must be processed by tax day of the next year.

How do I setup my investments?

After you have reached a balance of $2,000 in your HSA, you may enable your HSA Investments. You will need to log in at our website, my.nyhart.com.

  1. Click on Your Balances.
  2. Click on Manage Investments.
  3. Click on Setup Investment Transfers.
  4. Enable Sweep Amount Limit by checking the box.
  5. Specify a value at or above $2,000 to be swept into your investments account.
  6. Click Save.

What is my investment threshold?

Your investment threshold is the amount that you specify in Setup Investment Transfers; a minimum of $2,000. The threshold determines the amount that is pushed to your investments. With sweeps on, it will automatically send money over the threshold in $100 increments over to the investments. If the HSA account falls below the threshold, it will also automatically pull money out of investments back to the HSA account.

Sweeps can be turned off at any time by re-entering the Setup Investment Transfers screen and disabling the sweep check box.

How are sweeps handled?

Sweeps into the investment accounts are handled by the investment values that you have assigned in Manage Investments. Reverse sweeps are pulled pro-rata from all investments.

How do I transfer or realign my investments?

You may transfer or realign your investments by changing your investments in Manage Investments. After you have changed the percentages, it will give you the option to realign.

What are basis points (bps)?

Basis points are administrative fees applied to mutual funds. 25 basis points is equal to .25% for the year.

How long does it take for my investment trades to process?

It takes 3 business days for a trade to process. Trades created after 2:30 pm EST are started on the next business day.

What is an HSA distribution?

An HSA distribution is a withdrawal from your HSA.

How do I create a distribution?

You may create a distribution by using your debit card or our website, my.nyhart.com. A distribution created online can pull from both your HSA account and your investment account.

How long does a distribution take to process?

A distribution can take up to 3 business days to process.

How many distributions can I make?

You can create and receive as many distributions as you have funds available for.

When will I receive distributions?

Distributions are processed on business days. Direct Deposits are available in your personal account within 72 hours of processing. Checks may take up to 5 business days to arrive.

Can I create a distribution for expenses incurred in a previous year?

Yes, you may create distributions for qualified expenses incurred in previous years that your HSA was active. You cannot request distributions for expenses prior to your HSA’s effective date.

Who determines whether my expenses are IRS-qualified medical expenses?

We provide an Expense Eligibility Table to help determine eligibility. We are also available to assist with eligibility questions via email at support@nyhart.com or by phone at 800-284-8412.

What happens if I use my HSA for unqualified medical expenses?

You may repay your HSA by making a mistaken distribution or you may pay a tax penalty when you file your taxes for the year on the prohibited distribution.

What is needed for a Death Distribution?

If a beneficiary is on the HSA, we will need the HSA Death Distribution Form to be completed and returned to us with a copy of the death certificate.

If a beneficiary was not listed on the account, we will need a completed HSA Death Distribution Form, a copy of the death certificate, and one of the following:

  1. Letters Testamentary for Estate
  2. Small Estate Affidavit
  3. Affidavit of No Administration

If a death distribution does not have the necessary paperwork, we will reach out to the submitter via letter or phone to request additional documentation.

What happens to my account balance at the end of the plan year?

The FSA “Use-or-Lose” rule has been modified to allow a carryover amount at the end of the year. However, it is up to your employer determination as to whether or not your plan allows for carryover.

  • Only expenses incurred during your period of coverage can be reimbursed by the FSA. Expenses incurred before or after the period of coverage are not reimbursable.
  • An expense is considered “incurred” when you are provided with the care that gives rise to the expense, not when you are formally billed, or pay for the service.
  • Up to $500 of unused dollars in the Health Care FSA at the end of the plan year may be carried over; any amount greater than $500 will be forfeited to the plan sponsor.
  • Dependent Care FSA remains a “Use-or-Lose” account. Any balance left at the end of the year will be forfeited to the sponsor.

Your election is irrevocable. You cannot change or cancel your election during the plan year unless you have a qualifying Change in Status event, and your adjusted election is consistent with such a change.

