Colonial Life

• File A Claim
• Colonial Service Guide for Policy Holders
• Colonial Service Forms
• GTL Employee Assistance Program
• GTL Life Planning Services
  (Organization Name: ColonialLife-LifePlanning)

Dental

• MetLife Dental Forms 
• MetLife Contact Information 
• MetLife Provider Search 

Vision

• Superior Contact Information 
• Superior Provider Search 
• Superior Discounts 

Pet Insurance

• Nationwide Pet Insurance

Legal

• Legal Resources Website 

Student Loan Assistance Program

• Gradfin Enrollment Portal

Flex Accounts

• Ameriflex Spending Account Claim Form 
• Ameriflex Contact Information 
• Ameriflex Member Login / Check Your Balance 
• Mobile App Download: Apple App Store | Google Play Store 
• The FSA Store 
• The FSA Store Contact Information 
• The FSA Store Eligibility List 

 

Employee Assistance Program (EAP)

The Health Advocate Employee Assistance Program (EAP), available through your Colonial Life Group Term Life Insurance, offers confidential, short-term counseling from Licensed Professional Counselors for a full range of personal issues and achieving a healthy work/life balance across the life span. In a crisis, emergency help is available 24/7.

– Stress, anxiety, depression

– Relationship, family, parenting issues

– Substance Abuse

– Anger, grief, loss

– Life transitions

– Referrals for additional treatment, as needed

888-645-1772  |   ColonialLife.com/EAP

Work/Life Planning Services

The Health Advocate work/life services, available through your Colonial Life Group Term Life Insurance, offers financial and legal counseling services, as well as grief support and referral for up to 12 months after a claim.

877.240.6863   |   HealthAdvocate.com/members  (Organization Name: ColonialLife-LifePlanning)

FLEX SPENDING WITH ZERO GUESSWORK

Your Health, Your Funds, Your Choice

Take control of your health and wellness with guaranteed FSA-eligible essentials. Pierce Group Benefits partners with the FSA Store to provide one convenient location for Flexible Spending Account holders to manage and use their FSA funds, and save on more than 4,000 health and wellness products using tax-free health money. Through our partnership, we’re also here to help answer the many questions that come along with having a Flexible Spending Account!

– The largest selection of guaranteed FSA-eligible products

– Phone and live chat support available 24 hours a day / 7 days a week

– Fast and free shipping on orders over $50

– Use your FSA card or any other major credit card for purchases

Other Great FSA Store Resources Available To You

– Eligibility List: A comprehensive list of eligible products and services

– FSA Calculator: Estimate how much you can save with an FSA

– Learning Center: Easy tips and resources for living with an FSA

– Savings Center: Where you can save even more on FSA-eligible essentials

– FSAPerks: Take your health and funds further with the FSA Store rewards program

 

Shop FSA Eligible Products Through Our Partnership with The FSA Store!

BONUS: Get $20 off any order of $150+ with code PGB20FSA (one use per customer).

 

NEED HELP? WE’VE GOT YOU COVERED!

FSA Store Customer Service

FSA Store Frequently Asked Questions

Online Account Instructions

How to Access Your Ameriflex Account:

Go to MyAmeriflex.com and click “Login” from the upper right hand corner. When prompted, select “Participant.”

How to Register Online For Your Ameriflex Spending Account:

Click the register button atop the right corner of the home screen.

1. As the primary account holder, enter your personal information.
   – Choose a unique User ID and create a password (if you are told that your username is invalid or already taken, you must select another).
   – Enter your first and last name.
   – Enter your email address.
   – Enter your Employee ID, which in most cases, will be the account holder’s Social Security Number(no dashes or spaces needed).
2. Check the box if you accept the terms of use.
3. Click ‘register’. The process may take a few seconds. Do not click your browser’s back button or refresh the page.
4. Last, you must complete your Secure Authentication setup. Implemented to protect your privacy and help us prevent fraudulent activity, setup is quick and easy. After the registration form is successfully completed, you will be prompted to complete the secure authentication setup process:
   Step 1: Select a Security Question option, and type in a corresponding answer.
   Step 2: Repeat for the following three Security Questions, then click next.
   Step 3: Verify your email address, and then click next.
   Step 4: Verify and submit setup information.
5. The registration process is complete! Should you receive an information error message that does not easily guide you through the information correction process, please feel free to contact our dedicated Member Services Team at 888.868.FLEX (3539).

