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Flexible Spending Arrangements and Dependent Care Assistance Program

The SEBB Program provides Flexible Spending Arrangement (FSA) and Dependent Care Assistance Program (DCAP) benefits for SEBB organizations. Navia Benefits Solutions processes claims and provides customer service for these benefits.

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

The SEBB 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?

Employees who meet the eligibility criteria outlined in WAC 182-31-040 are eligible to participate in the Medical FSA, Limited Purpose FSA, and DCAP (WAC 182-31-060).

Employees eligible for SEBB benefits due to locally negotiated criteria are not eligible for the SEBB FSA and DCAP benefits (WAC 182-30-130).

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 SEBB medical, dental, or vision 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 totaling $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.

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 $550 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 Medical FSA page on the School 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 high deductible health plan (HDHP) with a health savings account (HSA). Enrolling in a Limited Purpose FSA with a HDHP 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 SEBB medical, dental, or vision 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 totaling $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 Limited Purpose FSA for the following plan year or have at least $120 left in their current year's balance. Any amount above $550 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 Limited Purpose FSA page on the School 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 only available once they have been deposited each month. Employees may 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 School employees website.

Administrative fees and responsibilities

The employer administrative fee for the Medical FSA, Limited Purpose FSA, and DCAP is included in the total funding rate paid to the SEBB Program by SEBB organizations for each eligible employee.

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

SEBB organization

  • Provide Medical FSA and DCAP enrollment forms and educational materials to their employees upon request. These materials can be downloaded and printed from Navia’s website.
  • Receive and process payroll deduction files from Navia.
  • Transmit FSA and/or DCAP payroll deduction detail information to SEBB My Account.
  • Forward actual dollars collected monthly from FSA and/or DCAP payroll deductions to designated Lockbox: HCA – SEBB FLEX
    PO BOX 84245
    Seattle, WA 98124-5545.
  • Provide all employee data needed to complete the annual IRS mandated nondiscrimination testing to Navia. 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.

Navia Benefit Solutions

  • Assist with enrollment activities by providing general information and customer support to employees on its website and toll-free phone number (1-800-669-3539).
  • Provide paper and online enrollment (via their website) during the SEBB Program annual open enrollment period.
  • Accept employees’ eligibility documentation from their employing SEBB organization.
  • Participate in several SEBB Program annual open enrollment benefit fairs sponsored by HCA.
  • Check employees’ enrollment forms and deduction amounts, and transmit the deduction amounts to SEBB My Account.
  • 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 HCA with monthly bank account reconciliations, annual forfeiture reports, and other reports as needed.

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 SEBB Program annual open enrollment information to all eligible employees.
  • Provide an FSA and DCAP summary in the Employee Enrollment Guide.
  • 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. HCA will pay any deficits that might occur from the FSA.
  • Schedule evaluation meetings, if appropriate, with employers to discuss Navia’s performance.

Enrolling or making changes

Employees may enroll in or make changes by submitting completed forms to their payroll or benefits office during the following timeframes as allowed pe WAC 182-30-100:

Newly eligible

  • No later than 31-days after an employee becomes eligible for SEBB benefits by completing the SEBB Midyear Enrollment form.
    • For employees whose first day of work is on or after September 1 but not later than the first day of school enrollment begins the first day of work for the new school year.
    • For employees whose first day of work is at any other time during the school year enrollment begins the first day of the month following the day the employee becomes eligible for SEBB benefits.
      • Exception: For employees who establish eligibility at any time in the month of August, enrollment begins on September 1 if the employee is also determined to be eligible for the employer contribution toward SEBB benefits for the school year that begins on September 1 (WAC 182-31-040).

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 OE Enrollment form to begin participation January 1 of the following year.

Annual open enrollment (OE)

  • No later than the last day of annual OE by going online to Navia’s portal at SEBB.naviabenefits.com or by using Navia's SEBB Open Enrollment form. Online enrollment and the OE 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 high deductible health plan (HDHP) 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 HDHP with an HSA and a Medical FSA will only be enrolled in the HDHP with a HSA.

Special open enrollment (SOE)

  • No later than 60 days after an eligible special open enrollment (SOE) event has occurred by completing the SEBB Change in Status form and must provide proof of the SOE event (SEBB Policy Addendum 45-2A).
    • The enrollment or change begins the first day of the month following the later of the event date or the date the form is received by the payroll or benefits office. 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 enrollment or change will begin the first day of the month in which the event occurs.

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 eligible 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 SEBB org’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 open enrollment 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.

Work with Navia directly if you have employee’s that do not receive 12 paychecks per year and need to adjust the per paycheck amount.

When an employee transfers from one SEBB organization to another, and transfers their FSA/DCAP benefit, 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 cancel participation or change their election amount unless a qualifying event creates a special open enrollment.

For more information, see the Accounting and training manual and the SEBB My Account Manual (chapter 2) on the Manuals webpage.

Loss of eligibility or ending employment

An employee is no longer eligible to participate in an FSA or DCAP account when they lose eligibility for the employer contribution toward SEBB benefits, although they may be eligible to continue participating in an FSA. There are no continuation options available for the DCAP.

Navia debit cards will be deactivated by the last day of the month in which an employee loses eligibility. After that, the employee may submit claims for reimbursement.

Medical FSA and Limited Purpose FSA

Employees enrolled in a Medical FSA or Limited Purpose FSA who end employment or retire during the plan year must complete and submit the SEBB FSA Termination form to their payroll or benefits office within 30 days of coverage ending.

The form requires that the employee choose one of the following options:

Stop participation: Employee declines to continue participation but retains access to their full election amount.

  • The full annual election may be claimed for expenses incurred before the SEBB benefits end date, which is the last day of the month in which the employee lost eligibility.
  • Claims may be submitted to Navia, up to the available account balance, through March 31 of the following plan year.
    • An employee’s account balance may include FSA contributions from their final paycheck.

Continue participation: Employee may continue participation through accelerated contributions or COBRA.

  • Accelerate contributions (if offered by SEBB organization)
    • Employee pays the remaining contributions for the plan year from their last paycheck.
    • Allows eligible expenses to be incurred through December 31.
    • Claims can be submitted to Navia through March 31.
  • COBRA: Continue payments post-tax
    • Available if employee has claimed less than they have contributed to the FSA.
    • Navia will mail a COBRA election notice to the employee.
      • Navia must receive the employee’s Navia COBRA election form no later than 60 days from the date SEBB benefits ended, or from the postmark date on the election notice, whichever is later.
    • Contributions paid directly to Navia for the rest of the plan year.

Dependent Care Assistance Program

Employees who terminate employment and have unspent DCAP funds, may continue to submit claims for eligible expenses as long as the expenses allow them to attend school full-time, look for work, or work full-time.

Expenses may be incurred through December 31. Claims may be submitted to Navia, up to the available account balance, through March 31 of the following plan year.

Transferring to another SEBB organization

Employees who enroll in an FSA or DCAP and later transfer to another SEBB organization, 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 School Employment Transfer form to the new SEBB org no later than 31 days after the first day of work.
    • SEBB organizations should set up payroll deductions before signing and submitting the form to Navia.

To learn more, see the FSA and DCAP enrollment guides available on Navia’s Forms and Documents webpage.

Contact

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