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Presentation on theme: "THE FEDERAL FLEXIBLE SPENDING ACCOUNT PROGRAM"— Presentation transcript:



3 What is a Flexible Spending Account?
An account where you contribute money from salary BEFORE taxes are withheld A way to save money on day care and health care services and items for you and your family A Fed-friendly tax break Key Benefit: More Money in Your Pocket! March 22, 2017

4 *A few exceptions, discussed later
How does FSAFEDS work? Estimate your expenses and determine your annual contribution from salary, pre-tax Enroll in a Health Care, Limited Expense Health Care or Dependent Care FSA Incur eligible expenses Submit your claims* Get reimbursed FAST *A few exceptions, discussed later March 22, 2017

5 How do you save money with FSAFEDS?
Your contributions to FSAFEDS are deducted from your salary BEFORE taxes…just like Thrift Savings Plan contributions. You’re going to have these expenses, so why pay more in taxes than you have to? The average person will save about 30% each year A Fed earning $50,000 and contributing $2,000 to an FSAFEDS account will have around $600 more to spend PUTS MORE MONEY IN YOUR POCKET! March 22, 2017

6 Savings Illustration March 22, 2017

7 Three types of FSAs 1. Health Care FSA (HCFSA)
- For eligible health care expenses not paid by FEHB, FEDVIP or any other insurance $250 minimum election per year $2,500 maximum election per year – this IS NOT a household limit, your spouse may have a separate account March 22, 2017

8 Three types of FSAs (cont.)
2. Limited Expense Health Care FSA* (LEX HCFSA) - For those enrolled in or covered by a High Deductible Health Plan (HDHP) with a Health Savings Account (HSA) *Limited to only eligible dental and vision expenses not paid by FEHB, FEDVIP or any other insurance $250 minimum election per year $2,500 maximum election per year – this IS NOT a household limit, your spouse may have a separate account March 22, 2017

9 Three types of FSAs (cont.)
3. Dependent Care FSA (DCFSA) - For eligible non-medical day care expenses (childcare, eldercare) so you (or your spouse) can work, look for work or attend school full-time. $250 minimum election per year $5,000 maximum election per year – this IS a household limit and includes any child care subsidy amounts and other FSA dependent care accounts Note: You (and spouse) must have earned income during the year, even if looking for a job. March 22, 2017

10 Eligibility for FSAFEDS
Must be employed by an Executive Branch Agency or another organization offering FSAFEDS March 22, 2017

11 Eligibility for FSAFEDS (cont.)
HCFSA Must be FEHB eligible Participants do not have to be enrolled in FEHB March 22, 2017

12 Eligibility for FSAFEDS (cont.)
LEX HCFSA Must be enrolled in or covered by an HDHP with an HSA under the FEHB March 22, 2017

13 Eligibility for FSAFEDS (cont.)
DCFSA Do not need to be FEHB-eligible or enrolled in FEHB Ineligible: intermittent employees expected to work fewer than 180 days/year March 22, 2017

Administrative Fees All agencies pay the fees for their employees Employees do not pay fees to participate PUTS EVEN MORE MONEY IN YOUR POCKET! March 22, 2017


16 HCFSA Eligible Expenses
Health care expenses not paid by FEHB or FEDVIP or any other insurance Expenses incurred by you and/or your dependents are eligible March 22, 2017

17 Typical HCFSA Expenses
Co-payments, co-insurance and deductibles (but not insurance premiums) Chiropractic care Contact lenses, solutions, cleaners and cases Dental care (Including crowns, endodontic services, implants, oral surgery, periodontal services, sealants, etc.) Diabetic supplies First aid kits March 22, 2017

18 Typical HCFSA Expenses (cont.)
Flu shots Foot care (e.g., athlete’s foot products, arch supports, callous removers, etc.) Hearing aids (including batteries) Home diagnostic test and kits (e.g., cholesterol, colorectal screenings, etc.) Home medical equipment (wheelchairs *, oxygen, respirators, etc.) Orthodontia *With Letter of Medical Necessity March 22, 2017

19 Typical HCFSA Expenses (cont.)
Over-the-counter non-medical items, such as, but not limited to band aids, braces & supports and reading glasses Over-the-counter drugs and medicines WITH a prescription – insulin is the exception Physical therapy Prescription drugs Prosthetics Psychiatric services and care March 22, 2017

20 Typical HCFSA Expenses (cont.)
Substance abuse treatment Transportation expenses related to medical care Vision care (including eyeglasses, prescription sunglasses, refractions and vision correction procedures) For a complete list of eligible expenses, go to and click on “Eligible Expenses Juke Box” under the “Quick Links” drop-down menu March 22, 2017

