Updated June, 2018
N/A for Municipalities
How to enroll in the pre-tax HCSA and/or DCAP Program
New participants complete and return to your Payroll Coordinator the enrollment form. Forms and instructions are on the forms section of this site. For additional details, see the FSA page or contact ASIFlex at 1.800.659.3035. The next Open Enrollment will take place April 4 - May 2, 2018, for benefits effective July 1, 2018. Participants must re-enroll each year.
If you miss the spring Annual Enrollment
Employees that miss the Open Enrollment, must wait until next spring to enroll in FSA benefits, unless you have a qualifying status change. See the participant handbook and status change form for qualifying status change details.
The ASIFlex Card
The ASIFlex card provides a convenient method to pay for out-of-pocket health care expenses for you, your spouse and any tax dependents. The advantage of the card is that you do not have to pay with cash or a personal credit card. The card will allow you to pay the merchant or health care provider directly from your FSA health care account. Use of the card is optional and you can choose at each point of service if you want to use the card, the mobile app, file online, or file a traditional claim. The card is accepted at health care and certain retail providers that accept VISA®. It is not accepted at restaurants, gas stations, or department stores.
How to use the ASIFlex Card
The ASIFlex card can be used at health care providers who accept VISA®, and certain retail merchants that sell eligible health care products. At the point-of-sale, present the card and sign for a credit transaction or enter your PIN for a debit transaction. You may be subsequently required to provide supporting documentation to ASIFlex to show the actual date of service, patient name and a description of the service provided. It is important to retain itemized receipts and insurance carrier Explanation of Benefit (EOB) statements as documentation is required in many cases. See Additional Resources for necessary documentation details.
How to reactivate a temporarily deactivated ASIFlex Card
If a participant fails to provide required supporting documentation for an expense paid with the ASIFlex card, his/her Health Care FSA debit card(s) will be temporarily inactivated and new charges will be denied until the prior charge is substantiated. Be sure to submit substantiation promptly to avoid deactivation of your card. Once the charge in question is substantiated, the debit card will be activated. ASIFlex activates cards on a daily basis.
You must indicate your health plan when you enroll in FSA benefits
The IRS allows certain co-payments to be automatically approved without the need for backup documentation if it can be matched to the specific employer plan that you have enrolled in. Without this information, you will be required to provide backup documentation to substantiate the card transaction for co-payments. See Additional Resources for necessary documentation details.
When documentation is required to substantiate your ASIFlex card transactions
The IRS has very strict and specific rules regarding use of the ASIFlex card. Although copayments for your GIC health plan, certain over-the-counter health care products, and recurring expenses for dental or chiropractic care are generally not subject to back up documentation, the following items need substantiation and you will be required to provide it to ASIFlex upon request:
- Charges subject to your plan year deductible or coinsurance
- Physician, hospital or health care provider services other than copays
- Dental, vision and hearing devices expenses
- Copays paid under your spouse’s health plan.
If you are not a member of a GIC health plan, or a member of a GIC health plan and are accessing non routine services, such as Physical Therapy or Occupational Therapy; these HCSA-eligible copay charges are handled for the FSA Account
Your initial copayment with a provider (PCP, PT, etc.) will need to be substantiated with documentation verifying the expense. After the initial charge is substantiated, future identical charges (same provider/location and dollar amount) will be processed as a recurring charge and additional documentation will not be needed.
You will be notified if documentation is required in order to substantiate your ASIFlex card transaction
If documentation is required, ASIFlex will send a letter or email/text to explain what is needed. If you do not respond, a second and then a final and final request will be sent. If you fail to respond to these requests, as required by IRS regulations, the card will be temporarily inactivated. In order to re-activate your ASIFlex card, you must provide the documentation requested. If you are unable to substantiate the transaction, send a check in the stated amount to the plan.
How to provide documentation in order to substantiate an ASIFlex card transaction
If you receive a documentation request from ASIFlex or the quickest method is to login to your ASIFlex account and upload the documents. Or, include a copy of the ASIFlex request letter/message with your documentation and mail or fax the information to ASIFlex.
How to get an ASIFlex card
Health Care FSA participants automatically receive a set of two cards. You may order additional card sets for $5 and order forms are available at ASIFlex’s website. The cards will be mailed to your home address and arrive in a plain white envelope. Read the cardholder agreement and call to activate your card and select a PIN. If for any reason you decide that you do not want the card, please send a written request to cancel the card to ASIFlex.
How long the ASIFlex card is good for
A) As long as you re-enroll in benefits each year, the ASIFlex card will be effective until the expiration date shown on the card, which is generally five years. If you use all funds early in the plan year, hang on to the card as it will be re-loaded with future year election amounts.
The FSA grace period
The FSA grace period is a 2 ½ month period following the close of each plan year during which you may continue to incur expenses to be applied toward a previous plan year balance. For example, if on June 30, you have $450 remaining in your account, you may continue to incur expenses through September 15 to apply toward that balance.
Transportation expenses are eligible HCSA expenses
Transportation, parking, mileage, and related travel expenses that are essential to an employee or dependent receiving eligible care are reimbursable through the HCSA. See IRS Publication 502 under useful links on the ASIFlex website.
