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. 

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.

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? 

For the 2023 plan year, you can contribute: 

  • A minimum of $120
  • Up to a maximum of $2,850

For the 2022 plan year, you can contribute:

  • A minimum of $120
  • Up to a maximum of $2,750

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.
  3. Divide that amount by the number of paychecks you will receive that year. This is how much will be deducted each pay period.

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.

How do I enroll?

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

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.
  • No later than 60 days after you or an eligible family member has a qualifying event that creates a special open enrollment.
  • During annual open enrollment: Visit the Navia Benefit Solutions website.

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.

Unused funds up to $570 will carryover to the next plan year. Any funds above $570 will be forfeited.

Note: Carryover will occur for the first time in January 2023.

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 $570 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 $570 remaining

A subscriber has $650 left in their Medical FSA on December 31 (over the $570 maximum that can be carried over). If they enroll in a Medical FSA, $570 of the $650 will carry over and be added to their Medical FSA election for the next plan year; the remaining $80 will be forfeited. If they do not enroll in an FSA, $570 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, $570 of the $650 will carry over and be added to their Limited Purpose FSA election for the next plan year; the remaining $80 will be forfeited.

If they do not enroll in an FSA, $570 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 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

The state's collective bargaining agreement says that represented employees whose rate of pay on November 1 results in an annual salary of $50,004 a year or less will receive a $250 Medical FSA contribution the following January.

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. It does not count against your annual maximum contribution.

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.

Keep in mind: You cannot receive this benefit if you enrolled in a CDHP with an HSA or waive PEBB medical coverage (except to enroll as a dependent on another PEBB account).

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 happened 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: 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