What is a VEBA account (VEBA)?

VEBA accounts are tax-free medical expense accounts for retired people and their eligible dependents.

Who is eligible on my VEBA?

You can claim eligible expenses for yourself and any dependents you report on your income taxes.

What are the ways I can access my account?

Not all employers who offer VEBA benefits allow for online access.

For Depauw, you may login at veba.nyhart.com using:

Username: Social Security Number

Password: MMYY (of DOB )

For Zionsville, you may login at veba.nyhart.com using:

Username: Social Security Number

Password: Home Zip Code

Dalton does not currently offer online access.

What types of healthcare expenses and insurance premiums are eligible for reimbursement?

Common qualified expenses include co-pays, coinsurance, deductibles, prescriptions, etc. qualified insurance premiums include medical, dental, vision, tax-qualified long-term care (subject to IRS limits), Medicare Part B, Medicare Part D, and Medicare supplement plans.

What type of documentation is required for reimbursement?

According to IRS Guidelines, all claims submitted through VEBA must be substantiated to verify the eligibility of the expenses. All expenses must be substantiated by independent third-party providers. The third-party information must describe the following:

  1. Patient's Name: The name of the person who received the service or for whom the item was purchased. For retail store purchases, this information may be excluded.
  2. Provider's Name: The provider that delivered the service or the merchant where the item was purchased.
  3. Date of Service: The date when services were provided or the item was purchased.
  4. Type of Service: A detailed description of the service provided or item purchased.
  5. Cost: The amount paid for the service or product and/or the portion that is not reimbursed through your insurance carrier.

When do I need to submit my claims?

Throughout the year you can submit claims.

A Claim Form will need to be filled out and included with documentation for email, mail, and fax submissions. The form is available at https://veba.nyhart.com under Forms & Resources. Claims are processed in the order they are received.

What is a Health Reimbursement Arrangement (HRA)

An HRA is an employer-funded health benefit plan that reimburses employees for out-of-pocket medical expenses.

Can I put funds into the HRA?

According to IRS rules, HRAs are fully owned and funded by the employer.

Who is eligible on my HRA?

You can claim eligible expenses for yourself and any dependents you report on your income taxes.

What are the ways that I can access my account?

To access your account, we have two user-friendly options; Nyhart FSA/HRA/HSA Mobile App and our website.

The Nyhart FSA/HRA/HSA Mobile App can be used on smartphones and tablets. Instructions for accessing the Nyhart FSA/HRA/HSA Mobile App are available under Forms & Resources at my.nyhart.com. You will use the following login credentials for the Nyhart FSA/HRA/HSA Mobile App:

Username: Social Security number
Password: Social Security number and your ZIP code together with no spaces or dashes.
Example: 12345678946250

Please note that this is a different login than you would use to log in to our website.

The Nyhart Mobile App will allow you to: view your balances, view account activity, view notification history, file claims, and submit receipts for outstanding debit card transactions.

If you are logging in for the first time or have not previously changed your login credentials, you may log in to our website at my.nyhart.com by using the following login credentials:

Username: Social Security number
Password: ZIP code

Your account is automatically created when you are enrolled. You will not need to register your account on our website. You may change your login credentials after initial login. If you forget your password, you may reset it by clicking on “Forgot Your Password?”

Where can I find a list of eligible expenses?

Nyhart provides a list of eligible expenses for reference on our website at https://my.nyhart.com. The Expense Eligibility Table is available in the left column, after you log in. The table will give you detailed descriptions of eligible expenses. If you are still unsure after reviewing the table, you may pre-qualify expenses by submitting documentation to support@nyhart.com or by calling (800) 284-8412.

What type of documentation is required for reimbursement?