After registering, you can log into your account to:

– Check your balance

– Order replacement cards

– Submit claims for reimbursement

– Update your reimbursement method, and more…

Want to Manage Your Account on the go?

Download the MyAmeriflex mobile app, available through the App Store or Google Play. This is the quickest and easiest way to access your account on the go. The mobile app offers the same functionality as your online account.

Your credentials for the MyAmeriflex Portal and the MyAmeriflex Mobile App are the same; there is no need for separate login information!

Using Your Ameriflex Card

You’ll receive a Mastercard debit card linked to your Ameriflex account that can be used to pay for eligible expenses. If you have more than one account, such as a flexible spending account and dependent care account, your card is linked to both accounts and knows which funds to pull from when you make a purchase. If you lose your card, you can request a complimentary replacement by logging into your Ameriflex account or the Ameriflex mobile app.

Eligible Expenses

Before you make a purchase, it’s important to verify that the expense is eligible under the rules of your plan. Spending and saving accounts reimburse specific expenses unique to those accounts. Visit our Help Center for more information about eligible expenses.

Help Center and Support

Your satisfaction is our top priority, and our team of experts are ready to help whenever you need it. The Help Center is the best place to go for quick answers to your questions and more information about your account. You can access the Help Center at myameriflex.com/HelpCenter.

The Ameriflex Participant Services team is available Monday – Friday: 7:00 AM to 8:00 PM CST and Saturday: 9:00 AM to 1 :00 PM CST.

Call: 888.868.3539
Email: service@myameriflex.com
Live Chat: myameriflex.com

Set aside tax-free money for daycare and dependent care services.

Use the below information to determine if a Dependent Care Account (DCA) is right for you and how to best take advantage of a DCA account.

How It Works

When you enroll in a Dependent Care Account (DCA) you get to experience tax savings on expenses like daycare, elderly care, summer day camp, preschool, and other services that allow you to work full time.

The Value & Perks

– Save On Eligible Expenses: You can use a DCA to pay for qualifying expenses such as daycare, summer day care, elder care, before and after school programs, and pre-school.

– Keep More Money: The funds are taken out of your paycheck “pre-tax” (meaning they are subtracted from your gross earnings before taxes) throughout the course of the year. Let’s say you earn $40,000 a year and contribute $1,500 to an DCA; so, only $38,500 of your income gets taxed. That means you are increasing your take-home pay simply by participating!

– Easy Spending and Account Management: You will receive an Ameriflex Debit Mastercard linked to their DCA. They can use their card for eligible purchases everywhere Mastercard is accepted. Account information can be securely accessed 24/7 online and through the mobile app.

Eligible DCA Expenses

The IRS determines what expenses are eligible under a DCA. Here are some examples of common eligible expenses:

– Daycare or elder care

– Before-school and after-school care

– Preschool and nursery school

– Private sitter

– Summer day camp

– Nanny service

For a full list of eligible expenses, go to myameriflex.com/eligibleexpenses.

An account for setting aside tax-free money for healthcare expenses.

Use the below information to determine if a Flexible Spending Account (FSA) is right for you and how to best take advantage of an FSA account.

How It Works

When you enroll in a Flexible Spending Account (FSA) you get to experience tax savings on qualified expenses such as copays, deductibles, prescriptions, over-the-counter drugs and medications, and thousands of other everyday items.

Can I have an FSA and an HSA?

You can’t contribute to an FSA and HSA within the same plan year. However, you can contribute to an HSA and a limited purpose FSA, which only covers dental and vision expenses.

As per IRS Publication 969, an employee covered by an HDHP and a health FSA or an HRA that pays or reimburses qualified medical expenses generally can’t make contributions to an HSA. An employee is also not HSA-eligible during an FSA Grace Period. An employee enrolled in a Limited Purpose FSA is HSA-eligible.

