bars

Sysco

Limited Purpose FSA

Set aside money for eligible dental and vision expenses. Available to eligible colleagues.

times
EligibilityEnrolling in BenefitsMaking Changes During the YearSelecting a Medical PlanHealthcare AdvocateContact a Benefits ProviderYour Rights and Protections Against Surprise Medical Bills

The Limited Purpose Flexible Spending Account (LPFSA) administered by Inspira (formerly PayFlex) works the same way as the HCFSA does, except it can only be used for dental and vision expenses. The LPFSA is only available to those enrolled in the HSA medical plan.

The IRS has rules about eligible expenses. Learn more on the IRS website and speak with your tax advisor.

Saving and Using Your LPFSA Dollars

  • In 2024, you can save from $100 to $3,200.
  • When you use network dentists or eye doctors, your out-of-pocket expenses will be automatically deducted from your LPFSA.

Keep things simple with the mobile app, where you can manage your account, make payments, withdrawals and deposits and use a bar code scanner to see if an item is an eligible expense.

If you have already downloaded the PayFlex mobile app, you will automatically be prompted to update it.

To learn more about managing your Inspira account, go here.

"Use It or Lose It" Rule

The LPFSA has a "use it or lose it" rule.

  • Claims must be incurred during the plan year (January 1 – December 31) and submitted by March 15 of the following year to be eligible for reimbursement.
  • Any money you do not use by the end of the year is forfeited.

Claim Forms & Guidelines

FSA claims can be quickly processed online through the Inspira website or app. For a hard copy of the LPFSA claim form, click here. For the FSA Claim Filing Guidelines, click here.  

Levels of Coverage:
No items found.
Plan Details:
Documents:
There are no documents associated with this Benefit.

See the Plan Documents page for additional downloads.

Benefit Provided By:
Related Contact Information:
call_bubble
Flexible Spending Accounts
Inspira Financial
1-844-729-3539
Visit Website