Health Care Flexible Spending Account

Administered by General Agency Company, 525 E. Broadway, Mount Pleasant

Account Reimbursement Schedule 2018-2019  Request for Reimbursement Form - Direct Deposit Form - CMU Choices Flex Plan Document - Medical Disclosure Authorization Form  General Purpose vs Limited Purpose - Health care FSA Carryover FAQs

General Purpose FSA
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 medications may also be reimbursable when prescribed by a doctor for a "medically necessary" reason.
​Limited Purpose FSA
​Funds in a limited-purpose health FSA can only be used to pay for qualifying dental, vision and orthodontia expenses.  This account is set up to used alongside a Health Savings Account (HSA).
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.
General Purpose 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
​Limited Purpose Eligible Expenses
​Covers qualified out-of-pocket expenses for dental and/or vision care provided to you, your spouse, or dependents including dental and vision deductibles and copays, dental work, dentures, vision exams, vision correction procedures, contact lenses and solutions, and eyeglasses.  Please see General Purpose vs Limited Purpose for more detail.
Contribution Minimum $100.00 per plan year to a maximum of $2,650/annually. If both you and your spouse have access to a Health Care Spending Account, you are each eligible to deposit up to $2,650/annually in your separate accounts.
If you have funds left in the flexible spending account at the end of the plan year, see details regarding deadlines and carry over rules here.  All  claims for eligible expenses must be received by our FSA administrator, The General Agency, on or before September 30th following the end of the Plan Year for active employees.  For terminated or retired employees, claims must be received by our FSA administrator within 90 calendar days following termination of employment.  Unless COBRA  is elected, claims must be incurred prior to the termination or retirement date.
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.