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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. HCA contracts with Navia Benefit Solutions to process claims, and provide customer service for PEBB members.

Manage your Medical FSA

Visit Navia Benefit Solutions

Am I eligible?

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.

A Medical FSA is an employee benefit so, when your employment ends, you retire, or you go on unpaid leave that is not approved Family and Medical Leave Act (FMLA) or military leave, you can no longer contribute to your Medical FSA.

You cannot enroll in both a Medical FSA and a consumer-directed health plan (CDHP) with a health savings account (HSA).

What happens to my funds when coverage ends?

When your PEBB insurance coverage ends or you go on unpaid leave that is not approved under 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.

Continuation coverage through COBRA

A participant, their spouse, or qualified dependent may choose to continue the Medical FSA if one or more of the following qualifying events occur:

  • Death of the participant.
  • Termination of the participant’s employment (other than for gross misconduct) or a reduction in hours.
  • Divorce of the participant; or dissolution or termination of a state-registered domestic partnership with a domestic partner who qualified as a dependent.
  • A dependent child loses eligibility for PEBB insurance coverage.
  • A participant becomes enrolls in benefits under Medicare.

When any of these occur, you or a dependent must notify Navia Benefit Solutions. If, on the date of the qualifying event, your remaining benefits for the current year are greater than your remaining contribution payments, Navia Benefit Solutions will give each eligible dependent the right to choose Medical FSA continuation coverage. If you are eligible for this option, Navia Benefit Solutions will mail a COBRA election notice to you.

If you elect Medical FSA continuation coverage through Navia Benefit Solutions, you must do so no later than 60 days from the date the notice of continuation rights was mailed to you.

You may continue participating in the Medical FSA by making post-tax contributions directly to Navia Benefit Solutions for the remainder of the plan year. Participation in the Medical FSA would continue through December 31, or until you stop making the monthly contribution on the predetermined payment date. If you do not make a payment on time, you may submit claims only for expenses incurred through your last active month of paid participation.

You also cannot receive reimbursement from your Medical FSA if the date of service for the expense is during an unpaid work period when eligibility is lost. For example, if you lose eligibility starting July 1, you can only receive reimbursements for the rest of the plan year if:

  • You continue making contributions directly to Navia Benefit Solutions during the months of July through December, and
  • The dates of service for the expenses occur during the months you continue to contribute.

2021 plan year

If you maintain your Medical FSA contribution during continuation coverage through December 31, 2021, you will also have access to the grace period (January 1 to March 15) to incur expenses, and until the March 31 deadline to submit claims to Navia Benefit Solutions for your 2021 Medical FSA balance.

2022 plan year

If you maintain your Medical FSA contribution during continuation coverage through December 31, 2022 you have until until the March 31, 2023 deadline to submit claims to Navia Benefit Solutions.

What is carryover?

2022 plan year

For the 2022 plan year, you must incur all expenses by December 31, 2022 and submit all claims to Navia Benefit Solutions for reimbursement by March 31, 2023. If you are no longer employed or have retired and still have money left in your account, you can still submit claims for reimbursement by March 31, so long as the services took place while you were employed.

If you have not spent all the funds in your Medical FSA by December 31, 2022 — and you are still employed and remain eligible for the Medical FSA — you may be able to take advantage of the carryover feature. That means up funds may carry over into the following year without affecting annual maximums.

To receive carryover, you must enroll in either the Medical FSA or Limited Purpose FSA for the following year or have at least $120 left in your 2022 balance. Unused funds up to $550 will roll over to 2023. Any funds above $550 will be forfeited. Carryover will occur for the first time in January 2023.

2021 plan year

For 2021, the grace period still applies. The grace period is a set time in which you can spend any leftover funds from last year on eligible expenses.

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.

How much can I contribute?

  • In 2021, you can contribute a minimum annual amount of $240, up to a maximum annual amount of up to $2,750.
  • In 2022, you can contribute a minimum annual amount of $120, up to a maximum annual amount of up to $2,750. 

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.

How do I submit 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.

Contact

Navia Benefit Services
Online: Navia Benefit Solutions
Email: customerservice@naviabenefits.com
Mobile App: download for iPhone or Android
Phone: 425-452-3500 or toll free 1-800-669-3539, Monday-Friday 5 a.m. to 5 p.m. (Pacific)
Mail: Navia Benefit Solutions, PO Box 53250, Bellevue, WA 98015-3250