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Medical Flexible Spending Accounts

UNDERSTAND

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 2012, this amount must be between $240 and $3,600 (the same range as for 2011). 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.

Eligibility

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:

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: 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:

ACT

Enrollment

  1. New hires or current employees who experienced a recent qualifying life event may enroll in a FSA account for the 2012 plan year provided eligibility and enrollment requirements are met.
  2. Next, estimate the amount of eligible dependent care expenses you expect to incur during the calendar year.
  3. Complete the 2012 Enrollment Form. Be sure to indicate the "University of Washington" on the form.
  4. 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:

  1. 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.
  2. 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.

Claims must be filed by March 31 for expenses incurred during the previous calendar year. Any dollars from the previous year not claimed by March 31 are forfeited as required under the tax code. (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:

  1. 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.
  2. 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

If you have submitted a claim by completing the paper form, you may choose to have the funds returned to you by check or through direct reimbursement option, whichever you elect.

You should receive your reimbursement within 10 days from the time you mail your properly completed reimbursement request. To avoid delays, be sure to include all the necessary information on the reimbursement form and mail or fax it directly to the FSA administrator.

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.

Contact Information

US Mail Address

UPS or FedEx Address

ASIFlex
PO Box 6044
Columbia, MO 65205-6044
ASIFlex
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: asi@asiflex.com*
ASIFlex Website: http://pebb.asiflex.com/

*Emailed claims will not be accepted.

EXPLORE

FSA Topics

Grace Period for 2011 FSA Participants
All FSA claims for services provided January 1, 2012 through March 15, 2012, will automatically be processed against the 2011 plan year first, if filed by the claims filing deadline for that plan year. If your claim exceeds the available funds from the 2011 plan year, any excess will be automatically applied to the 2012 plan year. All claims must be postmarked or faxed by March 31, 2012, or remaining funds will be forfeited.