Medical flexible spending arrangement

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.

Am I eligible?

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.

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.

However, there is one exception. SEBB organizations can negotiate for their employees who work less than 630 hours to have SEBB benefits. But even if your organization does so, these employees are not eligible for a Medical FSA.

How can a Medical FSA help me?

The Medical FSA is an employer-sponsored benefit that 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.

What is the Medical FSA grace period?

This SEBB benefit has a grace period, which is a set time in which you can incur eligible expenses and spend any leftover funds from last year. 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. The grace period runs from January 1 through March 15 after the plan year is concluded. 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.

The grace period does not apply if you enroll in an HDHP with an HSA for the next plan year. If you enroll in this type of plan, 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.

How do I enroll in a Medical FSA?

You will enroll in the SEBB Medical FSA on the Navia Benefit Solutions website. Details will be available closer to the first annual open enrollment (October 1 through November 15, 2019). Paper enrollment forms will also be available to mail, fax, or email to Navia Benefit Solutions for processing.

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.

How much can I contribute?

IRS rules set the maximum you may contribute to a Medical FSA for each plan year.

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.

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.

What will happen to my existing Medical FSA funds?

We encourage you to use all of your funds in 2019. Doing so will minimize the risk that you will forfeit money. It may also lessen any confusion you might experience during the switch to the SEBB Program.

If your current Medical FSA offers:

  • Carryover (meaning your Medical FSA allows you to carryover up to $500 of unspent FSA funds into the next plan year). You will not be able to carry over any Medical FSA funds from the 2019 plan year to the 2020 plan year. You must spend your Medical FSA balance by December 31.
  • A grace period. You may still be able to take advantage of it (even if the grace period runs past December 31, 2019) depending on how your employer handles this transition. Please contact your payroll or benefits office to learn more.

What if I want to enroll in an HDHP with an HSA for 2020?

You cannot have a Medical FSA and a health savings account (HSA) at the same time. If you enroll in a high-deductible health plan (HDHP) with an HSA for 2020, and your current Medical FSA includes a grace period, you must spend all your funds and have all claims paid by December 31, 2019. If you do not, neither you nor your employer can contribute to your HSA until April 1, 2020.

Your unused 2019 FSA funds will not carry over into your SEBB HSA.