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Flexible Spending Arrangements and Dependent Care Assistance Program

The Public Employees Benefits Board (PEBB) Program provides Flexible Spending Arrangement (FSA) and Dependent Care Assistance Program (DCAP) benefits for state agencies and higher education institutions, including community and technical colleges. Navia Benefits Solutions processes claims and provides customer service for these benefits.

Employees of PEBB participating employer groups are not eligible for the state's salary reduction plan (PEBB FSA and DCAP benefits) (WAC 182-12-116).

Access FSA and DCAP resources, including forms and documents.

Visit Navia's portal

What is a Flexible Spending Arrangement or the Dependent Care Assistance Program?

The PEBB Program's Medical Flexible Spending Arrangement (FSA), Limited Purpose FSA, and Dependent Care Assistance Program (DCAP) allow eligible employees to set aside money from their paychecks on a pretax basis to pay for qualified expenses each plan year (January 1-December 31).

Who is eligible?

Eligible employees of state agencies and higher education institutions, including community and technical colleges, and the State Board of Community and Technical Colleges are eligible to participate in the Medical FSA, Limited Purpose FSA, and DCAP (WAC 182-12-116).

For a summary of these benefits, click on each item below.

The Medical FSA allows employees to set aside pretax money to spend on eligible out-of-pocket medical expenses, including annual deductibles, copays, coinsurance, dental expenses and vision expenses. Employees may use Medical FSA funds for themselves and their qualified dependents, even if their dependents are not enrolled in a PEBB medical or dental plan.

The employee decides how much to contribute to their Medical FSA. They may set aside a minimum annual contribution of $120 up to an annual maximum contribution of $2,750 for the 2022 plan year. The amount deducted from an employee’s pay is the total annual election amount divided by the number of paychecks the employee will receive during the plan year.

The full amount elected is available on the first day of the month the employee’s benefits become effective.

  • For example: An employee elects to contribute an annual amount of $1,500. After two months of contributions, the employee incurs an eligible expense of $2,000. Even though the employee has not yet contributed the full amount, they can be reimbursed for $1,500.

Employees cannot have both a Medical FSA and a consumer-directed health plan (CDHP) with a health savings account (HSA) or both a Medical FSA and a Limited Purpose FSA in the same plan year.

$250 Medical FSA contribution for represented employees

The current collective bargaining agreement (CBA) states that represented employees whose rate of pay is $50,004 a year or less on November 1 of the previous year are eligible to receive a $250 Medical FSA contribution in January of the following year.

Eligible employees receive this employer-paid benefit even if they do not enroll in a Medical FSA. The contribution does not come out of the employee’s paycheck.

  • Navia will:
    • Open a Medical FSA account with the $250 and mail a debit card to the employee if the employee did not enroll in a Medical FSA for the plan year, or
    • Add the $250 to an employee’s existing Medical FSA debit card.

Employees will not receive this benefit if they waived PEBB medical (except to enroll on another PEBB account as a dependent) or if they enroll in a CDHP with an HSA for the next plan year.

To learn more about the $250 CBA contribution for represented employees, see the Medical FSA CBA Contribution FAQ , the Medical FSA Enrollment Guide, and visit the FSAs page on the public employees website.

Carryover and claim submission deadline

If all the funds in a Medical FSA have not been spent by December 31, and the employee is still eligible to participate, they may be able to take advantage of the carryover feature. That means certain unspent funds may carry over into the following year without affecting annual maximums.

To receive carryover, employees must enroll in a Medical FSA for the following plan year or have at least $120 left in their current year's balance. ​Any amount above $570 remaining in the account at the end of the plan year will be forfeited.

Employees must submit all claims to Navia Benefit Solutions for reimbursement by March 31 of the following plan year.

To learn more, see the Medical FSA Enrollment Guide and visit the Flexible Spending Arrangements page on the public employees website.

The Limited Purpose FSA allows employees to set aside pretax money to spend on eligible out-of-pocket dental and vision expenses. The Limited Purpose FSA is intended for employees who are enrolled in a consumer directed health plan (CDHP) with a health savings account (HSA). Enrolling in a Limited Purpose FSA while in a CDHP plan allows employees to save more of their HSA funds for medical expenses.

Employees may use Limited Purpose FSA funds for themselves and their qualified dependents, even if their dependents are not enrolled in a PEBB medical or dental plan.

The employee decides how much to contribute to their Limited Purpose FSA. They may set aside a minimum annual contribution of $120 up to an annual maximum contribution of $2,750 for the 2022 plan year. The amount deducted from an employee’s pay is the total annual election amount divided by the number of paychecks the employee will receive during the plan year.

The full amount elected is available on the first day of the month the employee’s benefits become effective.

