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Medical Flexible Spending Arrangement (FSA)
The Medical Flexible Spending Arrangement (FSA) lets you 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 School Employees Benefits Board (SEBB) subscribers.
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We know 2020 probably didn't go as you planned. That's why we're offering you extra flexibility with your 2020 and 2021 Medical FSA funds. Learn more about these changes.
You are eligible if you meet criteria listed in Washington Administrative Code (WAC) 182-31-040. Generally, the Medical Flexible Spending Arrangement (FSA) is available to SEBB employees who are expected to work at least 630 hours during the school year.
School employees hired mid-year may also be eligible for a Medical FSA if they are expected to work at least 17.5 hours a week for six of the last eight weeks of the school year, and are expected to work 630 hours the next school year.
You cannot enroll in both a Medical FSA and UMP High Deductible.
The Medical FSA allows you to set aside pretax money from your paycheck to pay for out-of-pocket health care costs like deductibles, copays, coinsurance, dental, vision, and more. You can use your Medical FSA to pay eligible health care expenses for you, your spouse, or your qualified tax dependents, even if they are not enrolled on your SEBB account.
This SEBB benefit has a grace period, which is a set time in which you spend any leftover funds from last year on eligible expenses. We offer this grace period instead of the option to carry over funds to the next plan year.
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. 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.
However, if you enroll in UMP High Deductible, you must use all 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 1, the employer contributions from January through March (and the SmartHealth $125 wellness incentive, if you earned it) will be deposited into your HSA.
You can set up a Medical FSA account:
- No later than 31 days after the date you become eligible for SEBB benefits.
- During the SEBB Program’s annual open enrollment.
- No later than 60 days after you or an eligible family member has a qualifying event that creates a special open enrollment.
To enroll during the SEBB Program's annual open enrollment, visit the online portal on the Navia Benefit Solutions website. To enroll when you are first eligible, or due to a special open enrollment, submit the Midyear Enrollment Form to your payroll or benefits office.
You must enroll in a Medical FSA for each plan year you want to participate because your enrollment does not automatically continue year to year. If you want to enroll, make sure to elect this benefit again during each SEBB Program annual open enrollment.
IRS rules set the maximum you may contribute to a Medical FSA for each plan year. You can contribute a minimum annual amount of $240, up to a maximum annual amount of $2,750 for 2021.
To figure out how much you want to contribute, estimate your expenses for the plan year (January 1 through December 31) and enroll in 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.
You can start submitting reimbursement claims for eligible expenses on or after the first day of the plan year, January 1. The full amount you set aside for your annual Medical FSA contribution is available to spend on January 1. You may submit claims for services as often as you like, but not until after the services have been provided.
Note: Due to the COVID-19 pandemic, you may use unspent 2020 or 2021 Medical FSA funds after you leave employment, without enrolling in PEBB Continuation Coverage (COBRA). Learn more about this option.
For all other years, when your SEBB 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 Flexible Spending Arrangement. 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 SEBB Continuation Coverage (COBRA) or SEBB 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 year.
You can continue your Medical FSA election if the time between employment is 30 days or less and within the current plan year. Submit the School Employment 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 SEBB Medical FSA Termination form to your payroll or benefits office.