• Flexible Spending Account (FSA)

Give Yourself a Pay Raise!

The flexible spending account (FSA) program allows you the opportunity to set aside money from your paycheck on a pre-tax basis to pay for certain eligible health care expenses. Eligible expenses include medical, dental or vision services, dependent care of a qualified dependent child or adult so that you can work, or for premiums for individually purchased medical, dental, vision or disability insurance. You can not use FSA funds to pay for Oxy medical, dental or vision premiums.

Use it or Lose it!

Carefully review your personal situation before enrolling in any reimbursement account – the IRS requires that you forfeit any unused money remaining in your reimbursement accounts at the end of the calendar year.

Make the most of your FSAs

PrimePay

  • Phone: 877-632-9472
  • Email: primeflex@primepay.com

Medical Spending Account/Health Care FSA

The health care FSA allows you to set aside money to help you pay for medical, dental and vision expenses that are not covered by or fully reimbursed by your insurance. This account is a supplement to our benefit menu and is not intended as a replacement to the medical plan. Debit cards are available, allowing you to pay for qualified out-of-pocket health care expenses not covered by insurance. Alternatively, you may pay for expenses out of pocket and subsequently file for reimbursement. Reimbursable expenses must be incurred during the plan year by you, your spouse and children up to age 26, and include:

  • Health plan copays and deductibles;
  • Prescription copays;
  • Over-the-counter items based on the OTC list of allowable expenses and expenses that need a doctor’s prescription;
  • Eye care products/corrective lenses and corrective procedures for the eye;
  • Out-of-pocket expenses for treating a specific condition (dental, orthodontic, acupuncture, chiropractic, homeopathic provider visits, Lamaze classes, lactation assistance and devices, smoking cessation, weight-loss programs for clinical obesity or deemed to treat an underlying health condition)

Some examples of expenses that will not be reimbursed:

  • Cosmetics and cosmetic procedures
  • Vitamins and supplements
  • Medical, dental and vision plan premiums
  • Over-the-counter drugs to alleviate or treat personal injuries or sickness (i.e., antacids, cold medicine, pain relievers) without a prescription
  • Weight loss programs for general health and appearance (not for specific diseases)

For a complete list of eligible expenses, visit www.irs.gov/pub/irs-pdf/p502.pdf.

Your health care FSA may not exceed $3,050 each plan year per individual. The entire amount you contribute is available to use on your effective date of coverage.

Dependent Care Account

The dependent care FSA gives you the opportunity to pay for care services so that you and/or your spouse/domestic partner can work or attend school full-time. You may contribute up to $5,000 each plan year to the dependent care FSA if you are filing a joint tax return or as head of household. If you are married and you and your spouse file separate tax returns, the maximum amount you may contribute is $2,500 each plan year.

In order to qualify for reimbursement, services must be related to the care of:

  • Children under age 13 who are listed as dependents on your income tax return
  • Dependents of any age who are incapable of caring for themselves and who regularly spend at least eight hours a day in your home

Eligible dependent care expenses, covered while you are at work, include:

  • Nursery school, pre-kindergarten, extended day or after-school programs
  • In-home care for dependents unable to care for themselves (children or adults)
  • Daytime summer recreational camp
  • Adult private sitter (they must be someone you claim on your taxes)

For a complete list of eligible expenses, visit www.irs.gov/pub/irs-pdf/p503.pdf. As you incur dependent care expenses, you may submit a claim for reimbursement not to exceed the amount that is in your account at the time of reimbursement.

Getting Reimbursed

There are several ways for you to be reimbursed from your FSA for eligible expenses. When you have an eligible expense, you can submit a claim for reimbursement and have a check mailed to you or you may elect direct deposit to your checking or savings account.

Requests and Extensions

Requests for reimbursement may be filed at any time after the expense is incurred and up to 60 days after the end of the plan year with an additional two and one half-month extension for the health care and dependent care FSAs only, under Internal Revenue Code Notice 2005-42 (but not later than 60 days after you terminate employment). You must be a plan participant and employee to use this extension. If you still have a balance on December 31 of the plan year, this extension allows you to continue to spend and exhaust that account until March 15 in the new plan year. The balance in the old plan year account must be depleted before the new plan year expenses are applied to the new plan year balance. The deadline to file a claim for 2021 balances is April 30.

Termination

If you terminate employment at the end of the plan year or in the beginning of the new plan year, a 60-day grace period for withdrawal of funds will still apply as it does upon termination of employment midyear. Only the expenses incurred while you were a plan participant can be reimbursed.

Proof of the expense must be third party documentation such as an itemized statement, receipt, and/or an Explanation of Benefits (EOB) from your insurance company. Please note that credit card receipts and canceled checks are not acceptable forms of documentation under the Internal Revenue Code.

Save Your Receipts

If you elect the dependent care FSA benefit and your care provider does not provide you with a bill or receipt, you will need to request one – it does not have to be typed, it can be handwritten and signed by the care provider. If you do not receive the full amount of your request, please do not resubmit the bill; the balance will be paid upon your next contribution.

If Your Claim is Denied

If your claim is denied for any reason, you will receive written notification. If you disagree with the decision, you have the right, as outlined in the Plan Document and Summary Plan Description, to an appeal.

Important IRS Rules

If you elect to participate in these accounts, you must enroll each year in order to continue participating. Enrollment is never automatic.

Since you are allowed to reduce your taxes through your participation in the FSAs, certain IRS restrictions apply.

  • You cannot transfer money between your health care and/or
    dependent care FSA.
  • You cannot change the amount you originally elect to contribute during the plan year, unless you have a qualifying life status event. Those events are as follows:
    • Change in employee’s legal marital status
    • Change in number of tax dependents
    • Termination or commencement of employment of employee, spouse or dependent (eligibility must be affected)Dependent satisfies (or ceases to satisfy) dependent eligibility
    • Change in employment status (eligibility must be affected)
    • Change in residence or worksite of employee, spouse or dependent (eligibility must be affected)
    • Change in insurance
    • Change in spouse’s benefits
    • Change in child(ren) losing parent’s benefits
    • Change in dependent care provider’s fees
    • Dependent care provider ceased services
    • HIPAA Special Enrollment/COBRA event
    • Judgment, decree or court order
  • You cannot claim expenses on your federal income tax return if you’ve already been reimbursed for them through an FSA.
  • You must spend all of your account funds during the plan year.
  • Any funds left in your account at the end of the year cannot be carried over and will be forfeited.
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