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Flexible Benefits

(state and higher education employees)

PayFlex
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stateoftn.payflexdirect.com

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Flexible spending accounts (FSAs) are great for those who expect to spend on healthcare or dependent care.

FSAs can help you reduce your taxable income and save you money. An FSA allows you to pay certain expenses from your pre-tax income rather than after-tax income. The maximum amount you can contribute to a FSA is set by the Internal Revenue Service (IRS). The limits are subject to change yearly.

Eligibility: Insurance-eligible state and higher education employees (excludes offline agencies) can enroll in the following FSAs. Part-time employees may not enroll in these benefits.

FSAs offered and 2019 contribution amounts:

Medical FSA: Annual limit - $2,650. Carryover limit - $500

  • Used to pay for certain medical, dental, vision and prescription costs not covered by your insurance. You do NOT qualify for a medical FSA if you are enrolled in the CDHP/HSA. Up to $500 of your unused FSA balance can be carried over into the next plan year instead of you “losing it.”

Limited Purpose FSA (L-FSA): Annual limit - $2,650. Carryover limit - $500

  • May only be used to pay for certain dental and vision costs not covered by insurance. For employees enrolled in the CDHP/HSA, the L-FSA is a great way to save on vision and dental expenses while continuing to grow your HSA balance.

Important! You cannot enroll in both a medical FSA and L-FSA in the same year. The L-FSA is a great option for CDHP/HSA enrollees because it provides a way to save tax-free on eligible dental and vision expenses, while allowing your HSA funds to continue growing!

Dependent Care FSA (DC-FSA) Annual limit - $5,000 (up to $2,500 per spouse for married couples filing jointly). No carryover amount allowed.

  • Used to pay for certain dependent-care costs, such as after school care, baby-sitting fees, adult or child daycare and preschool. Certain requirements must be met by the eligible employee and/or his or her spouse. For details, review the governing Plan Document located on the Publications page.

Availability of Funds: 

  • Employees who enroll in a medical FSA or L-FSA during annual enrollment will have their full election amount available to them the first week of January, or within approximately 3-4 weeks after they enroll. 
  • DC-FSA funds are only available as they are taken from your paycheck; your full election amount is not available up front. In addition, you may only file claims for dependent care for which you have a sufficient amount in your account to pay for them (i.e., you may not file claims for a future date).

Transportation and Parking (state employees only)

  • Used to pay for certain work-related commuting and/or parking expenses.

Going forward, state employees who have a transportation/parking FSA must submit current year claims by April 30 of the following year. Claims submitted after that date will be denied. However, you will not lose your funds if you continue to be enrolled. You will only lose funds if you do not spend them or are no longer enrolled in a transportation/parking FSA. 

This HSA/FSA grid shows details about contributions, tax benefits and how you can use your funds. (CTRL+ + to enlarge the size)

Enrollment:

State employees: To put money in a FSA, you must do so in Edison.

  • Medical, limited purpose or dependent care FSAs: You must make your elections during annual enrollment (unless you have a special qualifying event) - enrollment does not continue from year-to-year. You will enter your annual contribution in Edison. The system will calculate the amount to take out of each check based on the number of paychecks you receive each year.
  • Transportation and parking (state employees only): You can enroll in Edison during annual enrollment. If currently enrolled, you do not have to reenroll. To make changes outside of annual enrollment, you would submit a paper form
  • Higher education employees: For new hires, to put money in a FSA, you will do this on PayFlex’s website (stateoftn.payflexdirect.com).
  • State employees: Employees enrolled in a FSA should review their paystubs regularly to ensure they are correctly enrolled in the FSA they want, and that correct amount is being taken from each paycheck. If you think your enrollment is incorrect (for example - you are enrolled in transportation/parking FSA, but meant to enroll in medical FSA), you have until March 30th of the current flexible benefits plan year to contact your agency benefits coordinator for research and resolution (or within 90 days of your flex benefits effective date - whichever comes first). You must provide documentation in writing to Benefits Administration upon request. After those 90 days, your enrollment is set for the year and you may not change or cancel your FSA enrollment unless you have a special qualifying event (SQE) as defined by IRS rules. The exception is transportation/parking FSAs and employees may change their contribution amount or cancel/start enrollment throughout the plan year.

CDHP enrollment

If you are enrolled in a CDHP/HSA, you and your enrolled spouse cannot use a flexible spending account (FSA) for medical expenses. You can have a limited purpose FSA (L-FSA) to use for dental and vision expenses. You should consider contributing the maximum allowed to your HSA before contributing to your limited purpose FSA (L-FSA) because HSA dollars are not "use-it-or-lose-it" like an FSA.

PayFlex debit cards

  • Medical FSA and L-FSA members will get a debit card to use their funds at the pharmacy and provider's office, making it quick and easy to pay your deductible, copays and coinsurance.
  • For those who enroll during annual enrollment, PayFlex will send all newly enrolled medical FSA and limited purpose FSA (L-FSA) participants a debit card in December. New hires/newly enrolled will receive your debit card within 3-4 weeks of enrollment. You may order additional debit cards for your dependents (cost may apply) by logging into your account at stateoftn.payflexdirect.com > Account Settings > PayFlex card > Order Dependent Debit Card.
  • Plan members who currently have a medical FSA or L-FSA debit card will not receive a new debit card. Your current card will continue to work. You can use it at pharmacies, doctor’s offices and other healthcare facilities to pay from your account.
  • If you enroll in the CDHP/HSA and a L-FSA, the same debit card will work for both accounts. PayFlex will take any dental or vision expenses from your L-FSA “purse” on the debit card before using any of your HSA funds. This allows your HSA funds to continue to grow.
  • If you currently have a HSA with a debit card and plan to enroll in a L-FSA, you will use the same debit card for both your HSA and L-FSA eligible purchases.
  • Dependent care (DC-FSA) and transportation and parking FSA par­ticipants will not use a debit card.

You should keep all health insurance, dental insurance, and vision insurance explanation of benefits (EOBs) when using the debit card to pay for eligible healthcare expenses. PayFlex may contact you later and request them. If you cannot provide EOBs, use of your debit card may be suspended and you will be required to file paper claims or upload claims to PayFlex on their website for FSA or L-FSA processing.

PayFlex accounts

If you enrolled in a medical FSA or limited purpose (L-FSA), you should go online at PayFlex to create an account and register your new debit card to pay many of your medical expenses that are not already covered by insurance. After you create your account, you can review your claims activity, upload documentation, provide claims substantiation (if requested), order an additional debit card and see your account balances. Instructions for setting up your PayFlex account can be found here.

If you are enrolled in a dependent care FSA (DC-FSA) only, you cannot use a debit card, but you can create an online PayFlex account in order to see your DC-FSA account balance, claims, and activity. Instructions for setting up your PayFlex account are here.

You can order an additional PayFlex Card, your account debit card, once you log in at Payflex. New users will need to register first by clicking on the “Register Now” button. From the employee portal, look for "Account Settings" and click on “PayFlex card.” Click on the button labeled “Order a Dependent Card” and enter the spouse or dependent name and click submit.

Reimbursements

Please click here for instructions on how to receive reimbursements for 2018 claims for your medical, limited purpose, dependent care and transportation and parking.

PayFlex manages medical, limited purpose (L-FSA) and dependent care FSA (DC-FSA) programs. Benefits Administration manages transportation and parking flexible benefits (for state employees only).

Benefits Administration resources

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