Flexible spending account program

Open enrollment for the flexible spending account (FSA) program for 2025 is now underway. If you currently participate in the FSA program and wish to continue your participation in 2025, you must re-enroll now. Click the link below for an enrollment form. All forms must be submitted by? November 30, 2024.

2025 FSA enrollment form

See the summary plan description for details regarding the operation of the FSA program.

What is an FSA?

Flexible spending accounts (FSA’s) are a great way to save money. An FSA allows you to set aside tax free dollars from your paycheck each month to pay for certain out-of-pocket expenses for health and/or dependent care. Dependent care may include child care for dependent children through the age of 12, child care for disabled children, and elder care for a parent living in your home.

What is a flexible spending account?

A flexible spending account (FSA) is a benefit plan that allows you to set aside tax free dollars from your pay check into a special account that can be used throughout the year to reimburse yourself for eligible out-of-pocket expenses. Since you are paid back” out of an account that is never subject to taxes, the bottom line is that you pay less tax on your total earnings. PCC has adopted the FSA program, administered by PacificSource Administrators to provide?money-saving alternatives for qualifying, participating employees and their dependents.

Who is eligible to participate?

Eligible employees include Classified, Managerial, Academic Professional, Confidential, full-time faculty, and part-time faculty who have completed 600 contact hours (part-time faculty are eligible for dependent care expense account only).

What type of accounts may I set up?

You may set up a “Health Care Expense Account” to pay for certain out-of-pocket medical/dental expenses not covered by insurance, and/or a “Dependent Care Account” to pay for eligible daycare expenses. Part-time faculty may set up a Dependent Care Account only.

When may I enroll?

If you are a regular, benefits-eligible employee, you may enroll within the first 30 days of your date of hire, or during FSA open enrollment in the fall. Part-time faculty may enroll within 30 days of completing 600 contact hours, and also during open enrollment in the fall, provided they have completed the requisite hours. Certain Qualified Status Change events may allow you to add an FSA outside of open enrollment including changes in legal marital status, number of dependents (birth, adoption, death), and employment status.

How do I set up an account?

You will first need to determine how much money you want to set aside from your paycheck for your flexible spending account(s). Consider last year’s out-of-pocket medical and dependent care expenses, any medical/dental care costs you foresee that might not be covered by insurance, and any changes in your family or work situation that may impact these expenses. This worksheet may be helpful in determining your expenses.

If you choose a health care account, you may elect up to $3,300 per year for eligible health care expenses.?If you choose the dependent care account, you may elect up to $5,000/?year per household for day care expenses, or $2,500 each if married and filing a separate tax return.?Your salary reductions for a dependent care account will be used to pay for expenses you incur for the care of an eligible dependent as defined by the Internal Revenue Code which may include elder care for a parent living in your home.

After determining how much money to set aside monthly from your paycheck, you will need to complete and submit the FSA form. Unlike health benefits, you must re-enroll each plan year to continue your participation in the FSA program.

How do I get money out of my accounts?

An FSA reimbursement form with required documentation will need to be submitted by fax (1-866-446-6090) or mail (P.O. Box 2797, Portland, OR 97208-2797) to PacificSource Administrators. If you wish, you can directly deposit your reimbursement check into a bank account.

The Prepaid Benefits Debit Card

PCC also offers the Wex Health Debit Card to those FSA participants who have a health care related expense account. The Wex Health Debit Card gives you an easy, automatic way to pay for qualified health care expenses not covered by your health insurance. The card is a special stored–value debit card that draws on the value of your annual FSA election amount. No PIN is needed, and there is no cash back option. Whenever you incur a qualified healthcare expense, you swipe your Wex Health Debit Card as you would a credit card. There is no cost to you for using the card. It will automatically be issued to you if you enroll in the health care related expense plan for 2023; however, you are not required to use the card. View more information on the Wex Health Debit Card.

How does FSA operate?

General rules
  1. Only expenses incurred on or after your FSA participation start date and prior to the end of the plan year are eligible for payment under the plan. Expenses must be incurred during your plan year to be eligible for reimbursement. “Incurred” means the date the service was rendered, not the date you paid the bill. In the cases of termination, participation ends?on the?last day of the month in which you terminate.
  2. Expenses for domestic partners and their children are not eligible for reimbursement since the federal government does not recognize domestic partnerships.
  3. You may submit claims incurred during your plan year for 90 days after the end of the plan year, March 31. Claims submitted beyond this “run out” period, following the end of the plan year will be ineligible for reimbursement.
  4. Once enrolled, you must remain a participant for the entire plan year unless a qualifying event occurs which may allow you to make an election change (see “When May I Enroll?”).
Use it or lose it

This is a key point you must understand: If you have set aside dollars through salary reduction, and you do not use those dollars for claims incurred by the end of the plan year, you will lose your money. Because of this, it is recommended that you be conservative in the amount you set aside, especially if this is your first time using the FSA accounts. Also, it’s worth noting that many medically-related, over-the-counter expenses can be reimbursed from the Health Care Account. If you’re ending up the plan year with money left over, check to see what over-the-counter products you could purchase to take full advantage of the money you’ve set aside.

Appeals

You may appeal a claim denial by submitting a Request for Review to PacificSource Administrators within 60 days after the earlier of the date of notice of your claim denial or the expiration of ninety (90) days after your claim was submitted. Contact a Benefits Specialist for more information (see below).

Additional information

The above summary is intended to highlight only the major benefit provisions of the FSA plan. It is not meant as a summary plan description for plan participants, nor does it intend to summarize the full provisions, limitations and exclusions of this plan. See the summary plan description for details regarding the operation of the FSA program.

Questions?

Check out the frequently asked questions or contact a Benefits Partner.