Health Care Spending Account

A Health Care Spending Account (HCSA) is a benefit program provided by your employer to provide top-up coverage for Health, Vision, Dental and other medical expenses that are not covered under your group benefits program but are allowed under the Income Tax Act.

To be eligible for HCSA, Plan Members must be covered for Extended Health or Dental Benefits with Wawanesa Life. If Extended Health and Dental Benefits are waived due to similar coverage under a spouse’s plan, they will continue to be considered eligible under this HCSA.

While a dependent can’t be enrolled directly to participate, a Plan Member is able to claim expenses for an Eligible Dependent using their HCSA balance. An Eligible Dependent is any person for whom the Plan Member may claim a medical expense tax credit on the federal tax return in the taxation year.

Your employer determines the amount of contributions (money) to be deposited into the Plan Member’s Health Care Spending Account. This is the total amount available to be used to claim eligible expenses incurred by Plan Members and/or their Eligible Dependents.

Only Canada Revenue Agency’s Medical Expense Tax Credit program expenses are eligible for reimbursement.

Examples of eligible expenses:

• Co-insurance, deductibles and any amounts not covered under your group benefits plan
• Payments to medical practitioners, hospitals, orthodontists, etc.
• Artificial limbs, aids and other medical equipment
• Eyeglasses, contact lenses and laser eye surgery
• Rehabilitative therapy
• Dentures

Examples of ineligible expenses:

• Athletic or fitness club fees
• Over the counter medication
• Organic food
• Supplements
• Cosmetic Procedures aimed at enhancing one’s appearance (ie. liposuction, botox injections, teeth whitening)

At the beginning of each benefit year, your employer allocates a specified amount of contributions to your HCSA. These contributions are for you to use at your discretion to pay for medically related expenses allowed under the Income Tax Act.

Example:

More information on your HCSA program type can found in your Benefits Booklet or by contacting a Customer Service Representative at 1-800-665-7076.

A Benefit Year is a 12-month period that usually runs from January 1 to December 31. The Benefit Year that applies to your plan can be found in your Benefits Booklet or by contacting a Customer Service Representative at 1-800-665-7076.

All Plan Members can sign up for Plan Member Online Claims through the Wawanesa Life website or mobile app. You can submit your expenses electronically, view your claims history, and check your coverage.

To submit your claim through our website:

1. Sign in to your account
2. From the Claims and Benefit menu, select “Submit a HCSA Claim”
3. Follow the on-screen prompts to enter the claim type, provider and expense details
4. Review and submit your claim

Be sure to enter all amounts paid by other sources in the “Other Carrier Paid” field. This amount includes payment(s) made by your Health and Dental plan with Wawanesa Life.

To submit your claim through our mobile app:

1. Sign in to your account
2. Click “Submit a claim”
3. Follow the on-screen prompts to enter the claim type, provider and expense details.

Alternatively, claims can be submitted by mail. Visit our website at www.wawanesalife.com to download a HCSA claim submission form.

Simply log into Plan Member Online claims and sign up for direct deposit for quick payments.

All eligible expenses incurred must be submitted through all group health or dental plans before submitting under HCSA. As a Plan Member you may choose to set up auto coordination to have any unpaid amount from your Health and Dental claims automatically paid under your Health Care Spending Account.

Payment for Eligible Dependents who have other insurance follow the same rules applied to the health and dental benefits under the group plan. More details on coordination of benefits can be found in the employee benefits booklet.

To set up HCSA auto coordination through our website:

1. Sign in to your account
2. Select “Account Settings” (from the dropdown menu below your name)
3. Select “Coverage”, then “Health Care Spending Account”.
4. In the Coordination of Benefits section, select the benefits you would like to auto coordinate.

To set up HCSA auto coordination through our mobile app:

1. Sign in to your account
2. Select “Coverage”, then “Health Care Spending Account”
3. Under “Actions”, select “Auto Coordination”.
4. Select the benefits you would like to auto coordinate.

You can turn off the auto coordination at any time. If you do not wish to have an expense auto coordinated, be sure to turn it off prior to entering your claim.

Proof of an eligible expense must be submitted no later than 31 days following the benefit year. Your specific benefit year will depend on the type of plan that has been implemented by your employer. For specific information regarding the claim submission period for your plan please refer to your Benefits Booklet or contact a Customer Service Representative at 1-800-665-7076.

If the plan type selected by your employer is a No Rolling plan or a Rolling Claims plan, unused contributions will be forfeited at the end of the benefit year. If the plan type selected by your employer is a Rolling Contributions plan, then unused contributions will be carried forward to the next benefit year. Any contributions carried forward will be forfeited at the end of the next benefit year if not used.

For specific information regarding unused contributions for your plan please refer to your Benefits Booklet or contact a Customer Service Representative at 1-800-665-7076.

You will have 30 days from when you are no longer an active employee to submit claims for eligible expenses incurred prior to the date your active employment ends, provided that the HCSA remains active. After 30 days any unused contributions will be forfeited.

You can access your current benefits booklet on Plan Member Online Claims, or by contacting your Plan Administrator.

If you have questions about your HCSA you can contact a Customer Service Representative at 1-800-665-7076.