As a married couple, one spouse cannot be enrolled in an FSA at the same time the other is contributing to an HSA. FSA coverage extends tax benefits to family members allowing the FSA holder to be reimbursed for medical expenses for themselves, their spouse, and their dependents.

The Value & Perks

– Election Accessibility: You will have access to your entire election on the first day of the plan year.

– Save On Eligible Expenses: You can save up to 40% on thousands of eligible everyday expenses such as prescriptions, doctor’s visits, dental services, glasses, over-the-counter medicines, and copays.

– Keep More Money: The funds are taken out of your paycheck “pre-tax” (meaning they are subtracted from your gross earnings before taxes) throughout the course of the year. Let’s say you earn $40,000 a year and contribute $1,500 to an FSA; so, only $38,500 of your income gets taxed. That means you are increasing your take-home pay simply by participating!

– Easy Spending and Account Management: Employees will receive an Ameriflex Debit Mastercard linked to their FSA. Employees can use their card for eligible purchases everywhere Mastercard is accepted. Account information can be securely accessed 24/7 online and through the mobile app.

Eligible FSA Expenses

The IRS determines what expenses are eligible under an FSA. Below are some examples of common eligible expenses:

– Deductibles

– Copays

– Prescriptions

– Teeth cleaning

– LASIK

– Glasses and contact lenses

– Band-aids

– Sunscreen

– Over-the-counter medicine (prescription required)

– Feminine menstrual care

For a full list of eligible expenses, go to myameriflex.com/eligibleexpenses.

The “Use-or-Lose” Rule

If you contribute dollars to a reimbursement account and do not use all the money you deposit, you will lose any remaining balance in the account at the end of the eligible claims period. This rule, established by the IRS as a component of tax-advantaged plans, is referred to as the “use-or-lose” rule.

To avoid losing any of the funds you contribute to your FSA, it’s important to plan ahead as much as possible to estimate what your expenditures will be in a given plan year.

HELPFUL TIPS:

– If you are a new employee and unable to log into the online system, please speak with the Benefits Representative assigned to your location, or contact Human Resources.

– If you are an existing employee and unable to log into the online system, please contact the Harmony Help Desk at 866-875-4772 between 8:30am and 6:00pm, or speak with the Benefits Representative assigned to your location.

COMPLETE THE STEPS BELOW TO BEGIN THE ENROLLMENT PROCESS: 

1. Go to: https://harmonyenroll.coloniallife.com
– Enter your User Name: RAN7L4X- and then Last Name and then Last 4 of Social Security Number (RAN7L4X-SMITH6789)
– Enter your Password: Four digit Year of Birth and then Last 4 of Social Security Number (19766789)
Your password must have: 1 lowercase letter, 1 uppercase letter, 1 number, and 8 characters minimum.
Your password cannot include: first name, last name, spaces, special characters (such as ! $ % &), or User ID.

2. The screen prompts you to create a NEW password [__________].

3. Choose a security question and enter answer [__________].

4. Click on ‘I Agree’ and then ‘Enter My Enrollment’.

5. The screen shows ‘Me & My Family’. Verify that the information is correct and enter the additional required information (title, marital status, work phone, e-mail address). Click ‘Save & Continue’ twice.

6. The screen allows you to add family members. It is only necessary to enter family member information if adding or including family members in your coverage. Click ‘Continue’.

7. The screen shows updated personal information. Verify that the information is correct and make changes if necessary. Click ‘Continue’.

8. The screen shows ‘My Benefits’. Review your current benefits and make changes/selections for the upcoming plan year.

– HEALTH CARE FSA: Enter annual amount. MAX $3,050/year

– DEPENDENT CARE FSA: Enter annual amount. MAX $5,000/year

– DENTAL: You may enroll online in Dental coverage.

– VISION: You may enroll online in Vision coverage.

– GROUP TERM LIFE: You may enroll online in Group Term Life coverage.

– LEGAL PLAN: You may enroll online in Legal coverage.

