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Medical Flexible Spending Arrangement (FSA)
The Medical FSA allows you to set aside pretax money from your paycheck to pay for out-of-pocket health care costs. The Health Care Authority (HCA) contracts with Navia Benefit Solutions to process claims, and provide customer service for PEBB members.
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We know 2020 probably didn't go as you planned. That's why we're offering you extra flexibility with your 2020 and 2021 Medical FSA. Learn about these opportunities.
A Medical Flexible Spending Arrangement (FSA) is only offered to PEBB benefits-eligible employees who work at state agencies, higher-education institutions and community and technical colleges.
You cannot enroll in both a Medical FSA and a consumer-directed health plan (CDHP) with a health savings account (HSA).
The Medical FSA is an employer-sponsored benefit that allows you to set aside money from your paycheck on a pretax basis to pay for out-of-pocket health care costs like deductibles, copays, coinsurance, dental, vision, and more (See eligible expenses). You can use your Medical FSA to pay health care expenses for you, your spouse, or your qualified tax dependents, even if they are not enrolled in your PEBB medical or dental plan.
This benefit has a grace period, which is a set time in which you can spend any leftover funds from last year on eligible expenses. We offer this grace period instead of the option to carry over funds to the next plan year.
The Medical FSA plan year runs from January 1 through December 31 every year. Then, the grace period for that plan year runs from January 1 through March 15 of the following year. You must incur all expenses for the previous year by March 15, and submit all claims by March 31. Any funds not claimed by March 31 are forfeited to the Health Care Authority. Once the money is forfeited, you will not be able to claim it.
If you enroll in a CDHP with an HSA, you must use all of your Medical FSA funds and get reimbursed for your claims by December 31, the date before the new plan year begins. If you don’t, neither you nor your employer can contribute to your HSA until April 1. In April, the employer contributions from January through March (and the SmartHealth $125 wellness incentive, if you earned it) will be deposited into your HSA.
You can set up a Medical FSA account:
- No later than 31 days after the date you become eligible for PEBB benefits.
- During the PEBB Program’s annual open enrollment.
- No later than 60 days after you or an eligible family member has a qualifying event that creates a special open enrollment.
To enroll during the PEBB Program's annual open enrollment, visit the online portal on the Navia Benefits Solutions website. To enroll when you are first eligible, or due to a special open enrollment, submit the Midyear Enrollment Form to your payroll or benefits office. (University of Washington employees must enroll through Workday.)
You must enroll in a Medical FSA for each plan year you want to participate. Your enrollment does not automatically continue year to year. If you want to enroll, make sure to choose this benefit again during each open enrollment.
You can contribute a minimum annual amount of $240, up to a maximum annual amount of up to $2,750 for 2021.
To figure out how much you want to contribute, estimate your expenses for the plan year (January 1 through December 31) and enroll in a Medical FSA for that amount. Divide that amount by the number of paychecks you will receive that year to find out how much will be deducted each pay period.
For more help, use the Navia Benefit Solutions Tax Savings Calculator.
- Online: Navia Benefit Solutions
- Mobile App: download for iPhone or Android
- Email: email@example.com
- Fax: 425-451-7002 or toll free 866-535-9227
- Mail: Navia Benefit Solutions, PO Box 53250, Bellevue, WA 98015-3250
You can begin submitting reimbursement claims for eligible expenses on or after the first day of your plan year, January 1. The full amount you set aside for your Medical FSA contribution is available on the first day of the plan year for expenses. You may submit claims for services as often as you like, but not until after the services have been provided.
The state's collective bargaining agreement says that represented employees whose rate of pay on November 1, 2020 results in an annual salary of $50,004 a year or less will receive a $250 Medical FSA contribution in January 2021.
You will receive this employer-paid benefit even if you don’t enroll in a Medical FSA. This contribution will not come out of your paycheck.
If you are eligible for this benefit, Navia either sends you a debit card loaded with the $250, or they add the funds to your existing account and debit card.
If you received this benefit last year, in January 2020, you have until March 15, 2021 to spend that $250. If you also receive this benefit in January 2021, you will not receive a new debit card. Your existing debit card will be loaded with the new funds. If you have misplaced your debit card, call Navia Benefit Solutions at 1-800-669-3539.
Keep in mind: You cannot receive this benefit if you enrolled in a CDHP with an HSA for 2021 or waived PEBB medical coverage (except to enroll as a dependent on another PEBB account) for 2021.
When your PEBB insurance coverage ends or you go on unpaid leave that is not approved under the Family and Medical Leave Act (FMLA) or military leave, you are no longer eligible to contribute to your Medical FSA. Eligibility ends on the last day of the month of loss of coverage or unapproved leave. You will be able to claim expenses incurred while employed, only up to your available funds, unless you are eligible to continue your Medical FSA coverage under PEBB Continuation Coverage (COBRA) or PEBB Continuation Coverage (Unpaid Leave), through Navia Benefit Solutions. Claims may be submitted up to your account balance and must be submitted to Navia Benefit Solutions by March 31 of the following plan year.
You can continue your Medical FSA or DCAP election if the time between employment is 30 days or less and within the current plan year. Submit the PEBB Agency Transfer form to your new employer’s payroll or benefits office no later than 31 days after your first day of work. If you end employment or retire during the year, submit the PEBB Medical FSA Termination form to your payroll or benefits office.