Welcome to your new ConnectYourCare account · 2019-02-16 · forever! *State taxes apply to contributions, investment and interest earnings in CA, ... • Organ transplant • Orthodontia

© ConnectYourCare. All Rights Reserved.

Welcome to your newConnectYourCare account

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Welcome!We’re pleased to offer you the most advanced and user-friendly account solution.

– Accounts that help you SAVE• Health Savings Account (HSA)• Limited Purpose Flexible Spending

Account (LPFSA)• Dependent Day Care FSA (DCRA)

– Easy access to funds and information• Participant portal and mobile app • Payment card• Dedicated microsite - connectyourcare.com/qualcomm• Customer service available 24x7 at 1-855-687-2128• New! Exclusive Qualcomm service email address

[email protected]


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The HSA Advantage• Use for you, your spouse

and eligible tax dependents (even if not covered by your health plan).

• Distributions allowed at any time without restriction.

• Funds never expire.• Distribution is tax-free* for

qualified medical expenses.

• Your HSA is yours forever! *State taxes apply to contributions, investment and interest earnings in CA, NJ, & AL


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Examples of Qualified Medical Expenses• Acupuncture• Alcoholism treatment• Ambulance• Automobile modifications

for physically handicapped

• Birth control pills• Braille books &

magazines • Chiropractic care• Christian Science

practitioner• Contact lenses & related

materials• COBRA premiums• Crutches• Dental treatment• Dentures• Diagnostic services• Drug addiction treatment

• Eye examination • Eye glasses• Fertility treatment• Flu shot• Guide dog or other

animal aide• Hearing aids• Hospital services• Immunization• Insulin• Laboratory fees• Laser eye surgery• Long-term care

premiums or expenses

• Medical testing device• Nursing services• Organ transplant• Orthodontia• Physical exam

• Physical therapy• Prescription drugs• Psychiatric care• Retiree medical

insurance premiums• Smoking cessation

program• Sunscreen & sun block

(SPF15+, broad spectrum)

• Surgery• Transportation for

medical care• Weight loss program

necessary to treat obesity

• Wheelchair


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Examples of Qualified OTC ExpensesSome over-the-counter items are eligible for purchase with HSA funds.


Eligible without a Prescription:• Bandages• Braces & supports• Catheters• Contact lens supplies &

solutions• Denture adhesives• Diagnostic tests & monitors• Family planning items• First aid supplies• Insulin & diabetic supplies• Ostomy products• Reading glasses• Wheelchairs, walkers, canes

Eligible with a Prescription*:• Allergy & sinus medicine• Antibiotics• Cold sore remedies• Cough, cold & flu• Feminine anti-fungal/anti-itch• Hemorrhoidal preps• Laxatives• Motion sickness• Pain relievers• Respiratory treatments• Sleep aids & sedatives• Stomach remedies

Dual Purpose Items:These items can be used for a medical purpose or for general health and well being and are eligible only with a prescription, doctor’s directive or letter of medical necessity:• Dietary and weight loss

supplements• Fiber supplements• Orthopedic shoes & inserts• Snoring cessation aids• Vitamins & herbal

supplements

* A “prescription” means a written or electronic order for a medicine or drug that meets the legal requirements of a prescription in the state in which the medical expense is incurred and that is issued by an individual who is legally authorized to issue a prescription in that state.

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Examples of Not Qualified Expenses• Cosmetic surgery • Concierge service fees

(billed for future services; no treatment actually provided)

• Exercise equipment • Fitness programs • Funeral expenses • Hair transplants • Household help

• Illegal operations and treatments

• Maternity clothes • Most insurance premiums

(COBRA, long term care and retiree medical premiums are allowed)

• Teeth whitening


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Account Access – Anywhere, Anytime

© 2016 ConnectYourCare. All Rights Reserved.

“Great website and using the card could not be easier.

Overall I cannot find a single thing I would want to be changed about this HSA.”

‐ Citi HSA participant

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Three Ways to PayPayment Card • Easy way to pay, funds deducted directly from your account• Dental and vision expenses are pulled from your LPFSA first, until

depleted• Receipts may be requested for LPFSA expenses

• Press credit to use with no PIN, or debit to use PIN (preset as last 4 digits; reset your PIN by calling 1-888-999-0121)

Health Plan Claims – UHC and Kaiser• Claims sent from your health plan to CYC• Pay your portion your provider or reimburse yourself• “Claims from Insurance Plan” section portal

Pay With Personal Funds & Request Reimbursement • Eligible expenses paid using personal funds (all DCRA expenses)• Enter request online or on mobile application• Submit documentation for LPFSA and DCRA claims

– Snap picture with the mobile app

– Upload scanned images on portal


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Dedicated Microsite: connectyourcare.com/Qualcomm


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Participant Portal


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Check Your Balance


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Enter a Reimbursement Request


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Reimburse Myself Screen


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Enter HSA Beneficiary Information


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Order Additional Cards


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HSA Investment Options


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Contributions Outside Payroll


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Adding Dependents


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Roll Over Your Previous HSA • All HSA funds in

one account, one payment card

• Eliminate any fees for previous HSA

• Easy to transfer process– Complete transfer

form and mail it to the address on the form.

– Transfers may take 4-6 weeks depending on your prior Trustee/Custodian’s processing time.


Rollover Formconnectyourcare.com/

qualcomm

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Mobile Solutions• Mobile App

– Available for Android, iOS and Windows devices– View account balance, alerts and transaction history– Submit a new claim – Make payments to your providers– Tap to call Customer Service– Upload claim documentation with your device’s camera

• Mobile Browser– Streamlined version of online account

• Mobile Alerts - Two-Way Texting– Request and receive information via text message– Sign up for this feature through your online account


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Get the Most Out of Your Account Today1. Go Mobile!

2. Order additional cards for your spouse and eligible dependents.

3. Set up Direct Deposit for faster reimbursements.

4. Set up your HSA Beneficiary information online.

5. Add your dependents.


Documents

Welcome to your new ConnectYourCare account · 2019-02-16 · forever! *State taxes apply to contributions, investment and interest earnings in CA, ... • Organ transplant • Orthodontia