– CANCER ASSIST
You may enroll online in Cancer Assist coverage.

– DISABILITY – EDUCATOR DISABILITY ADVANTAGE (EDA1100)
You may enroll online in EDA1100 coverage.

– ACCIDENT 1.0
You may enroll online in Accident 1.0; however, persons over age 64 applying for coverage and employees wishing to purchase an individual policy for their spouse should speak with the Benefits Representative.

– MEDICAL BRIDGE
You may enroll online in Medical Bridge coverage.

– CRITICAL ILLNESS 6000
You may enroll online in Critical Illness 6000 coverage.

– TERM LIFE 5000
You may enroll online in Term Life 5000; however, employees wishing to purchase an individual policy for their spouse should speak with the Benefits Representative.

– WHOLE LIFE 5000 Plus
You may enroll online in Whole Life 5000 Plus; however, employees wishing to purchase an individual policy for their spouse should speak with the Benefits Representative.

9. Click ‘Finish’.

10. Click ‘I Agree’ to electronically sign the authorization for your benefit elections.

11. Click ‘Print a copy of your Elections’ to print a copy of your elections, or download and save the document. Please do not forget this important step!

12. Click ‘Log out & close your browser window’ and click ‘Log Out’.

IN-PERSON

During your open enrollment period, a Pierce Group Benefits representative will be available by appointment to answer any questions you may have and to assist you in the enrollment process.

ONLINE

You may enroll or make changes online to your flexible benefits plan. To enroll online, please visit: https://harmonyenroll.coloniallife.com

ENROLLMENT PERIOD: MARCH 20, 2023 – MARCH 24, 2023

YOU CAN MAKE THE FOLLOWING BENEFIT ELECTIONS ONLINE DURING THE ENROLLMENT PERIOD:

– Enroll/Re-Enroll in Flexible Spending Accounts⁺ (Medical Reimbursement and Dependent Care).

– Enroll in, change or cancel Dental Insurance.

– Enroll in, change or cancel Vision Insurance.

– Enroll in, change or cancel Group Term Life Insurance.

– Enroll in, change or cancel your Legal Select plan.

– Enroll in, change or cancel Colonial coverage.

⁺You will need to re-enroll in the Flexible Spending Accounts if you want them to continue each year.

ACCESS YOUR BENEFITS ONLINE WHENEVER, WHEREVER.

You can view details about your benefits, view educational videos about all of your benefits, download forms, chat with one of our knowledgeable Service Center Specialists, and more on your personalized Pierce Group Benefits website. Our website is also mobile friendly, making it easy to view your plan information on the go!

IMPORTANT NOTE & DISCLAIMER

This is neither an insurance contract nor a Summary Plan Description and only the actual policy provisions will prevail. All information in this booklet including premiums quoted is subject to change. All policy descriptions are for information purposes only. Your actual policies may be different than those in this booklet.

Pre-Tax Benefits

Flexible Spending Accounts: Ameriflex
– Medical Reimbursement Maximum: $3,050/year
– Dependent Care Reimbursement Maximum: $5,000/year
You will need to re-enroll in the Flexible Spending Accounts if you want them to continue next year.
IF YOU DO NOT RE-ENROLL, YOUR CONTRIBUTION WILL STOP EFFECTIVE JUNE 30, 2023.

Dental Insurance: MetLife

Vision Insurance: Superior

Cancer Benefits: Colonial Life

Accident Benefits: Colonial Life

Medical Bridge Benefits: Colonial Life

 

Post-Tax Benefits

Disability Benefits: Colonial Life

Critical Illness Benefits: Colonial Life

Life Insurance: Colonial Life
– Term Life Insurance
– Whole Life Insurance
– Group Term Life Insurance (Including EAP + Work/Life Programs)

Pet Insurance: Nationwide

Legal Select Plan: Legal Resources

 

Additional Benefits

Student Loan Assistance Program: GradFin

 

Please note your insurance products will remain in effect unless you speak with a representative to change them.