According to IRS Guidelines, all claims submitted through Health Reimbursement Arrangements (HRA) must be substantiated to verify the eligibility of the expenses. All expenses must be substantiated by independent third-party providers. The third-party information must describe the following:

  1. Patient's Name: The name of the person who received the service or for whom the item was purchased. For retail store purchases, this information may be excluded.
  2. Provider's Name: The provider that delivered the service or the merchant where the item was purchased.
  3. Date of Service: The date when services were provided or the item was purchased.
  4. Type of Service: A detailed description of the service provided or item purchased.
  5. Cost: The amount paid for the service or product and/or the portion that is not reimbursed through your insurance carrier.

Healthcare Expenses

If the expense was submitted to your insurance for payment, you will need to submit an Explanation of Benefits (EOB) to establish the amount that was not paid by the insurance plan. If the expense was not submitted to your insurance, you will need to submit itemized bills from the provider. If the expense was a prescription, submit the tag from the RX bag or a pharmacy summary.

Please be aware that cancelled checks alone are not sufficient documentation to verify an expense. Keep the original receipts for your records and send copies to Nyhart.

For most medical expenses, proof of a payment is not required. For orthodontia expenses; however, you must include documentation to indicate when payment was made along with the above information.

If over-the-counter (OTC) products were purchased, you will need to submit a copy of the receipt clearly indicating the name of the OTC products purchased along with a copy of the prescription from your physician.

When do I need to submit my claims?

Throughout the plan year, you may submit claims as often as you like. To verify your submission deadline date, you will need to log in to the website at https://my.nyhart.com. Click on Your Balances in the left-hand column. Click on the Accounts tab, and click on the plan you would like to see. This will open a pop-up box with the plan details. The Final Filing Date will be listed on the right-hand side of the first box.

Online claims can be submitted at https://my.nyhart.com. The Quick Start Guide can help walk you through the online claim submission process. To access the Quick Start Guide, log in to the website. Click on Your Balances on the left-hand side. Next, click on the Tools and Support tab at the top. Click on the Quick Start Guide.

A Claim Form will need to be filled out and included with documentation for email, mail, and fax submissions. The form is available at https://my.nyhart.com under Forms & Resources. Claims are processed in the order they are received.

Submissions can be sent via email to support@nyhart.com, by fax to 1-888-887-9961, or by mail to:

Nyhart
c/o HRA
8415 Allison Pointe Boulevard, Suite 300
Indianapolis, IN 46250

How do I change or add my banking account information?

You can change your banking account information at https://my.nyhart.com. After you log in, click on Your Balances from the column on the left. Go to the Profile tab. Click on Banking/Cards in the left-hand column. In the middle, you will have the option to Add Bank Account or View/Update current bank account on file. Click on Add Bank Account to add your banking information. Click on View/Update to change your current bank account information. You will be asked to confirm the answer to your security question before your banking information will be updated. If you cancel this action, your banking information will not be updated. Please note, that adding a bank account will not automatically change your reimbursement method.

If you are currently being reimbursed by check, you will need to update your reimbursement method to direct deposit. To update your reimbursement method, click on Your Balances. Go to the Tools & Support tab. Click on Change Payment Method. This will give you the option to select direct deposit. After clicking the Change Payment Method button, your account will be updated.

How can I appeal a claim that was denied?

If you do not agree with a denial, your recourse is to submit an appeal of denial to support@nyhart.com. All appeals must be in writing. The appeal will need to include the reason for your appeal and any additional documentation that is needed to support your appeal.

You may also mail the appeal to Nyhart.

What is a Commuter Benefit?

Commuter benefits are employer provided voluntary benefit programs that allow employees to reduce their monthly commuting expenses for transit and parking.

What are the current monthly limits?

Transit $265
Parking $265

What commuting expenses are covered?

Transportation expenses: Bus, ferry, train, and trolley tickets and/or passes

Parking expenses: meters, parking garages and lots fees

What commuting expenses are not covered?

  • Tolls
  • Taxis
  • Gas/fuel
  • Business trip costs
  • Airport parking fees
  • Parking fees at your home

What if I don’t use all of my allocated funds?

You can sign up or drop the benefit at any time. Your funds are rolled over from month to month.

Can I submit claims for my spouse or dependent(s) commuting expenses?

No, reimbursement is limited to employee expenses only.

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