Limited Purpose Flexible Spending Account (LPFSA) Overview
An LPFSA is for employees with a High Deductible Health
Plan (HDHP) and Health Savings Account (HSA), allowing pre-tax savings specifically for dental and vision expenses.
Contributions
Employees can contribute up to $3,300 in 2025 to a Limited Purpose FSA through payroll deductions, as per IRS guidelines. However, employers may choose to set a lower contribution limit for employees. Employers may also contribute to the Limited Purpose FSA, but they are not required to do so. Limited Purpose FSA funds are made available in full at the start of the plan year, regardless of the employee's current contribution balance.
Coverage
Eligible expenses are limited to:
- Dental Care: Cleanings, exams, fillings, crowns, implants
- Vision Care: Eye exams, prescription eyewear, LASIK
Non eligible expenses include:
- Medical: Doctor visits, co-pays, prescriptions
- Medical Equipment: Devices, first-aid supplies
- Teeth whitening
- Dental products (toothbrush, toothpaste, etc)
For a complete list of eligible expenses, refer to the Level app.
Eligibility
Eligibility is tied to enrollment in an HDHP and HSA. Check details in the Level app or with HR.
Conversion to Health FSA
An LPFSA may convert to a Health FSA if an employee switches to a non-HSA-qualifying health plan, experiences a qualifying life event, or during open enrollment. Review termination rules in the Level app or contact HR.
Making a Purchase
Use the Level Visa® card or submit claims via the Level app.
Grace Period
Unused funds are usually forfeited at year-end unless a grace or carryover period is provided. Some FSAs offer a 2.5-month grace period (through March 15th) to use remaining funds after year-end. Check your Level app for specifics.
Termination
Funds upon termination are handled per employer policy and IRS rules. COBRA may offer continued access to LPFSA funds. Review in the Level app or consult HR for guidance.
For full LPFSA details, refer to your Level app
The Level Visa® Card is issued by The Bancorp Bank, N.A., pursuant to a license from Visa U.S.A Inc. Card usage restrictions apply.