Flexible Spending Accounts

 

A Flexible Spending Account (FSA) is a savings account that allows you to use pre-tax dollars to pay for out-of-pocket prescriptions, medical, dental, vision or dependent care expenses.

There are two FSA account options:

1. Medical FSA allows you to use pre-tax money to pay for essential health care services that are not covered, or are partially covered by your medical and dental insurance plans. It also reimburses many other expenses and services that are not covered by insurance, such as medications and alternative care.
2. Dependent care FSA creates a tax break for childcare or elder care expenses that make it possible for you to work or attend school full-time.

 Our FSA benefit is administered by the third party, Allegiance.

 

Eligibility

Flexible Spending Accounts are available to any employee who qualifies for the full benefit package -

• faculty member with at least a .50 full-time equivalent (FTE)

• staff member who works at least 20 hours per week (.53 FTE)

Please visit our benefit eligibility page to read more.

***Please be aware that you cannot enroll in a Health Care Spending Account if you or your partner are also enrolled in a High Deductible Health Plan (HDHP) with a Health Savings Account (HSA)***

 

Cost

An FSA is fully funded by the employee. Deductions occur in the month in which the benefit becomes active - for example if you benefit starts on April 1st, your first deduction will appear on your April 30th payroll.

Medical FSA Annual Limits: The maximum contribution limit for the health care FSA is limited by the IRS. The plan year maximum contribution limit is $2,850.

Employees are allowed to roll up to $570 of unused Medical FSA funds from the 2021-2022 plan year and use them for reimbursement in the full 2022-2023 plan year. 

Dependent Care FSA Annual Limits: The maximum contribution limit for the dependent care FSA is limited by the IRS. The plan year maximum limit for an individual contribution is $5,000. The plan year maximum limit for a household contribution is $5,000. If you are married and filing separately, the annual limit is $2,500.

 

FAQ & Tips

When can I sign up and when is it effective?

• Within 31 days of your initial date of hire. The account goes into effect the first day of the month following your enrollment and your full annual election is available to you on the first day.

• During Open Enrollment. The account becomes effective the first day of April. You must actively re-enroll in the FSA program each year to take advantage of the tax savings.

How do I get reimbursed for my purchases?

• Submit a paper form with receipts and be reimbursed by check or by direct deposit.

• Submit receipts online and be reimbursed by check or by direct deposit.

• Use an Allegiance debit card. No need to be reimbursed, although a receipt may be necessary.

 

Flexible Benefit Plan Highlights

New Member Flexible Spending Accounts Overview

New Member Enrollment Steps

Step by Step Instructions - How to file a claim online

 

Healthcare Claim Form

Healthcare Qualifying Expenses

FSA Store (all purchases with your Allegiance debit card are pre-approved and do not need additional documentation)

 

Dependent Care Claim Form

Dependent Care Qualifying Events

Dependent Care Annual Contract

 

Contact

Group Number: 503711

Hours: 7am to 5pm

Phone: 877-424-3570

Website: allegianceflexadvantage.com