Flexible Spending Arrangements (FSAs)

Flexible Spending Arrangements (FSAs) allow you to set aside pretax money from your paycheck to pay for out-of-pocket health care costs. Navia Benefit Solutions processes claims and provides customer service for the PEBB Program.

You must enroll in an FSA each year you want to participate. Enrollment does not automatically continue from plan year to plan year. 

Important information about FSAs

You cannot have both a Limited Purpose FSA and a Medical FSA, nor can you have a Medical FSA and be enrolled in a consumer-directed health plan (CDHP) with a health savings account (HSA).

  • If you enroll in both a Medical FSA and a consumer-directed health plan (CDHP) with a health savings account (HSA) in the same year, you will be automatically disenrolled from the Medical FSA.
  • If you have a CDHP with an HSA you can enroll in a Limited Purpose FSA for eligible dental and vision expenses.

Need to manage your FSA?

What are FSAs?

FSAs allow you to set aside pretax money from your paycheck to pay for out-of-pocket health care expenses. Setting aside a portion of your pay with an FSA reduces your annual taxable income. Your election will be deducted from your paycheck pre-tax throughout the plan year, so you don't pay FICA (7.65%) or federal income tax (up to 37%) on your elected dollars. Listen to the Fund Your Future DRS podcast episode: Save on healthcare costs with FSA and DCAP to learn more about FSAs. 

Two types of FSAs

The PEBB Program offers: a Medical FSA and a Limited Purpose FSA. The Medical FSA covers a wide range of health care expenses. The Limited Purpose FSA covers only dental and vision expenses. It is intended for employees enrolled in a consumer-directed health plan (CDHP) with a health savings account.

What is a Medical FSA?

The Medical FSA allows you to pay for out-of-pocket health care costs like deductibles, copays, coinsurance, medications, menstrual care products, dental care, vision services, and more (see eligible expenses).

You can use your Medical FSA to pay for expenses for you, your spouse, or your qualified tax dependents, even if they are not enrolled in your PEBB medical or dental plan.

What is a Limited Purpose FSA?

The Limited Purpose FSA allows you to pay for out-of-pocket dental and vision costs like glasses, contact lenses and solution, dentures, dental copays, orthodontia, and more (see eligible expenses).

You can use your Limited Purpose FSA to pay for dental and vision services for you, your spouse, or your qualified tax dependents, even if they are not enrolled in your PEBB medical or dental plan.

Am I eligible?

You are eligible if you are a PEBB benefits-eligible employee who works at a:

  • State agency.
  • Higher-education institution.
  • Community or technical college.

How much can I contribute?

2024
  • A minimum of $120
  • Up to a maximum of $3,050
2023
  • A minimum of $120
  • Up to a maximum of $2,850

To figure out how much you want to contribute:

  1. Estimate your health care expenses for the year.
  2. Enroll in an FSA for that amount (must be between $120 and $3,050).
  3. Navia will calculate the amount deducted from each paycheck based on the number of paychecks you will receive that year.

Calculate only your dental and vision expenses for the Limited Purpose FSA.

Keep in mind: You may be able to carry over some unspent funds into the following year.

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

Why is the IRS maximum contribution limit different from what HCA adopts?

The maximum contribution limit is set by the IRS, and the amount is usually announced in late fall after HCA's annual open enrollment begins. Due to the timing of the IRS announcement, HCA adopts an increased maximum contribution limit for the following plan year.

How do I enroll?

Note: University of Washington and Washington State University employees use Workday to enroll.

During open enrollment 

When you're first eligible for benefits

  • Submit the Midyear Enrollment Form to your payroll or benefits office no later than 31 days after the date you become eligible for PEBB benefits.

If you have a special open enrollment event

  • Submit the Change in Status Form to your payroll or benefits office no later than 60 days after you or an eligible family member has a qualifying event that creates a special open enrollment.

Reminder: You must enroll in an FSA for each plan year you want to participate. Enrollment does not automatically continue year to year. If you want to enroll, make sure to choose this benefit again during each open enrollment.

What is carryover?

If you have not spent all the funds in your FSA by December 31, and you are still employed and didn't lose eligibility for the FSA, you may be able to take advantage of the carryover feature, where certain unspent funds may "carry over" into the following year without affecting annual maximums.

To carryover your unspent funds:

  • You must enroll in either the Limited Purpose FSA or Medical FSA for the following year, or
  • Have at least $120 left in your FSA balance.

How much can I carry over to the next plan year?

2024

Unused funds up to $640 will carryover to the next plan year. Any funds above $610 will be forfeited to the HCA.

2023

Unused funds up to $610 will carryover to the next plan year. Any funds above $610 will be forfeited to the HCA.

Real-world carryover examples

Less than $120 remaining

A subscriber has $100 left in their Medical FSA on December 31 (less than $120 minimum). If they enroll in a Medical FSA, the $100 will carry over and be added to their Medical FSA for the next plan year.

If they enroll in a CDHP for the next plan year, they cannot enroll in a Medical FSA. However, if they enroll in a Limited Purpose FSA, the remaining $100 will carry over and be added to their Limited Purpose FSA for the next plan year.

If they do not enroll in an FSA for the next plan year, the $100 will be forfeited because it is below the $120 minimum.

