Introduction to the Your Spending Account (YSA) Web Site · PDF fileIntroduction to the Your Spending Account

Introduction to the Your Spending Account™ (YSA) Web Site

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Your Spending Account™ (YSA) Web Site—an Ongoing Resource

The YSA Web site makes spending account transactions easy. Take a look at this brief overview to help you understand the features available to you and the steps you need to take. You may access the YSA Web site through a link on the Your Benefits Resources™ (YBR) Web site. To access YBR, you can go: ■ Through Total Comp @ Citi at www.totalcomponline.com, available from the Citi intranet and the

Internet; or

■ Directly to http://resources.hewitt.com/citigroup using your YBR user ID and password. If you haven’t set up a user ID and password, click on “Register as a New User.” You can request to have a password sent to you via email or U.S. mail. The password will be sent immediately via email, while passwords sent via U.S. mail will take five to seven days for receipt.

After you have logged on to the YBR site, select either “Health Care Spending Account” or “Dependent Day Care Spending Account” from the “Health and Insurance” tab drop-down menu under “Accounts.” If you have a Limited Purpose Health Care Spending Account (LPSA), you will access it by selecting “Health Care Spending Account.”

Your Benefits Resources Home Page

When you’re enrolled in the Health Care Spending Account (HCSA), Limited Purpose Health Care Spending Account (LPSA), and/or Dependent Day Care Spending Account (DCSA), and visit the YSA Web site, you’ll be able to:

■ Submit claims and review their status; ■ Access a list of eligible expenses and approved merchants; ■ Learn why submitted claims may need your follow-up and what to do about it; and ■ View your current account balance(s). Continue reading to see images of the YSA home page and other pages that you will use to manage your spending account(s). Home Page From the home page, you have access to:

1. Your Alerts—see when your attention is needed (for example, if more documentation is required for a debit card transaction);

2. Account balances; 3. All submitted claims; 4. A tutorial to learn how others have benefited from spending accounts; 5. Direct deposit information; and 6. Information on how to use your spending account(s) and YSA card.

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All Claims Page This page allows you to view a summary of your most recent claim submissions, the claim item status, and the amount paid. The claim status column tells you if documentation is still required for approval. A card icon informs you which items were purchased using your YSA card.

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Submitting a HCSA Claim You can choose to pay out-of-pocket for eligible expenses and submit a claim to YSA, rather than using your YSA card (formerly know as the Health Care Spending Account Card) at your medical or dental provider’s office or when purchasing certain health care items or prescriptions. If you do, you will need to submit a claim either online using the instructions below or a paper claim using the instructions on the form. (Important: Do not use your YSA card and submit an online or paper claim for the same expense. This will delay processing of your claim.)

Submitting a LPSA or DCSA Claim You pay out-of-pocket for eligible expenses and submit a claim to YSA. You will need to submit a claim either online using the instructions below or a paper claim using the instructions on the form.

All claim forms are also available on the “Forms” section of the Citi intranet at www.citigroup.net/human_resources/forms/benefits_forms.html. Be sure to include itemized receipts.

Note: The HCSA claim form is also used for LPSA claims.

Follow these steps to submit an online claim from this page:

1. Select the appropriate account page—HCSA/LPSA or DCSA (Image A); 2. Select “Submit Claims”; 3. Enter your claim detail information (Image B); 4. Select “Review Claims” at the bottom of the page; 5. Create Fax Cover Sheet; and 6. Fax the claim form and receipt(s) to Your Spending Account at 1-888-211-9900. Image A

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Enter Claim Detail—Image B

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Submit Claim—Create Fax Cover Sheet

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Fax Claim Form/Cover Sheet With Receipts to YSA

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Account Detail Page This page provides account activity summaries (claims paid, claims denied, etc.) by account and year.

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Your Preferences Page This page allows you change your YSA personal settings, such as:

■ Adding direct deposit information; ■ Viewing email addresses; and ■ Selecting whether to receive claim activity and/or YSA notices via U.S. mail.

Just select the link for the information you wish to change.

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Important Considerations Remember that the different spending accounts are used for specific types of expenses. Below is a brief overview of the different accounts and what they can be used for. The YSA Web site provides an expansive list of eligible expenses for each of these accounts.

Health Care Spending Account (HCSA)—In general, expenses that the Internal Revenue Service (IRS) considers as deductible on your income tax are eligible for reimbursement through the HCSA. This includes health plan deductibles, coinsurance, copayments, prescription drugs, some over-the-counter medicines, and dental and vision expenses.

Limited Purpose Health Care Spending Account (LPSA)—This is a spending account designed for use along with a Health Savings Account (HSA). If you are enrolled in either of the Citi High Deductible Health Plan options, you must enroll in this account and will not be able to enroll in the HCSA. This account can be used for eligible dental, vision, and certain preventive care medical expenses only.

Dependent Day Care Spending Account (DCSA)—This account is used for eligible day care expenses. Eligible expenses for reimbursement include day care for eligible dependents while you and your spouse (if applicable) are at work or searching for employment. This account cannot be used for your dependent’s health care expenses.

Automatic Claims Submission If you’re enrolled in an HCSA with automatic claims submission, the following Plans will submit your claims to the HCSA administrator so you will be reimbursed automatically for many eligible expenses without having to file a claim:

■ Aetna and Empire BlueCross BlueShield ChoicePlan 500;

You can continue your HCSA or LPSA coverage under COBRA through the end of the calendar year in which you terminate. If you do not continue coverage under COBRA, you cannot use the account for expenses incurred beyond your termination date. However, you will have until the following June 30 to submit your claims for expenses incurred before your termination date. You may submit DCSA claims for eligible expenses incurred after your termination date but within the calendar year in which your termination occurred. You must submit any eligible claims no later than June 30 of the year following your termination.

If You Leave Citi If you are no longer employed by Citi, you will still be able to access your HCSA, LPSA, and/or DCSA via the YSA Web site until you have used up your balance or the claim submission deadline has passed.

■ Oxford Health Plans PPO; ■ Citigroup Prescription Drug Program; and ■ MetLife Preferred Dentist Program (PDP). However, if you elect to receive a YSA card, the automatic claims submission feature will be turned off. For expenses not automatically submitted, you will need to file your claims using a claim form. You can find claim forms on the YSA Web site and the Citi intranet.

Using Your YSA Card—Save Your Receipts! If you elected to use a YSA card, you will be able to pay for most eligible HCSA expenses using your card. Note: The YSA card is only available for the HCSA. You will need to file a claim for any expenses for which you do not use your YSA card. You can find claim forms on the YSA Web site and the Citi intranet.

Each time you “swipe” your YSA card, be sure to save your receipt in case you are required at a later date to substantiate that your expense was eligible for reimbursement under the Plan. Per IRS rules, unsubstantiated expenses will be considered taxable income.

Your Spending Account™ and Your Benefits Resources™ are trademarks of Hewitt Associates LLC.