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Limited Purpose Flexible Spending Account
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Review these frequently asked questions and tips for managing your Limited Purpose Flexible Spending Account, or LPFSA.

If you already have an American Fidelity online account, simply log in to access your reimbursement account(s). If you have not created an account, register for an account now. Then, follow the prompts to complete the registration process. You will use this same registration information on the mobile app, AFmobile®.

Typical eligible expenses include qualified dental and vision expenses, like braces or eyeglasses. Ask your employer for the specifics of your plan.

The maximum allowed by law to contribute pre-tax into this account is $2,750 per plan year. Please note, this amount may be further limited by your employer.

Your entire LPFSA election is available on the first day of the plan year. To view your plan year, start and end dates, log in to your online account.

LPFSAs are “use or lose” accounts. This means, at the end of your plan year, the funds remaining in your account may be forfeited and returned to your employer.

If your employer has elected a carryover provision, you may be able to carry over up to $550 of unused LPFSA contributions to the next plan year.

If your employer has elected a grace period, you will have 2.5 months following the end of your plan year to incur LPFSA claims for the previous plan year’s account balance.

Your plan also includes a runoff period that allows you to file claims for the previous plan year’s expenses. However, these expenses must have been incurred during the plan year or grace period (if applicable).

Log in to your online account to view your plan dates or talk to your employer to discuss specifics.

CARES Act Update: For 2020 and 2021 plan years your employer had the option to extend claims period, runoff period, and increase carryover amounts. Please reach out to your employer for more details. Read a summary of Section 125 CARES Act updates here  

Only an individual who is a spouse, “qualifying child,” “adult child,” or “qualifying relative” of the account holder can be considered a qualifying dependent for reimbursement of medical expenses.

An LPFSA is typically reserved for paying specific HSA-compatible medical expenses—like dental and vision costs—while HCFSAs can be used for a wide range of eligible medical expenses.

Additionally, LPFSAs may be paired with a Health Savings Account (HSA), while an HCFSA may not. Generally, you may not have an HCFSA and LPFSA at the same time.

Learn more about HCFSAs 

An LPFSA covers eligible dental and vision expenses that you would otherwise pay for out of pocket. A DCA covers employment-related expenses for dependent care. These expenses must be services that allow you to go to work, and typically include day care and elder care for legal tax dependents.

Learn more about DCAs 

No. Contributed funds must remain in their designated account.

A Health Savings Account (HSA) allows eligible individuals who are covered by a qualified High Deductible Health Plan (HDHP) to pay for eligible medical expenses of the eligible individual, his/her spouse, and his/her tax dependents.

An HSA helps you pay for the medical expenses not covered by your HDHP—tax-free. 

Normally, you can only elect contributions into your HCFSA during a yearly open enrollment period, but there are exceptions. Qualifying life events include:

  • Status changes
    • Change in marital status
    • Birth of a child
    • Adopting or placing a child for adoption
    • Change in employment status that impacts plan participation status 
  • Certain judgments, decrees, or orders
  • Loss of entitlement to Medicare or Medicaid

Election changes may only be made if the change is consistent with and on account of the qualifying life event. Your employer determines if you can make mid-plan year election changes. You should contact your employer if you've experienced a qualifying event and wish to make a change.

A Benefits Debit Card allows you to pay for eligible medical expenses. Remember, if you have elected an LPFSA, your expenses would be limited to those related to dental and vision. So, if your employer has elected to offer the Benefits Debit Card, you may use the Card for dental and vision expenses only. 

Please note – if you use your Benefits Debit Card to pay for eligible dental and vision expenses, you must submit a receipt* for every transaction.

If you have a Benefits Debit Card, you may use it at dental and vision offices.

Additionally, many merchants also accept the card. To view a list of participating stores, visit Sigis Store Locator. If you have an LPFSA, you will only be able to use the card for dental and vision expenses.

Log in to your online account and select Access My Reimbursement Account. Then, hover over your name on the top right and click Debit Card(s). Click Report Lost or Stolen next to the appropriate card. Once complete, you will have the option to order an additional card.

Report a Card Lost/Stolen

If you received a notification or letter in the mail requesting documentation but failed to provide it to American Fidelity, your Benefits Debit Card will be temporarily blocked.