The age limit for dependent children for whom you may claim health care expenses
Dependent children are covered for HCSA expenses on the last day of the calendar year your dependent turns age 26 regardless of the dependent's residency, financial dependence, marital status, student status, or employment.
The $5,000 DCAP limit
The IRS limit of $5,000 (or $2,500 if married and filing separate tax returns) is per household, per calendar year.
The age limit for dependents covered under DCAP child care expenses
Dependent children under age 13 and older dependents who are not capable of self-care may qualify as your dependent. Refer to IRS Publication 503 for more information.
Qualifying providers of dependent care
Qualifying dependent care providers include daycare centers, preschool or nursery school, before/after school care, day camps or a private daycare provider. Note: Expenses for education and tuition for Kindergarten or higher grades are not qualifying expenses.
How to file a claim for FSA expenses
There are a variety of options for submitting FSA claims:
- ASIFlex Mobile App –File claims on-the-go anytime, from anywhere! Just snap a picture of your documentation and file your claim with the mobile app.
- ASIFlex Card – You can use the card for qualified health care expenses. Just present the card for payment at the point of sale; then submit documentation to ASIFlex upon request.
- ASIFlex Online – File your claims online by scanning your documentation, logging into your account, and filing your claim.
- Manual Submission – You can complete a claim form, attach documentation, and fax or mail these to ASIFlex.
Documentation that is required with your claim submission
Be sure to include the following information:
- Provider name/address
- Patient name
- Date the service/supply was provided, regardless of when it was paid
- Description of the service/supply
- Dollar amount paid for the service/supply
Acceptable forms of documentation include:
- For expenses covered under health, vision or dental insurance, the insurance payer's explanation of benefits (EOB) statement.
- For over-the-counter health care products the merchant receipt showing the merchant name, date, dollar amount, and product/service description
- For over-the-counter drugs/medicines your physician’s prescription and the merchant receipt as described above
- The provider's itemized statement showing the provider name/address, patient name, date service was provided, description of service and dollar amount
- For prescriptions, the pharmacy or mail-order receipt or a printout from your pharmacy
Examples of unacceptable claim documentation are:
- Cancelled checks
- Credit card receipts
- Statements that are not itemized and say "balance forward" or "previous balance due" or "paid on account"
- Statements for service that has not yet been provided (for example future dates of service)
- Pre-treatment estimates of services to be provided in the future
- Statements that do not include the date service was provided
- Statements that do not include the description of the service
- Statements that do not include the provider name, patient name and dollar amount you owe
How to change your FSA election amount during the plan year
IRS regulations stipulate that your elections remain in effect for the plan year unless you have a qualifying change in status. Examples of qualifying status changes are marriage, divorce, or birth or adoption of a child.
How to enroll in FSA benefits or change your election amount as a new employee or someone who has had a qualified status change
Enrollment forms or change forms must be completed and submitted to your Payroll Coordinator within 60 days of the qualifying status change.
How to update your address with ASIFlex
Send an email to ASIFlex. Include your name, employee ID number, your old address and your new address.
Going on paid leave of absence and how your FSA deductions will be made
If there is availability to take payroll deductions, those deductions and the program will continue through the end of the plan year.
How your Flexible Spending Account benefits are affected if you are a state employee going on an unpaid leave of absence
When you go on an unpaid leave of absence, you have three options for your Health Care Spending Account (HCSA) benefits:
- You may have the deductions for the unpaid leave taken on a pre-tax basis from the last paycheck prior to your leave providing there are sufficient funds for the deduction. When you elect this option, you may continue to submit HCSA claims for reimbursement and to use your HCSA debit card for eligible expenses during the unpaid leave of absence.
- You may decide not to contribute while on an unpaid leave of absence. When you choose this option, any claims submitted for reimbursement and any payments made with the HCSA debit card will be denied.
- You may choose to contribute to the HCSA account on an after tax basis. Be sure to notify your payroll coordinator and ASIFlex to set up this option. When you elect this option, you may continue to submit HCSA claims for reimbursement and use your HCSA debit card for eligible expenses during the unpaid leave of absence. However, there are no tax benefits with this option.
Expenses incurred while on the unpaid leave of absence are not eligible for Dependent Care Assistance Program (DCAP) reimbursement unless you are disabled and unable to care for a child.
What happens to your Flexible Spending Account (FSA) if you terminate employment or retire
If you leave state service during the FSA plan year, your participation in the Health Care Spending Account (HCSA) and Dependent Care Assistance Program (DCAP) will terminate as of midnight on the last date of your active employment.
Health Care Spending Account: Your Health Care Flexible Spending Account debit cards will be de-activated and you will only be able to submit claims for eligible health care expenses that were incurred on or before your last day of active employment. You have until October15 to submit claims for the Plan Year expenses. In order to use your HCSA account after you terminate state service, you may elect to continue to contribute to the HCSA account under COBRA by making direct payments on an after-tax basis. Your eligibility for HCSA COBRA will be determined by the plan administrator, ASIFlex. The amount billed to you by ASIFlex will include a 2% administrative fee.
DCAP: You may file claims for eligible dependent care expenses against your account balance for expenses you incur until your DCAP account is exhausted. Claims can be filed with dates of service through the end of the Plan Year. All claims must be filed by October 15.
Note: employees leaving state service cannot pre-pay or have a pre-tax deduction lump sum taken from their last check for the balance of their current year plan contribution.