*Important Note: The FAQs only apply to users who have CDH accounts with Forma, including LPFSA, FSA, DCFSA, HSA, and Commuter, and users who have HSA with WealthCare Saver.
Introduction
What are Benefits Cards?
The Forma Benefits Card is like a pre-paid debit card. The card is loaded with your CDH accounts' available balance. It’s a quick and easy way to pay for qualified expenses from your CDH Account, and it combines all the plans into one card.
How can I activate my Benefits Card?
Benefits Card will be automatically activated on the first swipe.
Request the Card
You will be auto-issued a benefits card when you are enrolled in the plan, or reach out to our Member Experience Team for a reissue. You can also request a card for yourself or your dependents on the Forma portal.
Can I get the tracking number for my Benefits Card Delivery?
Unfortunately, we don’t have a tracking number for the card mailing. You can expect to receive it in 5-7 business days after the card is issued.
Can I request a pin for my Benefits Card?
Yes, please see this article: Requesting a PIN number for your FSA Card
How do I save my card on Amazon?
Please follow the steps in this article: Why won't my FSA/HSA Card save to my Amazon Account?
Card Transactions Validations
How do Benefits card transactions work?
CDH accounts spendings are strictly regulated by the IRS. They require administrators to review the eligibility of the transactions. There will be two levels to determine the eligibility of the transactions.
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Authorization: at the first level, the transactions must meet at least one criteria below to be authorized and posted.
IIAS POS (Point-of-Sale) Substantiation - Merchants using an IIAS-approved credit card processing terminal provide transaction details electronically at the time of purchase that designates the purchase as FSA/HSA eligible.
Merchant Category Codes (MCCs) - MCCs are four-digit numbers that describe a merchant's primary business activities. MCCs are used by card issuers to identify the type of business in which a merchant is engaged. They can be used to track spending habits and to allot credit card points for qualified purchases. Each plan is designed with a list of accepted MCCs. Only transactions at the merchants of accepted MCCs will be authorized.
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Adjudication: Once the transactions are swiped and authorized, it will be adjudicated in the following ways:
Parameter Matching - Depends on the company’s policy, transactions with the amount below the threshold or matching co-pay amount will be auto-approved, and no further administrator adjudication is needed.
IIAS - If the transactions are authorized under the IIAS Substantiation criteria, they will be auto-approved at the point of sale at the same time, and no further administrator adjudication is needed.
Recurring Transaction - If you have a transaction that is of the same amount at the same merchant, the recurring setting will release the burden of the manual adjudication. You will only need to submit the receipt for the very first time. Once we approve the review-required transaction, the following recurring transactions would be auto-approved in the following 12 months.
Forma, as your administrator, must request additional documentation to determine claim eligibility if a benefits card transaction does not meet any of the criteria above.
The Difference Between Authorization and Adjudication
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Authorization occurs at the point of sale and is focused on whether the transaction is valid - the card is active, the cardholder is active, there is sufficient balance, the Merchant Category Code (MCC) is allowed, the MCC transaction limits and cumulative total limits haven’t been reached, the service category transaction limits and cumulative total limits haven’t been reached, etc. It determines whether the card transaction is posted at the point of sale.
Additional information:
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Adjudication occurs after the sale and is focused on whether the transaction meets the administrator-defined criteria for the plan - it matches a copay amount or copay multiple, threshold requirement, or is a recurring expense. It determines the card transaction eligibility.
What is the process for administrator adjudication?
If documentation is needed to substantiate, Forma will send a Receipt Notification Letter to your requesting documentation, and your transaction status will be pended. Typical Timeline for Participant Notifications:
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First Request - After the transaction was made and posted
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Second Request - 30 days after the first request
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Final Request - 15 days after the second request
If you fail to provide supporting documents 15 days after the final request, your card will be temporarily deactivated, and the transaction will be marked Ineligible. You will need to provide the supporting documents to Forma in order to adjudicate the transactions, or you will be required to pay back the amount.
What information must be included in the supporting documents?
Supporting documents can be in the form of a purchase receipt, itemized statement from the provider, or explanation of benefits from an insurance carrier. All documentation must include:
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Name
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Merchant or medical institute
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Service or item name
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Service date
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Amount
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*LMN (if necessary)
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*RX (if necessary)
You may reply to your Receipt Notification Letter, or send the documentation via Live Chat or email to support@joinforma.com.
Can I not provide a receipt to you because of the privacy issue?
Unfortunately, as an administrator, we are required to review the receipts to validate the transactions. You may submit the receipt to support@joinforma.com via Gmail in a confidential mode or any other encrypted message. All receipts are securely saved within our database, and we only need them per IRS guidelines.
Card Transactions Management
Why is my transaction pending?
The card transaction will be pended if the transactions do not meet the system auto-substantiation criteria. In such a case, please provide the receipt or any supporting documents via Live Chat or send it to support@joinforma.com to review the transaction.
The pending doesn't mean that the amount is pended - the amount of the transaction has been paid to the merchant at the point of sale (POS), but it requires further documentation for the administrator to validate the transactions.
You will receive a Receipt Notification Letter from Forma to ask you to provide the supporting documents. Please do not submit the documents as a new Manual Claim.
Why is my transaction denied?
There are several possible reasons for your denied transaction, and the most common ones are:
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The account balance has been depleted, there are no funds currently available to pay this amount.
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Purchased items are not eligible.
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Inactive card
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Not accepted at this merchant
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Not eligible on date of service
See here for more information:
Is there a spending limit for my benefits card?
Generally, no, you can spend up to your available balance of each plan. However, your employer might set the monthly spending limit for your Commuter accounts.
What happens I don't have enough balance to cover the whole transaction?
If the services/items are eligible under more than one account, our system will pull funds from both accounts based on the following orders:
FSA > LPFSA > HSA > DCFSA > Transit > Parking
Can I use my personal card as a backup payment?
No. If you only have one account but insufficient balance, you can ask the merchant to split the payment upon the transaction, or pay out-of-pocket first then submit the reimbursement claims to be partially reimbursed with the remaining balance you have.
How can I see the transactions history for my account?
Please go to your Forma Portal > Accounts > Recent Activity.
What do I do for possible fraud or merchant error transactions?
You will need to file a Card Dispute Request within 60 days of the transactions.
Ineligible Transactions
Why are the transactions marked Ineligible?
After manual adjudication, your transactions may be marked ineligible because of the following reasons but not limited to:
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Ineligible Service Date
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Ineligible Items
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Failure to provide supporting documentation within the timeframe
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Merchant Error
What happens if the transactions are ineligible?
Your card will be temporarily deactivated, and a balance due will be created. You will be required to pay back the balance due. See the article for more information:
If it's a merchant error, the merchant can make the refund to your card so that you don't need to pay back the balance due. Once the transactions are refunded, the original transactions will be resolved, and your card will be reactivated.
What happens if I don't repay the balance due?
If the amount is not repaid, the employer may choose to report those amounts as taxable income on the employee's W2. It’s an option to report it as taxable income, not a requirement.
Don't forget you have another option to spend your CDH accounts - learn how to submit and manage your pretax manual claims HERE! Also, we have different operations guidelines on your HSA accounts, so check out the HSA FAQs here if you are an HSA account holder.
If you have any questions, please feel free to reach out to our Member Experience Team via live chat, email to support@joinforma.com, or call us at 844-902-2902.