Medical Flexible Spending Arrangement (FSA)

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.

You cannot enroll in both a Medical FSA and a consumer-directed health plan (CDHP) with a health savings account (HSA) in the same year. If you do, 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.

You also cannot enroll in a Limited Purpose FSA and a Medical FSA in the same year.

How can a Medical FSA help me?

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.

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 do I enroll?

You can set up a Medical FSA account:

• No later than 31 days after the date you become eligible for PEBB benefits. Submit the Midyear Enrollment Form to your payroll or benefits office.
• During annual open enrollment. Visit the online portal on the Navia Benefits Solutions website.
• No later than 60 days after you or an eligible family member has a qualifying event that creates a special open enrollment. Submit the Midyear Enrollment Form to your payroll or benefits office.

University of Washington and Washington State University 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.

How much can I contribute?

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

• Online: Navia Benefit Solutions
• Mobile App: download for iPhone or Android
• Email: claims@naviabenefits.com
• Fax: 1-425-451-7002 or toll free 1-866-535-9227
• 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.

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 in January 2022.

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 2021, you have until March 15, 2022 to spend that $250. If you also receive this benefit in January 2022, 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 2022 or waived PEBB medical coverage (except to enroll as a dependent on another PEBB account) for 2022.

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 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.

Transferring to another agency to higher-education institution?

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.