for Faculty, Staff & Librarians - Flexible Spending Account
A Medical Flexible Spending Account (FSA) is an IRS-approved, tax-exempt account that saves you valuable tax dollars on eligible medical expenses. Each pay period, an amount of money that you have specified is deducted from your gross pay before federal income, Social Security, and Medicare taxes are calculated. Our plan is administered by ASIFlex.
How a Flexible Spending Account Works
When you enroll, you estimate your family's annual health expenses and choose the amount of money you want to set aside pre-tax for the plan year. For 2013, this amount must be between $240 and $2,500. (For 2012, this amount was between $240 and $3,600.) The amount you choose is deducted evenly from your paychecks throughout the year based on your length of appointment (e.g. 9, 10, 11 or 12 months).
As you incur eligible medical expenses, you may request withdrawals from your account to reimburse yourself for out-of-pocket expenses incurred by submitting a claim form with your bills to ASIFlex. Reimbursement will be issued in the form of a check or direct deposit reimbursement, whichever you elect.
FSA funds not used during the plan year will be forfeited.
If you are eligible for Public Employees’ Benefits Board (PEBB)-sponsored benefit programs, you can enroll in a Flexible Savings Account as long as you are not already enrolled in a Consumer-Directed Health Plan with a Health Savings Account (CDHP-HSA). FSA expenses can be reimbursed for:
- your spouse or your tax-qualified domestic partner (QDP), and/or
- Internal Revenue Code (IRC)-eligible dependents
These individuals do not need to be covered under your PEBB medical plan for their expenses to be reimbursed from your FSA.
Current plan participants: You must re-enroll in the plan each year in order to continue your participation. Open Enrollment is held during the month of November each year, with the FSA going into effect January 1 of the following year.
New hires who wish to enroll in an FSA must do so within 31 days from date of hire. Participation becomes effective the first day of the month following receipt of the properly completed enrollment form. Funds are available for those claims incurred after the account is set up.
Current University employees experiencing a qualifying life event may enroll in an FSA within 60 days from date of the qualifying event. Participation becomes effective the first day of the month following receipt of the properly completed enrollment form. Funds are available for those claims incurred after the account is set up. See qualifying life events.
Before You Enroll
Before enrolling in an FSA, consider the following:
- Exclusion: If you are enrolled in a consumer-driven health plan with a Health Savings Account (CDHP-HSA), you and your spouse cannot participate in an FSA. You may enroll in one or the other but not both.
- Be conservative with your estimates: Any money you do not spend during the plan year will be forfeited.
- Anticipated expenses: Determine whether some of your anticipated expenses are FSA eligible. View the list of eligible and ineligible expenses on the plan administrator's website.
- Over-the-counter (OTC) medicines will not be reimbursable through FSA without a doctor’s prescription.
Examples of OTC medicine categories that are no longer eligible for reimbursement from FSA without a prescription include: acid controllers; allergy and sinus remedies; antibiotics; baby rash ointments; cold sore remedies; cough, cold and flu products; digestive aids; motion sickness remedies; pain relief remedies; respiratory treatments; sleep aids and sedatives; and stomach ailment remedies. Equipment, supplies, and diagnostic devices will remain eligible for reimbursement without a prescription (e.g. hearing aid batteries, blood sugar test kits, etc.)
- Changing deductions: You cannot change the amount of money deducted from your pay during the plan year unless you have a qualifying life event that allows a medical plan change like marriage, birth or adoption, divorce, death, or change in residence.
- Filing claims: All claims must be submitted to the plan administrator at ASIFlex who determines whether they qualify for reimbursement.
- Planned surgery: Before undergoing a planned surgical procedure for which you will want reimbursement, be sure you understand any documentation and approval requirements that will be necessary. See the FSA Enrollment Guide or contact the plan administrator at 1-800-659-3035.
- Run-out period: You have a 90-day grace period at the end of a plan year to claim reimbursement for eligible medical expenses. For example, you have until March 31, 2013, to submit claims for 2012 medical expenses.
- Exception: If you elected to enroll in a CDHP with an HSA, you were required to use all your FSA funds for that year with no grace period.
- Grace Period: The IRS permits a "grace period" of two months and 15 days following the end of your plan year for a Medical Expense FSA. During the grace period, you may incur expenses and submit claims for these expenses. Funds will be automatically deducted from any remaining dollars in your Medical FSA. The grace period is not the same "run-out period." The run-out period extends until March 31 each year. This is a period for filing claims incurred anytime during the plan year, as well as claims incurred during the grace period.
- Exception: If you are enrolling in a CDHP with an HSA in the next plan year, you will not be allowed a grace period for the current plan year. You must use all funds before the end of the current plan year or forfeit the balance.
- Other Compensation: You cannot receive insurance benefits or any other compensation for expenses reimbursed through your FSA.
- Income Tax Deductions: Expenses reimbursed from an FSA cannot be deducted on your federal tax return because the money from the FSA is tax exempt.