21 Ineligible HCFSA Expenses
Day care expenses Cosmetic procedures (unless required to restore appearance or function due to disease of illness) Expenses you claim on your tax income return Expenses reimbursed by other sources, such as insurance Fitness programs (unless medically necessary*) *With Letter of Medical Necessity March 22, 2017

22 Ineligible HCFSA Expenses (cont.)
Hair transplants Insurance premiums, including COBRA, Tricare, dental, vision and long term care insurance Over-the-counter drugs and medicines (except insulin) unless prescribed by a physician Physician retainer fees including boutique and concierge practice membership fees Weight loss programs and drugs for general well-being Expenses incurred after March 15, 2015 March 22, 2017

23 LEX HCFSA Eligible Expenses
ONLY Dental and Vision expenses Not paid by FEHB, FEDVIP or other insurance Expenses incurred by you and/or your dependents including: Dental – cleanings, fillings, crowns, orthodontics and over-the-counter items such as denture care products, but not toothpaste Vision – eyeglasses, refractions, vision correction procedures, contact lenses, solutions, cleaners and cases March 22, 2017

24 DCFSA Eligible Expenses
Day care expenses that let you (and your spouse): Work Look for work Attend school full-time For children under age 13 and any dependent who is mentally or physically incapable of self-care Services cannot be provided by your dependent If you or a spouse have looked for work, you must have found a job and have earned income at some point during the year. If a spouse is a full-time student or incapacitated, he or she does not to have any earned income during the year. March 22, 2017

25 Typical DCFSA Expenses
Child care at a daycare center, day camp, sports camp, nursery school or by a private sitter Late pick-up fees Before and after-school care (but not tuition) Adult day care expenses Au Pair placement fees and weekly stipend Expenses for a housekeeper who also cares for an eligible dependent March 22, 2017

26 Ineligible DCFSA Expenses
Health care expenses Education or tuition fees Late payment fees Overnight camps Sports lessons, field trips, clothing Transportation to/from care provider Expenses incurred after March 15, 2015 March 22, 2017

27 Benefit Period Employees must enroll each Open Season to participate in the following benefit period Enrollments do not carry over year-to-year Benefit Period = January 1 through March 15 (of the next year) Salary contribution deducted equally among pay dates during the calendar year (January 1 – December 31) March 22, 2017

28 Online Calculator Interactive savings calculator available online at Enter salary and tax information Enter FSAFEDS contribution amount Enter estimated expenses Calculate potential annual tax savings March 22, 2017

29 Payroll Deduction Process
Employee identifies employing agency during enrollment FSAFEDS submits enrollment information to BENEFEDS BENEFEDS coordinates payroll deductions with your payroll provider BENEFEDS provides FSAFEDS with confirmed allotment information. FSAFEDS updates participant accounts. March 22, 2017

30 Availability of Funds DCFSA: only amount of current account balance is available for claim reimbursement HCFSA & LEX HCFSA: total annual election is available once agency information is confirmed March 22, 2017

31 “Use-or-Lose” Rule You must forfeit money unspent at the end of the Benefit Period (March 15th) IRS Rule (Section 125 of IRS Code) No exceptions You must file claims by April 30th following the end of the Benefit Period Plan carefully when making elections March 22, 2017

32 Extra 2 ½ Months If you enroll during Open Season, you have from January 1 to March 15 of the next year to incur eligible expenses 14 ½ months to spend your annual election You forfeit any FSA money not spent on eligible expenses by March 15, 2015 You have until April 30, 2015 to file claims March 22, 2017

33 Tracking Account Balances
Secure online account access via My Account Summary Call toll-free 1-877-FSAFEDS ( ) TTY line: Reimbursement Statement sent when claims processed Account Statements sent in January, March and October March 22, 2017

34 Federal Benefits Open Season Enroll November 11 – December 9, 2013 Enroll early to avoid the last minute rush! THAT’S MORE MONEY IN MY POCKET!

35 Enroll Online Go to
Follow the simple enrollment process Receive personalized confirmation Will appear at the end of the enrollment process Will automatically be ed to you if you provide an address during enrollment Will be available via My Account Summary March 22, 2017

36 Enroll By Telephone FSAFEDS Benefits Counselors
Toll-free FSAFEDS ( ) TTY line: Monday – Friday, 9:00 a.m. – 9:00 p.m. ET March 22, 2017

37 Enrollment Requirements
Must meet eligibility requirements for FSAFEDS participation Must agree to Electronic Funds Transfer (EFT) Fast reimbursement March 22, 2017

