If you receive notices from the Flexible Spending Account (FSA) Administrator, Optum Financial, about 2021 unsubstantiated health care claims, you need to substantiate, substitute, or repay your unsubstantiated claims (preferably by December 31, 2021). This page includes information on how to resolve your claims, and a timeline of what may occur between now and March 31, 2022 if you do not resolve your claims by December 31, 2021.
Basics of Unsubstantiated Health Care FSA Claims
If a health care FSA payment card transaction is not automatically substantiated, you will be notified of an “unsubstantiated claim” that needs to be resolved by substantiation, substitution, or repayment. You will receive notices about the unsubstantiated claim via the email address associated with your Optum Financial account:
- 10 days after the transaction
- 40 days after the transaction
- 70 days after the transaction
- 85 days after the transaction
Your payment card will be deactivated after 85 days, until your claims are resolved. Check the junk folder in your email for these notices. If you do not have an email associated with your Optum Financial account, the notices will be sent to the home mailing address associated with your account.
The FSA administrator sends these notifications for every health care FSA unsubstantiated claim throughout the year.
Resolving Unsubstantiated Health Care FSA Claims
prior to December 31, 2021 (to avoid the payroll withholding process):
To resolve a claim, you should do one of the following prior to December 31, 2021:
- Substantiate the original claim with documentation. Documentation may include:
- Explanation of benefits (EOB) provided by your health or dental insurance carrier (recommended when available)
- Itemized statement or detailed receipt
- Substitute the original claim with another eligible expense. A substituted claim cannot be a claim previously submitted, and must be for the 2021 plan year.
- Repay the amount of the claim directly to Optum Financial. To do so, log into your account, or contact Optum Financial directly to walk you through this option.
Additional communications are sent to you if you still have unsubstantiated FSA claims toward the end of the plan year. All notifications are sent to the email or mailing address associated with your account.
(from Optum Financial)
- via email 11/09/21, 11/19/21, 12/3/21, 12/16/21
(from Optum Financial)
- via U.S. mail 11/23/21 & 12/10/21
(from UW System)
- via email 01/14/22
Payroll Withholding Process
In January, Optum Financial will provide a report to the UW System reflecting employees with health care FSA unsubstantiated claims (incurred on/prior to 10/8/2021). The report is used for the payroll withholding process.
UW System will send an email to the affected employees to make them aware of the payroll withholding process, and that it will continue through March (even if claims are substantiated during the process). Payroll deductions will occur as follows:
|At or less than $100||The balance will be taken from your 1/27/2022 paycheck.|
|Greater than $100||The balance will be divided by five for even deduction amounts per pay period until the end of the run-out period (March 31st). See the below chart for the pay dates.|
Payroll deductions will be withheld from the following paychecks:
|Pay Period||Pay Date|
|01/02/2022 – 01/15/2022||01/27/2022|
|01/16/2022 – 01/29/2022||02/10/2022|
|01/30/2022 – 02/12/2022||02/24/2022|
|02/13/2022 – 02/26/2022||03/10/2022|
|02/27/2022 – 03/12/2022||03/24/2022|
Payroll Withholding Process – Frequently Asked Questions
I substantiated my claims a few days ago; why did I receive the payroll withholding notice in January?
The substantiation process and payroll withholding processes are complex. There is a chance your claims have been resolved; however, you also appeared on the unsubstantiated claims report. This is likely a timing issue. Payroll withholdings will need to occur and continue through March 31st. If necessary, after March 31st, a refund will be issued by Optum Financial.
May I resolve unsubstantiated claims during the payroll withholding process and if so, how?
Yes. You may do so until March 31, 2022; however, you will still be included in the payroll withholding process. Refer to the “After December 31, 2021” section above under “Resolving Unsubstantiated FSA Claims” for additional information. If necessary, after March 31st, a refund will be issued by Optum Financial.
I used my payment card in November and December, and have started to receive notifications from Optum Financial to resolve my claims. If I do not resolve my claims by December 31, 2021, will I be part of the payroll withholding process?
Only employees that used their payment card on/prior to October 8, 2021 that do not resolve their claims by December 31, 2021 will go through the payroll withholding process. If you used your payment card after October 8, 2021, and do not resolve your claims by March 31, 2022, you will be sent an invoice from ETF’s collection unit in May or June of 2022.
Why should I resolve unsubstantiated claims after the payroll withholding process has begun?
If you decide to substantiate your claims, a refund will be issued by Optum Financial. Additionally, your unsubstantiated claims will not be sent to ETF to collect your unsubstantiated claims debt if you resolve your claims on your own.
My payment card was deactivated due to my unsubstantiated claims. When will my payment card be reactivated?
Your payment card will be reactivated mid/late-April, after the entire payroll withholding process is complete (for all state agencies). While you are unable to use your payment card, you may submit eligible expenses for reimbursement through the Optum Financial mobile app or Optum Financial website.
What should I do if the payroll withholding process will cause me a significant financial hardship?
If the payroll withholding process will cause you a significant financial hardship, contact your institution benefits contact to determine if other options are available.
If you are no longer an active employee:
- You are responsible for updating your email and mailing address directly with Optum Financial.
- If you do not resolve an unsubstantiated claim, it will be converted to business debt.
For questions on how to resolve a health care FSA unsubstantiated claim, eligible expenses, or the status of a claim, contact Optum Financial at (833) 881-8158.
Every effort has been made to ensure this information is current and correct. Information on this page does not guarantee enrollment, benefits and/or the ability to make changes to your benefits.