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HCA is closed Thursday, November 26 and Friday, November 27. All Apple Health (Medicaid), PEBB, and SEBB customer services phones lines will be down after 5 p.m. Wednesday, November 25 through Monday morning, November 30.

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.

Eligibility requirements

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 CDHP with a health savings account (HSA).

How a Medical FSA can help

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.

Enroll in a Medical FSA

To enroll or reenroll visit Navia Benefits Solutions.

Note: University of Washington employees must enroll through Workday.

Medical FSA participation is only valid for the plan year in which you enroll and does not continue automatically. You must enroll each year you want this benefit during the PEBB Program's annual open enrollment.

You can set up a Medical FSA account:

  1. No later than 31 days after the date you become eligible for PEBB benefits.
  2. During the PEBB Program’s annual open enrollment period (November 1 through 30).
  3. No later than 60 days after you or an eligible family member has a qualifying event that creates a special open enrollment.

Decide how much to contribute

You can contribute a minimum annual amount of $240, up to a maximum annual amount of $2,700 for 2020 or up to $2,750 for 2021.

To determine how much you want to contribute per pay period, estimate your expenses for the plan year and enroll in a Medical FSA for that amount. The money deducted from your pay is divided by the number of paychecks you will receive in the plan year.

For more help, use the Navia Benefit Solutions Tax Savings Calculator.

Submit Medical FSA claims

When you incur an eligible expense, you can submit a claim online, use the mobile app, or send a claim form by fax, mail, or email to request reimbursement. You also can sign up for a debit card.

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.

Represented employees may receive a $250 Medical FSA contribution

The collective bargaining agreement states 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.

Deadline to spend down your Medical FSA account

If you have not spent all of the funds in your Medical FSA by December 31, you may continue to incur eligible health care expenses through the grace period. The Medical FSA grace period ends March 15 of the following year.

You must submit all claims for reimbursement to Navia Benefit Solutions no later than March 31 after the end of the plan year. After that date, your account will be closed and any balance remaining will be forfeited to the Health Care Authority. Once the money is forfeited, you will not be able to claim it. This is referred to as the "use-it or lose-it" rule.

Contact

Navia Benefit Services
Online: pebb.naviabenefits.com
Email: customerservice@naviabenefits.com
Mobile App: download for iPhone or Android
Phone: 425-452-3500 or toll free 800-669-3539, Monday-Friday 5 a.m. to 5 p.m. (Pacific)
Mail: Navia Benefit Solutions, PO Box 53250, Bellevue, WA 98015-3250