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Medical/Dental Insurance
Flexible Spending Account
for Faculty, Staff & Librarians

Open Enrollment is November 1-30

Medical Flexible Spending Account (FSA) enrollments are effective for ONE tax year only, and do NOT automatically renew from year to year. Therefore, all employees who wish to participate in a 2015 FSA must enroll anew during Open Enrollment this November.

UNDERSTAND

FSAs are IRS-approved, tax-exempt accounts 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.

Flex-Plan Services, Inc. is the FSA administrator for Public Employees’ Benefits Board (PEBB) members.

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 2014, this amount must be between $240 and $2,500. 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 Flex-Plan Services. 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.

Eligibility

If you are eligible for PEBB-sponsored benefits, you can enroll in a the FSA as long as you are not already enrolled in a Health Savings Account (HSA) through a Consumer-Directed Health Plan (CDHP). Eligible FSA expenses will be reimbursed to you, and can include charges to:

These individuals do not need to be covered under your PEBB medical plan for their expenses to be reimbursed from your FSA.

Enrollment Requirements

Current plan participants must re-enroll in the plan each year in order to continue their 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:

ACT

Enrollment

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.

  1. Check out the Employee Tools provided at the Flex Plan website, including the tax savings calculator, videos, and Enrollment Guide.
  2. Estimate the amount of eligible expenses you expect to incur during the calendar year.
  3. Create an account, if it is your first visit to the website.
  4. Enroll. You must either enroll online, or alternatively fax, email, or mail your enrollment no later than the last day of open enrollment. Be sure to indicate the "University of Washington" on the form.
  5. Please do not send the enrollment form to the UW Benefits Office. Fax or mail it to the address listed below.

Access Your FSA / File a Claim

After enrolling 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.

Here are the ways you can access your FSA:

  1. Fill out a Claim Form, attach proper documentation and fax, email or mail it to Flex-Plan Services (below).
  2. Use your benefit's debit card to pay for eligible expenses and the funds will come automatically out of your FSA and are paid to the provider. Download the FlexiCard Debit Card Application form.
  3. After you create an account with Flex-Plan Services, download the Flexi App for your Android or iPhone mobile device. You can use the "Submit a Claim" tool to enter your claim information, upload a photo of your documentation, and submit to Flex-Plan Services.

Proper Documentation

It is important to send the proper documentation that substantiates the claim, the IRS requires that the documentation have:

  1. Date of service- which falls within the plan year
  2. Type of service or item
  3. Cost or patient responsibility

Bills from providers and Explanation of Benefits (EOB’s) from insurance carriers are good forms of documentation. You do not need to show proof of payment unless you are submitting an orthodontia claim. Do not submit copies of cancelled checks, credit or debit card receipts. DO NOT send the claim form to the UW Benefits Office.

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 contact Flex-Plan customer service at 1-800-669-3539.

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 Flex-Plan Services. For more information, call Flex-Plan customer service at 1-800-669-3539.

Note: The Dependent Care Assistance Program (DCAP) may not be continued after layoff or termination of employment.

Contact Information

US Mail Address

UPS or FedEx Address Only

Flex-Plan Services, Inc.
PO Box 53250
Bellevue, WA 98015-3250
Flex-Plan Services, Inc.
11400 SE 6th St., Suite 125
Bellevue, WA 98004

Customer Service Center Phone: 1-800-669-3539
Claim Submission Fax: 425-451-7002 or toll-free 1-866-535-9227
Customer Service Email: customerservice@flex-plan.com
Website: http://pebb.flex-plan.com/

EXPLORE


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.

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