Healthcare Flexible Spending
Original Implementation Date: 01/01/2009 | Plan Effective Date: 01/01/2024
Annual Election
Annual Election Amounts
Maximum: $3200
(up from $3,050 for 2023)
(up from $3,050 for 2023)
Minimum: $150
Fund Availability
Open Enrollment Election
Incur expenses beginning: 01/01
Last day to incur expenses: 12/31
Qualifying Life Event
Incur expenses beginning: 1st day of month following date of life event
Last day to incur expenses: Last day of same month of qualifying event
Unused Funds
Run-Out Period
Participants have up to 90-days after the plan year ends to submit claims for eligible expenses incurred during the plan year and within the grace period
Any unused funds remaining in the account not claimed by the end of the run-out period will be forfeited and used to offset the administrative cost of the program
Paycheck Processing
All contributions will be deducted from the employee's paycheck on a pretax basis.
Open Enrollment Election
The annual election amount will be divided into 10-equal installments deducted from the employee's January - June and September - December paychecks.
Qualifying Event Elections
The annual election amount will be divided into equal installments based on the total number of remaining pay periods in the 10-month cycle and deducted from those paychecks.
Eligible Uses
For Your Dependents
The IRS defines an eligible dependent for the Healthcare FSA as follows:
Your spouse
Adult children under the age of 27 as of the end of the calendar plan year
Other tax dependents who are physically or mentally incapable of self-care
Any other person who resides in your home for at least 6 months of the year and whom you claim as a dependent on your federal taxes
Dependents do not have to be enrolled on your District-sponsored insurance plan(s) to qualify for the FSA.
For Out-of-Pocket Expenses
Alternative medicine, including acupuncture & hydrotherapy
Chiropractic services
Contact lens solutions
Copays
Costs of medical care for an elderly person
Deductibles & coinsurance
Dental expenses & orthodontia
Diabetic supplies
Durable medical equipment
Eye exams & prescription eye wear
Hearing aids & batteries
Infertility services
Laser-eye surgery
Orthopedic shoes/braces
Over-the-counter medicines/supplies
Prescriptions
Special school costs for physically and/or mentally handicapped children
Speech therapy
Telephone-teletype, television adapters, or closed-caption services for the deaf
Tutor costs for children with learning disabilities
Weight loss for obesity
Using Your Account
Debit Card
Participating employees will receive a Inspira/ PayFlex debit Mastercard and may request a second debit card for their spouse / domestic partner.
Available for use at most locations that Mastercard is accepted.
System will determine if the item is an eligible expense
Use card to pay for eligible unreimbursed healthcare expenses
- Inactive: Claim documentation requested by Inspira/ PayFlex has not been received
- Insufficient Funds: The reimbursement amount requested exceeds your remaining balance
- Invalid Merchant: The card is only accepted at healthcare merchants as well as non-healthcare merchants who have implemented an Inventory Information Approval System required by the IRS
- Merchant Problem: The merchant may be experiencing a problem coding eligible expenses on their own terminal
Account Online
Participants will receive access to their FSA accounts online through Inspira/ PayFlex® to track claims and contributions, view plan information, access a list of eligible expenses, download forms, request replacement debit cards, and submit claims for reimbursement.
Qualifying Events
You may only change your election amount during the annual Open Enrollment period or within 30 calendar days of a qualifying event. You may request to change, revoke, or make a new plan election for the remainder of the current plan year. The election must comply with the IRS "consistency" rule and be necessary since the event affects coverage eligibility of the employee, spouse / registered domestic partner, or dependent.
Qualifying Events include:
Change in legal marital status
Marriage / divorce / legal separation / annulment / death of spouse or registered domestic partnerChange in number of tax dependents
Birth / adoption / deathChange in employment status that affects eligibility
Termination / commencement / strike / lock-out / return from unpaid Leave of AbsenceDependent satisfies or ceases to satisfy eligibility requirements
Reaching age limit / marriage / divorce / etc.Medicare / Medicaid entitlements
Entitlement: Can decrease or revoke electionLoss of Eligibility: Can start or increase electionContinuation Options
Resignation / Retirement / Unpaid Leave of Absence
If you have a remaining balance in your account, then you may choose between the following options:
Elect COBRA continuation
This requires you to pay the monthly deduction to the District on a post-tax basis.
Submit Claims
You may send in any claims for reimbursement that were incurred prior to your employment termination.
Family Medical Leave Act (FMLA) or California Family Rights Act (CFRA)
If you qualify and are approved for leave under the Family Medical Leave Act (FMLA) or the California Family Rights Act (CFRA), then you will have the following options:
Prepay
You can prepay through a payroll deduction for any available payroll and can continue participation in the plan while you are on leave. The election amount will not be adjusted.Pay-As-You-Go
You can pay the required contribution while on leave. The payment can be made on a post-tax (if in unpaid status) or pretax (if in paid status) basis. The annual election amount will not be adjusted and the employee can submit claims incurred while the employee is on leave.Catch-Up
You can increase your deduction for the remainder of the plan year after you return from leave. The annual election amount will not be adjusted, and the employee can submit claims incurred during the leave when they return to work.Cancel the FSA
Claims incurred while on leave will not be eligible for reimbursement.