38 Enrollment Options – HCFSA Only
Paperless Reimbursement (PR) Available with many (not all) FEHB plans Claim filed with FEHB plan FEHB plan forwards out-of-pocket expenses directly to FSAFEDS Often no out-of-pocket payment Payment made directly to you from FSAFEDS account via Electronic Funds Transfer Some dental and vision claims require manual submission – please check the website March 22, 2017

39 PR - Participating Plans
Aetna Medical Plan APWU Health Plan Blue Cross and Blue Shield Service Benefit Plan Compass Rose Health Plan (formerly ABP) Foreign Service Benefit Plan GEHA Humana Mail Handlers Benefit Plan March 22, 2017

40 PR - Participating Plans (cont.)
M.D. Individual Practice Association Inc. NALC Health Benefit Plan SAMBA Health Benefit Plan UnitedHealthcare Insurance Co., Inc. March 22, 2017

41 PR - Participating Plans (cont.)
FEDVIP Plans Aetna (Dental) GEHA (Dental) United Concordia (Dental) FEP Blue Vision (Vision) Vision Service Plan (Vision) March 22, 2017

42 New Employee Enrollment
New employees have 60 days to enroll Must enroll before October 1 Otherwise, must wait for next Federal Benefits Open Season March 22, 2017

43 Enrollment Changes May change election(s) at any time during Open Season Qualifying Life Event (QLE) required outside Open Season March 22, 2017

44 Qualifying Life Event QLEs defined by IRS: Change in marital status
Change in number of dependents Change in dependents’ eligibility (e.g., child turning age 13) Change in cost or coverage (DCFSA only) (e.g., day care fee increase) Change in employment or residence Change in military duty status March 22, 2017

45 Qualifying Life Event (cont.)
Requested change must be consistent with event that prompts change For example: Increase DCFSA or HCFSA election after birth or adoption of child Decrease DCFSA election if spouse stays home with child March 22, 2017

46 Qualifying Life Event (cont.)
Must notify FSAFEDS of QLE from 31 days before to 60 days after event To submit a request online, login to “My Account Summary” and access the “Qualifying Life Event” section. Follow the simple instructions to submit your request online If you prefer to print a QLE form and save a copy for your records, the QLE form is still available under “Forms” at March 22, 2017

47 Qualifying Life Event (cont.)
Fax or mail your form to FSAFEDS You may submit your request either online or by form, but you may not do BOTH FSAFEDS will verify that event was a QLE and process requested election change QLE for birth/adoption of child is retroactive to date of event; all others are prospective Can only reduce elections to the amount already on deposit or reimbursed March 22, 2017

48 Separation/Retirement
No further allotments DCFSA balance, at separation, is available for eligible expenses incurred until end of Benefit Period or until balance is depleted No refund available HCFSA terminates at separation Only expenses incurred before separation are eligible for reimbursement March 22, 2017

49 Leave Without Pay (LWOP)
Agencies will not withhold allotments during non-pay status Options: Pre-pay elections through accelerated allotments Freeze account until return to pay status (Allotments recalculated across remaining pay dates) If LWOP is due to a QLE, participant can cancel or reduce annual election, if consistent with the QLE March 22, 2017

50 Claims & Reimbursement

51 Claim Forms Available online
Request by telephone or 1-877-FSAFEDS ( ) TTY line: FAX or mail claim to FSAFEDS (toll-free, inside U.S. only) or March 22, 2017

52 Required Documentation: HCFSA and LEX HCFSA
Completed and signed claim form AND Explanation of Benefits form (EOB) From FEHB or FEDVIP or other insurance Must indicate type of service, date(s) of service, amount owed March 22, 2017

53 Required Documentation: HCFSA and LEX HCFSA (cont.)
OR Detailed receipts Must indicate type of service, date(s) of service, amount paid None, with Paperless Reimbursement March 22, 2017

54 Required Documentation: DCFSA
Completed and signed claim form AND Copies of bill or signed receipt OR Have provider complete Part III of claim form Include provider’s tax ID or SSN on all claims March 22, 2017

55 Online Claim Submission (NEW!)
Go to Select “Online Claim Submission” Enter and save claim information as directed Upload appropriate claim documentation as a .PDF, .JPG or .TIF file Check the box and select the “I Certify” button to submit the claim March 22, 2017

56 Reimbursement Reminders
Expenses are incurred on date of service, not when expense is paid (Orthodontia is an exception) Expense must be incurred AFTER effective date of enrollment AND during the Benefit Period All claims must be postmarked or faxed by April 30, following end of Benefit Period Unclaimed funds are forfeited and used to offset administrative costs of the FSAFEDS program March 22, 2017

57 Contact Us 1-877-FSAFEDS (372-3337)
TTY line: Benefits Counselors are available Monday through Friday, 9:00 a.m. to 9:00 p.m., ET March 22, 2017


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