Health Care Flexible Spending Account
Administered by Benefit Consulting Group 115 1/2 S. Univesity, Mount Pleasant, MI

Account Reimbursement Schedule 2013-2014 -  Request for Reimbursement Form - Direct Deposit Form - CMU Choices Flex Plan Document - Medical Disclosure Authorization Form

Description Pre-tax dollars contributed to an HCSA can be used by you or any of your qualified dependents for such expenses as medical and prescription drug deductibles and co-payments, glasses, contact lenses, dental expenses, and most other health care expenses that are not covered by you or your spouse's other health care plans. Some over-the-counter medications may also be reimbursable when prescribed by a doctor for a "medically necessary" reason.
Eligibility Federal tax rules define dependents as your spouse.  Children through the end of the calendar year that they turn 26 if the child is the employee's Tax Code dependent for health plan purposes. Your parents if: they reside with you, you are responsible for their expenses and you claim them as dependents on your income tax return.
Eligible Expenses Any expense allowed, as a medical deduction on your income tax return is eligible for reimbursement under the FSA, as long as you do not also deduct those expenses on your income tax return. See health care expenses and over-the-counter medications.
Contribution Minimum $10.00 per pay to a maximum of $2,500/annually. If both you and your spouse have access to a Health Care Spending Account, you are each eligible to deposit up to $2,500/annually in your separate accounts
If you have funds left in the flexible spending account at the end of the plan year, and no eligible expenses to claim, you will forfeit the leftover dollars.  Fund balances are non-transferrable between the health FSA and dependent day FSA.
Availability On the effective date the whole balance is available for withdrawal from the Health Care Flexible Spending Account.
Direct Deposit If you participate in a Flexible Spending Account you must establish a direct deposit account for your reimbursements if submitting a paper claim for reimbursement.
​Status Changes ​Certain qualifying status change events may allow for mid-year benefit changes to Flexible Spending Account (FSA) elections.  Visit our Status Change web page at:  Status Changes*Important* Should you experience a change in moving from full to part-time or part to full-time status, it does NOT create a status change event in which you can change your Health FSA election.  IRS regulations permit Health FSA changes only in cases where there has been a change in eligibility or the number of dependents qualifying under the plan.  Therefore, it is very important that you carefully consider your Health FSA needs when making your elections.


1200 S. Franklin St • Mount Pleasant, Mich. 48859
Phone: 989-774-4000

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