Between $120 and $610 ($640 for 2024) remaining

A subscriber has $150 left in their Medical FSA on December 31 (between the carryover minimum and maximum amounts). If they enroll in a Medical FSA, the $150 will carry over and be added to their Medical FSA election for the next plan year. If they do not enroll in an FSA, the $150 will still carry over to establish a Medical FSA for their use in the next plan year.

If they enroll in a CDHP and a Limited Purpose FSA, the $150 will carry over and be added to their Limited Purpose FSA election for the next plan year.

If they do not enroll in an FSA, the $150 will still carry over to establish a Limited Purpose FSA for their use in the next plan year.

Over $610 ($640 for 2024) remaining

A subscriber has $650 left in their Medical FSA on December 31 (over the $610 [$640] maximum that can be carried over). If they enroll in a Medical FSA, $610 ($640) of the $650 will carry over and be added to their Medical FSA election for the next plan year; the remaining $40 ($10) will be forfeited. If they do not enroll in an FSA, $610 ($640) will still carry over to establish a Medical FSA for their use in the next plan year.

If they enroll in a CDHP and a Limited Purpose FSA, $610 ($640) of the $650 will carry over and be added to their Limited Purpose FSA election for the next plan year; the remaining $40 ($10) will be forfeited.

If they do not enroll in an FSA, $610 ($640) will still carry over to establish a Limited Purpose FSA for their use in the next plan year.

$250 CBA funds remaining

On December 31, a subscriber has $250 left in their Medical FSA (that was established by their collective bargaining agreement [CBA]). If they enroll in a Medical FSA, the $250 will carry over and be added to their Medical FSA election for the next plan year. If they do not enroll in an FSA, the $250 will still carry over to establish a Medical FSA for their use in the next plan year.

If they enroll in a CDHP and a Limited Purpose FSA, the $250 will carry over and be added to their Limited Purpose FSA election for the next plan year.

If they do not enroll in an FSA, the $250 will still carry over to establish a Limited Purpose FSA for their use in the next plan year.

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 email, fax, or mail to request reimbursement. You also can sign up for a debit card.

When can I submit them?

You can start submitting claims for eligible expenses on or after the first day of your plan year, January 1. The full amount you set aside for your FSA contribution is available on January 1.

Real-world example

You contribute $500 to your Medical FSA for the year. All $500 is available for you to use on January 1, even though the money has not yet been deducted from your paycheck. You may submit claims for services as often as you like, but not until after the services have been provided.

Are there deadlines?

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

Represented employees may receive a $250 Medical FSA benefit

If you are a represented employee, you might be eligible to receive a $250 Medical Flexible Spending Arrangement (FSA) contribution through your collective bargaining agreement. You are likely to receive this contribution if you meet all the following criteria:

  • You are a represented PEBB Program employee.
  • Your union is part of the health care Coalition described in RCW 41.80.020(3).
  • Your rate of pay on November 1, 2023 is $60,000 or less for a full-time equivalent position.
    • If you work part-time, you still may qualify for this contribution if your position as full-time would provide a salary of $60,000 or less. (The salary threshold was previously $50,004.) For example, if you earn $35,000 and works 20 hours per week, your full-time salary would be $70,000 and you would not qualify. Note: The salary threshold does not include overtime or bonuses.

You do not need to take any action to receive this $250 contribution, and it will not come out of your paycheck. It does not count against your annual maximum contribution.

If you are eligible for this benefit and already have a Medical FSA, Navia will add the funds to your existing account. If you do not have a Medical FSA, you will be enrolled and sent a Navia Benefits Debit MasterCard loaded with the $250. The debit card is sent in an unmarked envelope for your security.

If you have an FSA debit card, you will not receive a new one

If you have received the $250 contribution previously, you will not be sent a new debit card and can continue using the same debit card you already received. If you lost your debit card, contact Navia Benefit Solutions Customer Service at 1-800-669-3539, Monday through Friday, 5 a.m. to 5 p.m. Pacific Time to request a replacement debit card.

How are eligible employees notified about this benefit?

The Office of Financial Management (OFM) provides the PEBB Program the names and addresses of employees who are likely eligible for this benefit. The PEBB Program mails a letter to the likely eligible employees at the end of September. In February, Navia Benefit Solutions will send eligible employees a welcome letter.

What would make me not eligible to receive this benefit?

  • Your rate of pay on November 1 exceeds $60,000.
  • You enroll in a CDHP with an HSA (this limitation is an IRS rule because both FSAs and HSAs are tax-preferred benefits).
  • You waive PEBB medical coverage unless you waive to enroll as a dependent on someone else's PEBB medical plan that is not a CDHP with an HSA.
  • You are no longer eligible for PEBB medical coverage (you retire or terminate or lose coverage by the date the benefit is distributed).

Use and carryover

You are not required to use this benefit. Unspent funds from the previous plan year will carry over to the next plan year. See What is carryover for more information.

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 the Family and Medical Leave Act (FMLA) or military leave, you are no longer eligible to contribute to your FSA. Eligibility ends on the last day of the month you lose coverage or go on unapproved leave.

You will be able to claim expenses that were incurred only while you were employed, unless you are eligible to continue your FSA under PEBB Continuation Coverage. You must submit claims for reimbursement by March 31 the following year.

Transferring to another agency or higher-education institution

You can continue your FSA 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.

Contact

Navia Benefit Solutions
Online: Navia Benefit Solutions
Email: Navia customer service
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