Learn How to Unblock Your Card 

If you have both an LPFSA and an HSA, you may use your red Benefits Debit Card for both accounts. Eligible vision and dental expenses will be deducted from LPFSA first, since those funds expire at the end of your plan year. When your LPFSA funds have been used up, your HSA funds will be deducted.

If you have an unsubstantiated LPFSA claim, your card will remain blocked for all accounts—including your HSA—until approved documentation is submitted.

Learn How to Unblock Your Card 

Pending transactions cannot be auto adjudicated and will need to be substantiated by providing sufficient documentation. You will receive a documentation request letter for these transactions. Learn how to submit documentation.

To submit documentation:

 Log in to your online account or AFmobile

  • Select the Additional Documentation button
  • Select Reimbursement Account(s)
  • Select the pending transaction and click Add Receipt to upload documentation

If you have additional debit card users, you’ll need to request cards for them through your online account. Here’s how:

  • Log in to your online account.
  • Select the Access My Reimbursement Account button.
  • Hover over your username the right side of the navigation bar and select Profile.
  • At the bottom of this screen, select Add Family Member.
  • When adding a family member, the dependent or spouse’s Dependent ID is their Social Security number.
  • In the Add Family Member window, select the box to Issue Dependent Card.
  • When complete, click Next and Save.

The Internal Revenue Code (IRC) regulations have requirements stating that expenses must be substantiated using itemized receipts, third party statements, or an Explanation of Benefits. To comply with IRC guidelines, we request documentation of your expense to verify the eligibility of the purchase.

Your documentation should include:

  • Itemized receipts for an expense
  • Original date of service
  • Description of service rendered or expense
  • Charges for the service or expense
  • Provider of the service or expense
  • Recipient of the service or expense

You will receive a request for documentation via mail if you used your Benefits Debit Card to make a Limited Purpose FSA purchase, or if you submitted an out of pocket reimbursement claim without a receipt. You also may receive this letter if the documentation you submitted wasn’t sufficient.

These letters are sent the day after a purchase is made or when the claim is reviewed and determined to be missing documentation or containing insufficient information. So, when receiving this letter, you may have already submitted the necessary documents.

You will receive this letter if your Benefits Debit Card was used for an expense incurred outside the plan year, an ineligible expense, or if the documentation you submitted was insufficient.

When the documentation cannot be provided or the expense is ineligible, you have three options:

  • Submit a different itemized receipt to offset the transaction amount.
  • Contact American Fidelity to make a credit card payment.
  • Submit a check in the amount of the transaction to be applied to your Healthcare FSA account.

The fastest way to file a reimbursement claim is through your online account, or on our mobile app, AFmobile®.

  • Online
    1. Log in to your online account
    2. Click the File a Claim button on the top of the page
    3. Select Reimbursement Account
    4. Complete the claim form
    5. Click the Submit button
  • AFmobile
    1. Touch the Submit Reimbursement button on the AFmobile dashboard
    2. Complete the Claim Form
    3. Click the Submit button
  • Fax or Mail
    1. Download and complete a Healthcare FSA and HRA Reimbursement Claim Form and include all applicable receipts and documentation. Please note, paper claim filing is not the fastest option. File a claim online or through AFmobile to get your money faster.

Eligible expenses generally must have been incurred during the current plan year. Log in to your online account or check with your employer for specific rules applicable to your plan.

Once your claim and all required documentation have been received, the turnaround time for claims processing is generally 5-7 business days.

The fastest way to receive your reimbursement is through direct deposit. Enroll in direct deposit online by logging in to your online accountnavigating to your Reimbursement Account portal, and selecting My Profile. Or, you may also elect to receive a mailed check.

You may view your account information at any time by logging in to your online account. From this page you can click on your LPFSA account to review your balance and transaction history.

You can also view your account information from our app, AFmobile®. You will be able to view your account balance from the dashboard, or, click on your reimbursement account to view a complete transaction history. 

If your transaction is marked resolved, you’ve provided eligible documentation or made an out-of-pocket payment. No additional action is needed on resolved transactions.

How-To Videos

For additional assistance or to file an LPFSA claim, please log in to your account.

American Fidelity Assurance Company