  • For example: An employee elects to contribute an annual amount of $1,500. After two months of contributions, the employee incurs an eligible expense of $2,000. Even though the employee has not yet contributed the full amount, they can be reimbursed for $1,500.

Employees may not participate in a Limited Purpose FSA and a Medical FSA in the same plan year.

Carryover and claim submission deadline

If all the funds in a Limited Purpose FSA have not been spent by December 31, and the employee is still eligible to participate, they may be able to take advantage of the carryover feature. That means certain unspent funds may carry over into the following year without affecting annual maximums.

To receive carryover, employees must enroll in a Medical FSA for the following plan year or have at least $120 left in their current year's balance. ​Any amount above $570 remaining in the account at the end of the plan year will be forfeited.

Employees must submit all claims to Navia Benefit Solutions for reimbursement by March 31 of the following plan year.

To learn more, see the Limited Purpose FSA Enrollment Guide and visit the FSAs page on the Public employees website.

The Dependent Care Assistance Program (DCAP) reimburses qualifying childcare or elder care expenses. These expenses include babysitting, day care, elder day care, preschool, and registration fees while the employee works, is looking for work, or attends school full-time.

The employee decides how much to contribute to their DCAP account. They may set aside a minimum annual contribution of $120 up to an annual maximum contribution of:

  • $5,000 for a single person or married couple filing a joint income tax return
  • $2,500 for each married person filing separate income tax returns

DCAP funds are available once they have been deposited each month. Employees may only be reimbursed up to the dollar amount they have in their DCAP account at the time reimbursement is requested.

Employees may participate in a DCAP account and a Medical FSA or a Limited Purpose FSA in the same plan year.

Claim submission deadline

All eligible DCAP expenses must be incurred by December 31 (DCAP has no carryover feature). Employees must submit all claims for their DCAP account to Navia Benefit Solutions for reimbursement by March 31 of the following year.

Any funds remaining in the DCAP account after March 31 cannot be refunded and will be forfeited.

Employees who enrolled in DCAP for 2021 and have unspent funds, have until December 31, 2022, to incur expenses and submit claims against their 2021 DCAP funds. This extra 12 months is a leniency offered because of the ongoing effects of the COVID-19 pandemic.

To learn more, see the DCAP Enrollment Guide and visit the DCAP page on the public employees website.

Administrative fees and responsibilities

The employer administrative fee for the Medical FSA, collective bargaining agreement (CBA) medical FSA, Limited Purpose FSA, and DCAP is included in the total funding rate paid to the PEBB Program by the employer for each eligible employee.

The table below outlines the responsibilities of the employer, Navia Benefit Solutions, and the Health Care Authority (HCA).

Employer

  • Provide FSA and DCAP enrollment forms and educational materials to employees upon request. These materials can be downloaded and printed from the Navia's website.
  • Provide timely and accurate reconciliations of all employees’ eligibility and enrollment discrepancies upon Navia's request.
  • Participate in evaluation meetings held by HCA, if appropriate, to discuss Navia's performance.

State central payroll and higher-education payroll systems will:

  • Provide eligibility documentation related to employees directly to Navia.
  • Receive and process payroll deduction files from Navia.
  • Deposit actual dollars collected from an FSA and/or DCAP payroll deductions in account 165.
  • Transmit FSA and/or DCAP payroll deduction detail information to Navia.
  • Provide all employee data needed to complete the annual IRS mandated nondiscrimination testing to Navia.
Navia Benefit Solutions

 

  • Assist with enrollment activities by providing general information and customer support to employees on the Navia's website and toll-free phone number (1-800-669- 3539).
  • Provide paper and online enrollment (via their website) during the PEBB Program annual open enrollment period (November 1-30).
  • Accept employees’ eligibility documentation from their employers.
  • Check employees’ enrollment forms and deduction amounts, and transmit the deduction amounts to the appropriate payroll system for each employer.
  • Offer an FSA debit card (Navia Benefits Card) for participants to use when they incur qualifying expenses.
  • Offer fax numbers (1-425-451-7002 or toll-free 1-866-535-9227) to send claims and other correspondence.
  • Process and pay claims.
  • Provide the HCA with monthly bank account reconciliations, annual forfeiture reports, and other reports as needed.
  • Participate in several PEBB Program annual open enrollment benefit fairs sponsored by the HCA.

Health Care Authority

  • Manage the administration of the FSA and DCAP programs consistent with Chapter 41.05 RCW.
  • Communicate FSA and DCAP programs and the PEBB Program annual open enrollment information to all eligible employees.
  • Provide an FSA and DCAP summary in the Employee Enrollment Guide.
  • Determine annually the required CBA Medical FSA administrative fee to charge to higher education institution employers.
  • Pay to Navia the administrative fee in the contract between Navia and HCA.
  • Monitor monthly bank account reconciliations and annual forfeiture reports produced by Navia. The HCA will pay any deficits that might occur from the state’s FSA.
  • Schedule evaluation meetings, if appropriate, with employers to discuss Navia’s performance.

