Limited Purpose Flexible Spending Account (LPFSA) Support

A Benefits Debit Card allows you to pay for eligible expenses, such as prescriptions and copayments. If your employer has elected to provide a Benefits Debit Card, you may use this card instead of paying out of pocket.

Please note – if you use your Benefits Debit Card to pay for eligible medical expenses, you must submit itemized documentation for every transaction, like an explanation of benefits (EOB).

You may use it at most health care facilities, including hospitals, physician’s, dental, and vision offices.

Additionally, many merchants also accept the card. To view a list of participating stores, visit SIGIS Store Locator. 

Log in to your online account and select Manage 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 

To reactivate your card, you will either need to submit the requested documentation or pay back the transaction.

Note: If your card is no longer active, you may have submitted insufficient documentation for an existing claim.

Learn How to Reactivate Your Card 

Yes, you may use your Benefits Debit Card for both accounts. Eligible vision and dental expenses will be deducted from your 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, you will still be able to use your Benefits Debit Card for your HSA.

Learn How to Unblock Your Card 

Pending transactions require additional documentation to complete processing. You will receive communication when documentation is needed.

How to submit documentation to an existing transaction:

 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 qualified dependents, you may request a card for them through your online account, or on our mobile app, AFmobile^®. Here’s how:

• Online
  1. Log in to your online account.
  2. Select Manage My Reimbursement Account.
  3. Hover over your username the right side of the navigation bar and select Profile.
  4. At the bottom of this screen, select Add Family Member.
  5. In the Add Family Member window, select the box to Issue Dependent Card.
  6. When complete, click Next and Save.
• AFmobile
  1. Select the Profile, and then select Family Members.
  2. In the Add Family Member window, select the box to Issue Dependent Card.
  3. When complete, click Next and Save.

This depends on where you use your card and what type of expense it is.

Example of when documentation is not needed: If your card is used for an eligible expense at a merchant with the Inventory Information Approval System (IIAS), the details needed to approve the transaction will automatically be provided. No further documentation will be required.

Example of when documentation is needed: If your card is used at a doctor’s office for an expense, you will need to provide an itemized receipt or documents, so the details of the expense such as the date of service and the service provided may be verified. Keep in mind, the date of service must be within the plan year or grace period, if applicable, in your LPFSA plan.

The Internal Revenue Code (IRC) regulations have requirements stating that expenses must be verified using itemized documentation, 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.

Learn more: Why is Substantiation Required for Certain Debit Card Expenses?

Your documentation should include:

• Explanation of Benefits (EOB) from insurance carrier or,
• Itemized documentation for an expense which should include: 
  
  • Original date of service
  • Description of service rendered or expense
  • Charges for service or expense
  • Provider of service or expense
  • Name of patient who received service or incurred expense

Note: Credit card receipts are not sufficient unless they include the above information.

If you have used your Benefits Debit Card to make an LPFSA purchase, or if you submitted an out-of-pocket reimbursement claim without documentation, you will receive a request for documentation notice. You also may receive this notice if the documentation you submitted was insufficient.

You may receive this notice if:

• Your Benefits Debit Card was used for an expense incurred outside the plan year,
• Your Benefits Debit Card was used for an ineligible expense, or
• If documentation submitted is missing information.

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

• Submit different itemized document to offset the transaction amount,
• Contact American Fidelity to make a credit card payment, or
• Submit the notice received along with a check in the amount of the transaction to be applied to your LPFSA account.

For your convenience, there are several ways you can submit your documentation:

Mobile app: Use the “Additional Documentation” button on AFmobile^®

• Select Additional Documentation.
• Select Reimbursement Account(s).
• Select the pending transaction, and select Attach New Document to upload documentation.

Online: Upload through your online account

• Click the Manage My Reimbursement Account button
• Navigate to the transaction from Claim Activity, My Recent Transactions or Account Activity page.
• Select the appropriate transaction.
• Select Add Receipt.
• Browse or Drag and Drop document(s).
• Select Submit.
  
  

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 on the File a Claim button
  3. Select Reimbursement Account(s)
  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 claim form and include all applicable 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 must be incurred during your plan year. Log in to your online account to view your plan details. 

Turnaround time for claims processing is generally 3-5 business days after we receive all required documentation.

The fastest way to receive your reimbursement is through direct deposit.

Sign up for direct deposit online by logging in to your online account and selecting Manage My Reimbursement Account. Hover over your name to access your Profile, then click the Edit button above Reimbursement Method.

If you do not sign up for direct deposit, you will receive a check by mail. Note: This method will increase the time it takes to receive your reimbursement.

Log in to your online account and select your account to review your balance and transaction history.

You can also view your account information from our app, AFmobile^®. You can view your account balance from the dashboard or by clicking on your reimbursement account to view a complete transaction history. 

No, you may not add documentation to your existing denied claim. You will need to submit a new claim with the correct documentation.