 

Enrollment Period: MARCH 20, 2023 – MAY 24, 2023

Effective Dates: JULY 1, 2023 – JUNE 30, 2024

 

QUALIFICATIONS:

– Employees must work 30 hours or more per week.

IMPORTANT FACTS:

– The plan year for Colonial Insurance products, Spending Accounts, MetLife Dental, Colonial Group Term Life, Superior Vision, and Legal Resources Legal Select Plan lasts from July 1, 2023 through June 30, 2024.

– Deductions for MetLife Dental will begin June 2023. Deductions for Colonial Insurance products, Spending Accounts, Colonial Group Term Life, Superior Vision, Nationwide Pet Insurance, and Legal Resources Legal Select Plan will begin July 2023.

– Your Group Term Life coverage includes Health Advocate Employee Assistance + Work/Life Programs. An Employee Assistance Program (EAP) offers confidential support and resources for personal or work-related challenges and concerns. Please see the Group Term Life pages of this benefit booklet for more details and contact information.

– If signing up for any coverage on your spouse and/or children, please have their dates of birth and social security numbers available when speaking with the Benefits Representative.

– If you will be receiving a new debit card, whether you are a new participant or to replace your expired card, please be aware that it may take up to 30 days following your plan effective date for your card to arrive. Your card will be delivered by mail in a plain white envelope. During this time you may use manual claim forms for eligible expenses. Please note that your debit card is good through the expiration date printed on the card.

– Elections made during this enrollment period CANNOT BE CHANGED AFTER THE ENROLLMENT PERIOD unless there is a family status change as defined by the Internal Revenue Code. Examples of a family status change are: marriage, divorce, death of a spouse or child, birth or adoption of a child, termination or commencement of a spouse’s employment, or the transition of spouse’s employment from full-time to part-time, or vice-versa. Once a family status change has occurred, an employee has 30 days to notify the North Carolina Service Center at 1-888-662-7500 to request a change in elections.

– Flexible Spending Account expenses must be incurred during the Plan Year in order to be eligible for reimbursement.

– An employee has 3 months after the plan year ends to submit claims for spending account expenses that were incurred during the plan year. Please note that if employment terminates during the plan year, that employee’s plan year ends the day employment ends. The employee has 3 months after the termination date
to submit claims.

– With Dependent Care Flexible Spending Accounts, the maximum reimbursement you can request is equal to the current account balance in your Dependent Care account. You cannot be reimbursed more than has actually been deducted from your pay.

– As a married couple, one spouse cannot be enrolled in a Medical Reimbursement FSA at the same time the other opens or contributes to an HSA.

– The Colonial Cancer plan and the Health Screening Rider on the Colonial Accident and Colonial Medical Bridge plan have a 30-day waiting period for new enrollees. Coverage, therefore, will not begin until July 31, 2023.

– Additionally, some policies may include a pre-existing condition clause. Please read your policy carefully for full details.

– Please be aware there are certain coverages that may be subject to federal and state tax when premium is paid by pretax deduction or employee contribution.

– An employee taking a leave of absence, other than under the Family & Medical Leave Act, may not be eligible to re-enter the Flexible Benefits Program until the next plan year. Please contact your Benefit Administrator for more information.

Health

• Anthem Contact Information 
• Anthem Provider Search 
• Sydney Health App Download 
• Privacy Notice 
• Marketplace Notice 
• Women’s Health and Cancer Notice 
• Adverse Benefit Determination Notice 

Colonial Life

• File A Claim 
• Colonial Service Guide for Policy Holders 
• Colonial Service Forms 

Dental

• Delta Dental VA Contact Information 
• Delta Dental VA Provider Search / Member Login 
• Mobile App Download: Apple App Store | Google Play Store 

Vision

• Superior Contact Information 
• Superior Provider Search 
• Superior Discounts 

Student Loan Assistance Program

• Gradfin Enrollment Portal

Flexible Spending Accounts

• Flexible Benefits Administrators Contact Information 
• Flexible Benefits Administrators Member Login / Check Your Balance 
• Mobile App Download: Apple App Store | Google Play Store 
• The FSA Store 
• The FSA Store Contact Information 
• The FSA Store Eligibility List 

FLEX SPENDING WITH ZERO GUESSWORK

Your Health, Your Funds, Your Choice

Take control of your health and wellness with guaranteed FSA-eligible essentials. Pierce Group Benefits partners with the FSA Store to provide one convenient location for Flexible Spending Account holders to manage and use their FSA funds, and save on more than 4,000 health and wellness products using tax-free health money. Through our partnership, we’re also here to help answer the many questions that come along with having a Flexible Spending Account!

