| 2007 PEBB Dependent Care FSAs |
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| How does the FSA work? |
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A dependent care FSA helps you pay for eligible dependent care expenses with pre-income-tax salary dollars that you contribute monthly into the account. Go to this page to learn how and when to enroll.
You can set up a dependent care FSA if you are:
- Single with an eligible dependent, and the expenses are necessary for you to work
- Married with an eligible dependent, and the expenses are necessary for both you and your spouse to work
- Married with an eligible dependent, and your spouse is either disabled, actively seeking employment or a full-time student at least five months during the year.
NOTE: Dependent care FSA participants cannot claim expenses they incur when they are not working.
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| How much can I deposit? |
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- If you are single: $5,000
- If you are married and filing taxes jointly: $5,000
- If you are married and filing taxes separately: $2,500
- If you are married with a spouse who is disabled or a full-time student: $2,400 per dependent up to $4,800.
If you or your spouse earns less than the amounts shown above, the maximum amount you may deposit is either your monthly income or your spouse’s monthly income, whichever is lower.
If you both participate in a dependent care FSA (through the same or different employers), the $5,000 limit applies to the total of both accounts combined.
When you use a dependent care FSA to pay for your dependent care expenses, your use of the Federal and Oregon child care tax credits is limited.
You receive claim repayment only if you have funds available in your account. You can file for claim repayment as soon as your account receives a deposit and you have eligible incurred expenses.
NOTE: University nine-month employees (including classified academic year employees) who are not enrolled in the 12-month payroll distribution plan have only 10 deductions taken for the calendar plan year.
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| What expenses can I claim? |
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IRS regulations specify that the following expenses qualify for reimbursement:
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For the care and well-being of dependent children under the age of 13
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For the care of a disabled dependent of an eligible employee, who is incapable of self-care and who spends at least eight hours per day in the employee’s home
Reimbursement will be made only for services already provided. If you pre-pay for dependent care, you can submit a claim only after the services have been provided.
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| How do I plan for an FSA? |
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Because this is a “use it or lose it” account, you must carefully estimate how much you will spend on dependent care during the year. Listed below are examples of eligible and ineligible expenses. For detailed information on expenses, contact BenefitHelp Solutions.
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Eligible
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Ineligible
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A licensed or registered day care facility or nursery school
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Educational fees or tuition (including kindergarten)
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Care provided in your home (provider cannot be an IRS tax dependent or a dependent under the age of 19)
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Overnight camps
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Costs for provider’s room and board
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Food, when billed separately
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Employment taxes paid on provider’s behalf
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A dependent’s healthcare
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Before and after school care for children under the age of 13
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Enrichment programs (such as dance, sports or music lessons)
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Registration fees
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Housekeeping expenses
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General day camps for children under the age of 13
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Care not directly related to work.
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Home or day care for eligible disabled IRS tax dependents (must spend at least eight hours per day in your home)
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Transportation cost provided by day care.
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| How do I file a claim? |
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You may print a copy of the claim form at the BHS Web site, or you can register there to submit claim forms electronically.
To file for reimbursement:
- Complete a claim form
- Attach receipts or other proof of payment made for each eligible expense item or service. A receipt from the provider should include:
- The date of dependent care services
- The amount of the expense
- Dependent care provider’s name, address, and tax identification number or Social Security number (your provider should complete a Form W-10, which is available from the IRS).
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| What's the grace period? |
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Before the new grace period, if you didn’t incur the same level of out-of-pocket healthcare costs during the year as you had deposited in your account, you lost access to the leftovers on Jan. 1. You could still be reimbursed for expenses you had through Dec. 31 as long as you submitted claims by the March 31 deadline. But you couldn’t use leftover funds to pay claims incurred after December 31.
With the new grace period, you can now incur expenses in the first two-and-a-half months (75 days) of the next plan year to use last-year’s leftover funds.
2007 Plan-year FSA Schedule
Event
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Date
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Enroll for 2007 FSA (Open Enrollment)
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Oct. 1-31, 2006
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Start of 2007 Plan Year
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Jan. 1, 2007
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End of 2007 Plan Year
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Dec. 31, 2007
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Start of 2008 Plan Year
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Jan. 1, 2008
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2007 Plan-year Grace Period
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Jan. 1-March 15, 2008
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2007 Plan-year Claims Deadline
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March 31, 2008
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| How do I appeal denied claim? |
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If your claim is denied, you must appeal the claim denial to BenefitHelp Solutions. The company will send you a notification of the denied claim with the specific reasons for the denial.
The notification may advise you of what steps you might take in order to prove your claim. The notification also states the following:
- Your right to appeal by requesting an administrative review
- Your right to review (on request and at no charge) relevant documents and other information
- You (or your authorized representative) may request a review any time within 180 days of the claim denial notice.
Your written appeal should:
- State the reasons why you believe the claim should receive approval.
- Include any additional facts and/or documents that support your claim.
- Include any comments that you wish considered during your case review.
NOTE: If you do not appeal on time, you will lose your right to appeal.
An individual who was previously not involved in your claim will review and determine the result of your appeal. The appeal decision will be made within 60 days. You will receive a notice of claim denial when the claim remains denied, which will provide:
- Specific reason(s) for the decision
- Specific plan provision(s) on which the decision is based
- A statement of your right to review (on request and at no charge) relevant documents and other information
- A description of any specific rule, guideline, protocol, or other similar criterion or a statement that such a rule, guideline, protocol, or other similar criterion was relied on, and a copy to you free of charge upon your request.
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