Who is an eligible dependent?
Under the Plan, only the expenses of a Participant, a Participant’s Spouse or a Participant’s Dependent qualify for pre-tax treatment.
A person will be considered the Spouse of a Participant if the Spouse and Participant are married for purposes of federal tax law. Under federal tax law, a couple will be treated as married if they were married in a state where their marriage was legal under the law of that state at the time it occurred, irrespective of whether they continue to reside in that state.
Relatives as Dependents
A Participant’s relative will be considered to be his or her Dependent if the Participant provided over
half of the relative’s financial support for the calendar year. If the relative is a child, grandchild, brother, sister, niece or nephew of the Participant who is under age 19 (age 24 in the case of a full-time student), it is not necessary for the Participant to have provided over half of the relative’s support if the relative lived with the Participant for more than half of the calendar year and the relative did not provide more than one-half of his or her own support.
A special rule applies to health insurance coverage and health care reimbursements for the children of divorced parents. The child of divorced or legally separated parents is considered to be a Dependent of both parents if both parents together provide more than 50% of the child’s support and have custody of the child for more than half the year.
Also, for purposes of health plan benefits, “Dependent” also includes any child of a Participant whose 27th birthday will not have occurred by the last day of the current calendar year, irrespective of whether the child satisfies any of the financial support or residency requirements.
Non-Relatives as Dependents
To qualify as a Dependent, a person who is not related to a Participant must:
1. receive over 50% of his or her financial support from the Participant for the calendar year;
2. have the same principal residence as the Participant for the entire calendar year;
3. and, be a member of the Participant’s household (which is not possible if their living together violates the law of the state where they live).
When can claims be submitted for reimbursement?
Claims can be submitted for reimbursement for qualified expenses incurred during the plan year. Each plan allows for a “run-out” period at the end of the plan year, which means that any claims incurred during the plan year can be submitted for reimbursement after the end of the plan year. These expenses MUST be for services performed during your plan year.
How do I receive my reimbursement money?
The quickest way to receive your money is by direct deposit to your personal checking or savings account. Direct deposit enrollment forms are available here. Once enrolled in a direct deposit, all deposits are made via direct deposit until P&A is otherwise notified. You can also receive your money via a check mailed to your home.
How do I get up-to-date account information?
Access your account balance and other information anytime, anywhere with our text message feature. Simply update your P&A account profile with your mobile number. Text "BAL" to the number 70626 and receive a text message with your account balance. You can also text "CLM" to the number 70626 to receive the status of your claims.
You can also log in to your P&A account to access your real- time account information or call our customer service department at (800) 688-2611 for your latest account information. This system is available in English and Spanish.
Important rules to know
Internal Revenue Service (IRS) regulations impose a series of mandatory rules enforced by the government on these accounts. FSAs are implemented to help enhance your benefits, not detract from them. Understanding IRS rules will enable you to take full advantage of these great tax-savings.
Once-a year election rule- Participants are only allowed to enroll in an account once a year, which is also known as the open enrollment period. During this time you decide how much money you wish to put in your account. Please note that participants cannot change their annual election amount after open enrollment unless they experience a qualifying event, which includes the following:
- a change in legal status (e.g., marriage, death of spouse, divorce, legal separation or annulment);
- a change in the number of dependents due to events such as birth or adoption;
- a termination or commencement of employment of a spouse or dependent; and,
- a change in the cost of dependent care expenses.
The annual election amount will be evenly divided over the course of a Plan year before taxes are withheld, thus increasing employees’ take-home pay.
Uniform coverage rule- this rule applies only to the Medical Expense Reimbursement Account. The uniform coverage rule states that your full election amount is available to you on the first day of your plan year. What exactly does this mean? This means you have access to ALL of your funds right away! The uniform coverage rule allows your Health FSA to work like a line of credit. Expenses can be covered upfront, making it easier to budget your finances, especially during tougher economic times.
Use-or-lose rule- under this IRS guideline you must use your full election amount by the end of the plan year. Any remaining balance in your account will be forfeited. However, the IRS recently relaxed this rule. Your employer now has the chance to adopt a new provision that will allow up to $500 in Health FSA funds to be carried forward to the next plan year.
We encourage participants to plan carefully how much money they put into their account. Be conservative when selecting your annual election amount. Only calculate expenses you anticipate incurring. This can include expenses such as co-payments for prescriptions, vision expenses, and dental work.