– The largest selection of guaranteed FSA-eligible products

– Phone and live chat support available 24 hours a day / 7 days a week

– Fast and free shipping on orders over $50

– Use your FSA card or any other major credit card for purchases

Other Great FSA Store Resources Available To You

– Eligibility List: A comprehensive list of eligible products and services

– FSA Calculator: Estimate how much you can save with an FSA

– Learning Center: Easy tips and resources for living with an FSA

– Savings Center: Where you can save even more on FSA-eligible essentials

– FSAPerks: Take your health and funds further with the FSA Store rewards program

 

Shop FSA Eligible Products Through Our Partnership with The FSA Store!

BONUS: Get $20 off any order of $150+ with code PGB20FSA (one use per customer).

 

NEED HELP? WE’VE GOT YOU COVERED!

FSA Store Customer Service

FSA Store Frequently Asked Questions

Maximize your income and get reimbursed for out-of-pocket child/aged adult day care expenses with tax-free dollars.

Use the below information to determine if a Dependent Care Account (DCA) is right for you and how to best take advantage of a DCA account.

How It Works

The Day Care/Aged Adult Care FSA allows you to pay for day care expenses for your qualified dependent with pre-tax dollars. Eligible Dependent Care expenses are those you must pay for the care of an eligible dependent so that you and your spouse can work.

Eligible dependents, as revised under Section 152 of the Code by the Working Families Tax Act of 2005, are defined as either dependent children or dependent relatives that you claim as dependents on your taxes. Refer to the Employee Guide for more details. Eligible dependents are further defined as:

– Under age 13

– Physically or mentally unable to care for themselves such as:

• Disabled spouse
• Children who became disabled prior to age 19.
• Elderly parents that live with you

Contribution Limits

The annual maximum contribution may not exceed the lesser of the following:

– $5,000 ($2,500 if married filing separately) per household
– Your wages for the year or your spouse’s if less than above.
– Maximum is reduced by spouse’s contribution to a Day Care/ Aged Adult Care FSA

Eligibile Expenses

– Au Pair
– Nannies
– Before and After Care
– Day Camps
– Babysitters
– Daycare for an Elderly Dependent
– Daycare for a Disabled Dependent
– Nursery School
– Private Pre School
– Sick Child Center
– Licensed Day Care Centers

For a full list of eligible expenses, go to www.flex-admin.com.

The “Use-or-Lose” Rule

If you contribute dollars to a reimbursement account and do not use all the money you deposit, you will lose any remaining balance in the account at the end of the eligible claims period. This rule, established by the IRS as a component of tax-advantaged plans, is referred to as the “use-or-lose” rule.

To avoid losing any of the funds you contribute to your FSA, it’s important to plan ahead as much as possible to estimate what your expenditures will be in a given plan year.

Online & Mobile Access

Flexible Benefit Administrators, Inc. provides online account access for all FSA participants with the following features:

– FSA Login – View account transactions, create account alerts and download participation forms.
– FSA Educational Tools – FSA calculator: estimate how much you can save by utilizing an FSA.

Register for the Flexible Benefit Administrators Portal at www.flex-admin.com. Download the FBA Mobile App on the App Store or Google Play Store.

Helpful Hints

– You can’t change your election amount during the plan year, unless you experience a change in status or qualifying event.

– Save your receipts when you spend your healthcare FSA dollars. You may need itemized invoices to verify the eligibility of expenses or for reimbursement requests.

– The easiest way to manage your account is online at www.flex-admin.com or through the FBA Mobile App.

– You can’t contribute to an FSA and an HSA within the same plan year. As a married couple, one spouse cannot be enrolled in an FSA at the same time the other is contributing to an HSA.