- No Advance Reimbursement: You may only be reimbursed for services you have received.
- New hires or current employees who experienced a recent qualifying life event may enroll in a FSA account for the current plan year provided eligibility and enrollment requirements are met, otherwise any eligible employee may enroll in the upcoming year during the annual open enrollment period, November 1-30.
- Estimate the amount of eligible medical expenses you expect to incur during the calendar year.
- Complete the Enrollment Form. Be sure to indicate the "University of Washington" on the form. Note: The 2013 Enrollment Form will be available on the first day of open enrollment, November 1.
- Please do not send the enrollment form to the UW Benefits Office, but rather fax it directly to ASIFlex at
1-877-879-9038 (toll-free) or mail it to ASIFlex, P.O. Box 6044, Columbia, MO 65205-6044.
Request your FSA funds
After enrollment in the FSA, you don't have to wait for cash to accumulate to use your account. The maximum annual amount you plan to contribute is available throughout your period of coverage. Funds are available for those claims incurred after your account is set up. To access your FSA funds, simply file a reimbursement claim.
Filing a Reimbursement Claim
To request FSA reimbursement, take the following steps:
- Download and complete a FSA Claim Form including the following items with your claim:
- Receipt, invoice, or bill from your healthcare provider listing the date you received the service, the cost of the service, the type of service, and the person for whom the service was provide, and
- Explanation of Benefits (EOB) from your health insurance provider showing the type of service you received, the date and cost of the service, any uninsured portion of the cost.
- Written statement of medical necessity from your healthcare provide for services that could be deemed cosmetic.
- Submit the form by fax or post to ASIFlex at the address shown below. DO NOT send the claim form to the UW Benefits Office.
If you have unused funds in your FSA on December 31, you may seek reimbursement for services during the grace period. This means you have through March 15 following the end of the plan year to incur additional eligible expenses. You cannot use your previous plan year FSA funds for services provided after March 15. You must submit all requests for reimbursement to ASIFlex no later than March 31. After that date, you forfeit any funds left in your account. (Note the limitation and exception above for those enrolled in a CDHP with HSA.)
Debit Card Option
The FSA Debit Card is an optional convenience tool that allows you to access your pre-tax dollars directly rather than for pay out-of-pocket expenses and seek reimbursement afterwards. The card is swiped like a regular credit card, and depending on whether you use a retail outlet with an Inventory Control System (ICS), you may or may not have to submit documentation. For example:
- If you use your FSA Debit Card at retail outlets with an ICS in place to purchase your prescriptions, you will not have to submit documentation. These retail stores have a system in place that only allows eligible items to be paid with the FSA Debit Card.
- If you use your FSA Debit Card at retail outlets without an ICS, you will be required to submit follow-up documentation to ensure that your purchases are only for FSA-eligible expenses.
When you sign up for the FSA program, you can print the debit card application directly from ASIFlex's website. Your card will arrive within 7-10 business days of submitting it to ASIFlex. Learn how the ASIFlex debit card works .
Receiving an FSA Reimbursement
Request reimbursement online:
- Go to http://pebb.asiflex.com/
- Under "Quick Links," choose "File a Claim Online"
- Enter your ASI pin number, click "begin" and follow the online instructions.
Request reimbursement via paper form:
- Download and complete the reimbursement claim form according to instructions on the reverse side of the form.
- Fax or mail the form and required documentation to ASIFlex at the fax number or address shown below.
- Note: You may either provide documentation from the day care provider or have the provider complete the FSA section of the form, then sign and date the form. You do not need to do both.
Direct Reimbursement Option
You have the option to have your FSA reimbursement checks deposited directly into your checking or savings account. Depending on whether you opt for email or written confirmations, you will either receive an email or letter that the claim has been processed. To apply, complete the Direct Deposit form or call ASIFlex Customer Service at 1-800-659-3035.
Continuation of Benefits
Upon leave of absence, lay-off, or termination of employment, you may be eligible to continue your FSA through the end of the leave or calendar year by special arrangement with ASIFlex. For more information, call ASIFlex at 1-800-659-3035.
Note: The Dependent Care Assistance Program (DCAP) may not be continued after layoff or termination of employment.
|US Mail Address
UPS or FedEx Address
PO Box 6044
Columbia, MO 65205-6044
201 W. Broadway, Suite 4C
Columbia, MO 65203
Customer Service Center Phone: 1-800-659-3035
Claim Submission Fax: 1-877-879-9038 (toll-free)
Customer Service Email: email@example.com*
ASIFlex Website: http://pebb.asiflex.com/
*Emailed claims will not be accepted.
Disclaimer: The information on this page does not substitute for official plan documents. If there is a conflict between the information on this site and an official plan document, the official plan document will govern. Refer to the Benefits Forms & Publications page.
Plan availability and eligibility may change depending on your employment status and/or actions of the Washington State Health Care Authority (HCA), the agency that purchases and coordinates health insurance benefits for public employees, including employees of the University of Washington, through the Public Employees Benefits Board (PEBB) program.