Enrolling or making changes

Employees may enroll in and FSA or DCAP or make changes by submitting forms to their payroll or benefits office during the following timeframes allowed per WAC 182-08-199:

Newly eligible

  • No later than 31-days after an employee becomes eligible for PEBB benefits by completing the PEBB Midyear Enrollment form.
    • Enrollment begins the first day of the month following the date the form is received by the payroll or benefits office. If that day is the first working day of the month, enrollment begins that day.

Employees whose benefits begin in the months of November or December may complete the Midyear Enrollment form to participate for the remaining months in the year and/or the PEBB Open Enrollment form to begin participation January 1 of the following year.

Annual open enrollment (OE)

  • No later than the last day of annual OE (November 1-30), by going online to Navia’s portal at pebb.naviabenefits.com or by using Navia's PEBB Open Enrollment form. Online enrollment and the Open Enrollment form are only available during open enrollment.
    • Enrollment begins January 1 of the following year.
    • Employees must enroll in these benefits each year during annual open enrollment.

Employees enrolled in a consumer-directed health plan (CDHP) with a health savings account (HSA) may enroll in a Limited Purpose FSA in the same plan year, but they cannot enroll in a Medical FSA. Employees who elect both a CDHP plan with an HSA and a Medical FSA will only be enrolled in the CDHP with an HSA.

Special open enrollment (SOE)

  • No later than 60 days after an eligible special open enrollment (SOE) event has occurred by completing the PEBB Change in Status form and must provide proof of the SOE event (PEBB Policy Addendum 45-2A).
    • The change begins the first day of the month following the event date or the date the form is received by the payroll or benefits office, whichever is later. If that day is the first of the month, the enrollment or change begins that day.
      • Exception: If the SOE is due to birth or adoption, or assuming legal obligation, the change will begin the first day of the month in which the event occurs. ​

Note: UW and WSU employees must enroll through Workday.

Processing enrollments and changes

When forms are received, verify that they have been received within the required timeframes and completed in full. An incomplete form may result in missed deductions or the employee may experience problems with accessing their FSA and/or DCAP benefits.

If a form is received after the enrollment window has ended, notify the employee that they will not be enrolled and of their right to appeal through the regular appeals process. To assist in drafting a denial notice, use this sample notification letter.

For forms received timely and completed in full:

  • Date-stamp the form(s) with the date received.
  • Complete the employer portion on the form(s).
  • Include a cover sheet with the enrollment form(s). Indicate on the cover sheet that the form was received timely and include the employer's contact information.
  • Email, fax or mail the cover sheet and form to Navia Benefit Solutions.

During annual open enrollment, send the forms to Navia Benefit Solutions on a weekly basis. Forms received after November 30 could result in denied enrollments.

Payroll deduction guidelines

The amount deducted from an employee’s pay is the total annual election amount divided by the number of paychecks the employee will receive during the plan year (January 1-December 31).

If an employee enrolls midyear, the amount deducted is the total annual election amount divided by the number of paychecks they will receive for the remainder of the plan year.

When an employee transfers from one PEBB employer to another, and continues their FSA/DCAP, the per-paycheck deductions can increase to meet the annual contribution amounts by the end of the plan year. A transfer is not a qualifying event to change FSA or DCAP elections.

Employees cannot end participation or change their election amount unless a qualifying event creates a special open enrollment.

Transferring to another state agency or higher-education institution

Employees who enroll in an FSA or DCAP and later transfer to another state agency or higher-education institution, may continue their enrollment in an FSA or DCAP if:

  • The employee will be benefits eligible in the new position, and
  • There is no more than a 30-day gap between employments, and
  • The employee submits the PEBB Agency Transfer form to the new employer no later than 31 days after the first day of work.
    • Employers should set up payroll deductions before signing and submitting the form to Navia.

Learn more by reviewing the FSA and DCAP enrollment guides available on Navia’s Forms and Documents webpage.

Contact

Navia Benefit Solutions designated account manager
Contact for benefits administrators only
Chelsea Allen
Email:
 ESTeam4@naviabenefits.com

Navia Benefit Solutions Customer Service
Phone:
425-452-3500
Toll free: 1-800-669-3539
Monday-Friday 5 a.m. to 5 p.m. (Pacific)

Navia Benefit Solutions forms submission
Email:
election@naviabenefits.com
Fax: 425-233-6366
Mail: Navia Benefit Solutions, PO Box 53250, Bellevue, WA 98015

Employee contacts are available on the Contact the Plans page located on the Public employees website.