Maximize your income and get reimbursed for out-of-pocket healthcare expenses with tax-free dollars.

Flexible Spending Accounts (FSAs) allow you to pay certain healthcare and dependent care expenses with pre-tax money. You will not pay any Federal, State or Social Security taxes on funds placed in the plan. You will save approximately $27.65 to $37.65 on every $100 you place in the Plan. The amount of your savings will depend on your Federal tax bracket.

How It Works

Pre-Funded Account

This means that you can submit a claim for medical expenses on the first day of the Plan Year and you will be reimbursed your total claim amount up to your annual election. The funds that you are pre-funded will be recovered as deductions which are taken from your paycheck on a pre-tax basis.

Reimbursement

With this account, you can pay for your out-of-pocket healthcare expenses for yourself, your spouse and all your tax dependents for healthcare services that are incurred during your Plan Year and while an active participant. Eligible expenses are those incurred for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for affecting any structure or function of the body.

All manual or paper claims received in the office of Flexible Benefit Administrators, Inc. will be processed within one week via check or direct deposit. You may also use your Benefits Card to pay for expenses. Please refer to the Benefits Card section for details.

Election Changes

Election changes are only allowed if you experience one of the following qualifying events:

– Marriage or divorce
– Birth or adoption
– Involuntary loss of spouse’s medical or dental coverage
– Death of dependent (child or spouse)
– Unpaid FMLA or Non-FMLA leave
– Change in Dependent Care Providers

Eligibility

Complete your enrollment during the open enrollment period. Employees who experience a qualifying event are eligible to enroll within 30 days of the event. Deductions begin on the first pay period following your Plan start date.

You must re-enroll to participate in the Flexible Spending Accounts each year during the enrollment period. If you do not re-enroll, you will not be enrolled in the Plan and you will not be able to join until the next Plan Year or experience another qualifying event.

You can’t contribute to an FSA and HSA within the same plan year. As a married couple, one spouse cannot be enrolled in an FSA at the same time the other is contributing to an HSA.

Examples of eligible expenses…

Fees/Copays/Deductibles for:

Acupuncture
– Prescription eyeglasses/reading glasses/contact lens and supplies/eye exams/laser eye surgery
– Physician
– Ambulance
– Psychiatrist
– Psychologist
– Anesthetist
– Hospital
– Chiropractor
– Laboratory/diagnostic
– Fertility treatments

OTC expenses:

– Antacids
– Pain relievers/aspirin
– Ointments & creams for joint pain
– Allergy & sinus medication
– First aid creams
– Cough & cold medications
– Laxatives
– Anti-diarrhea medicine

For a full list of eligible expenses, go to www.flex-admin.com.

The “Use-or-Lose” Rule

If you contribute dollars to a reimbursement account and do not use all the money you deposit, you will lose any remaining balance in the account at the end of the eligible claims period. This rule, established by the IRS as a component of tax-advantaged plans, is referred to as the “use-or-lose” rule.

To avoid losing any of the funds you contribute to your FSA, it’s important to plan ahead as much as possible to estimate what your expenditures will be in a given plan year.

Online & Mobile Access

Flexible Benefit Administrators, Inc. provides online account access for all FSA participants with the following features:

– FSA Login – View account transactions, create account alerts and download participation forms.
– FSA Educational Tools – FSA calculator: estimate how much you can save by utilizing an FSA.

Register for the Flexible Benefit Administrators Portal at www.flex-admin.com. Download the FBA Mobile App on the App Store or Google Play Store.

Helpful Hints

– You can’t change your election amount during the plan year, unless you experience a change in status or qualifying event.

– Save your receipts when you spend your healthcare FSA dollars. You may need itemized invoices to verify the eligibility of expenses or for reimbursement requests.

– The easiest way to manage your account is online at www.flex-admin.com or through the FBA Mobile App.

– You can’t contribute to an FSA and an HSA within the same plan year. As a married couple, one spouse cannot be enrolled in an FSA at the same time the other is contributing to an HSA.