Health care FSA

Money you set aside for health care expenses

  • A health care FSA lets you set aside pre-tax dollars to pay for eligible health care expenses for you and your family, even if you or they aren’t covered under a Katy ISD medical plan.

  • You can contribute between $500 and $2,700 per year through automatic payroll deductions over 24 pay periods.

  • Since your contribution is pre-tax, less taxes come out of your paycheck.

  • The full amount you set aside is available to you on January 1, 2020.

  • You have to enroll each year.

  • First Financial Group of America administers the plan.

What your health care FSA covers
  • Deductibles, coinsurance and copays under your medical, dental and vision plans
  • Other eligible health costs that are not covered by your health care plan (for example, dental costs not covered by your dental plan)
  • Prescription drugs

 

Acupuncture Special medical equipment
Hearing aids Special education devices
Individual psychiatric and psychological counseling Smoking-cessation programs or related prescription drugs
Lasik or other vision correction surgery Weight-loss programs for individuals diagnosed as obese

 

Over-the-counter medical supplies and products, such as:

Bandages and wraps Contraceptives and family planning items
Braces and supports Denture adhesives
Catheters Insulin and diabetic supplies
Contact lens solutions and supplies  
What's not covered
  • Cosmetic surgery
  • Health plan premiums
  • Vitamins
  • Weight reduction programs (unless prescribed by a physician for obesity)
  • Over-the-counter smoking cessation medications, such as nicotine gum and patches

 

Over-the-counter medicines without a doctor’s prescription, such as:

Acid controllers Digestive aids
Allergy & sinus Feminine antifungal/anti-itch
Antibiotic products Hemorrhoidal preparations
Antidiarrheals Laxatives
Anti-gas Motion sickness
Anti-itch & insect bite Pain relief
Antiparasitic treatments Respiratory treatments
Baby rash ointments/creams Sleep aids and sedatives
Cold sore remedies Stomach remedies
Cough, cold & flu  
Rules and restrictions

In return for the favorable tax advantages, the IRS has strict rules on these accounts.

  • For 2020, the IRS will allow you to contribute up to $2,700 to a health care FSA and $5,000 to a dependent day care FSA.
  • You can’t change the amount you contribute until the next plan year, unless you have a qualified life event
  • You can’t transfer money from this account to another FSA account
  • To be reimbursed, you must be enrolled in the FSA when you incur expenses
  • You need to keep all of your records to substantiate all claims
  • You may use your FSA funds for expenses incurred through March 15, of the following year, and you have until May 15 of that year to submit documentation for those expenses
  • You lose any funds that you don’t spend by March 15, of the following year.
Determining your contribution

Only list expenses that are not paid through your medical, dental, vision or any other health plan. Using last year’s expenses can help. You can also use the Health Care Flexible Spending Account Worksheet. Estimate from the date your coverage begins if you’re hired or if you become eligible for benefits during the year.

And remember, if you’re enrolled in a Consumer plan, payment for all eligible medical care costs, including services under your medical plan, comes from your HealthFund account first. After your HealthFund is depleted, you may use your FSA to cover medical expenses.

How it works

The easiest way to access your health care FSA funds is with your Benefits Flex debit card, which you receive after you enroll. Here are some guidelines:

At the store

  • Certain stores accept your debit card to buy prescriptions and over-the-counter (OTC) items. Others accept your debit card for prescriptions only. For a list of certified and registered merchants, call member services at the number on the back of your debit card. For example, you can use your FSA debit card for OTC medications at CVS, Walmart, Sam’s Club, Walgreens and drugstore.com. You can only use your FSA card for an OTC medication if you have a doctor’s prescription for the medication.

At the doctor or dentist

  • Be very careful when paying for medical provider up-front costs. Ask the medical provider to file the claim with Aetna or, if your provider is out of network, file a claim yourself, before you use your debit card to make sure you’re paying the correct out-of-pocket amount, including any contract discounts. Then, if you’re responsible for a portion of the charges, you can pay that out of your health care FSA.

For dependents not covered by your medical plan

  • Tax dependents of FSA participants can use the debit card for medical, dental and vision expenses. Again, you’re required to submit receipts for these expenses when you submit your claim if you don't use your FSA debit card.

 

The IRS limits the misuse of FSA debit cards. Retail locations that contain pharmacies and also sell non-pharmacy items must use the Inventory Information Approval System (IIAS) to automatically substantiate pharmacy purchases and allow you to use your FSA debit card. Call First Financial Group of America at 866-853-3539 to find out which non-traditional pharmacy providers use IIAS. You may still use your FSA debit card at traditional pharmacies and with the Express Scripts mail service program.

2019 health care FSA account calendar

January 1, 2019 – March 15, 2020
Eligible health care FSA expenses are covered

 

May 15, 2020
Deadline to submit documentation for 2019 health care FSA expenses

 

If you get close to the March 15 date and have money in your health care FSA that you don’t know what to do with, use the money to stock up on covered OTC products listed above.

Filing a claim

If you do not use your Benefits Flex debit card, you must submit a claim form and any additional required documentation to First Financial Group of America to be reimbursed for your health care FSA expenses.

You can file paper by regular mail, online, by fax, or through the First Financial Flex Benefits Portal or by fax at 800-298-7785.

You can also view and submit claims using the FF Flex Mobile app, available through the iTunes and Google Play stores.

Helpful resources

For more information, call First Financial Group of America at 866-853-3539 between 7 a.m. and 5 p.m. weekdays, excluding holidays, or email. Also, review the flexible spending account FAQs.

 

Your cost

Minimum $500, Maximum $2,700

Based on 24 pay periods $0.00

For any benefits question or concern, including 24/7 Nurse Line access, one call does it all.
Call us at 866-222-KISD (5473)