Plan Summary

The Flexible Spending Account (FSA) program allows you to set aside money on a pre-tax basis to pay for eligible medical and dependent care expenses annually. You decide how much to set aside and that amount is deducted from each paycheck before Federal, State and FICA taxes are calculated so you save money on taxes.  The FSA program is administered by TASC.

  •  A Healthcare FSA is used to pay for eligible medical, dental, vision and prescription expenses that aren’t covered by your insurance.   You are NOT eligible for a Healthcare FSA if you are enrolled in a High Deductible Health Plan.
  • A Dependent Day Care FSA is used to pay for eligible dependent care expenses such as after school care, baby-sitting fees, adult or child daycare and preschool. 

  •  A Limited Purpose FSA is only available for employees who enroll  in the High Deductible Health Plan  and Health Savings Account.  It is used to use to pay for eligible dental, vision and post-deductible expenses that are not covered by insurance. 

Eligibility

All employees, including rehired annuitants, are eligible for this program, except:

  • Classified Limited Term employees (LTE’s),
  • Student Assistant with one of the following titles: fellows, scholars, trainees, and
  • Employee-in-Training with one of the following titles: grad intern/trainee, post-doc fellow/trainee.

Important Health Care & Dependent Day Care FSA Restrictions (2015 plan year and beyond)

  • You cannot change your election after you enroll for the plan year unless you have a qualifying Change in Status event (e.g. marriage, divorce, birth, leave of absence…)
  • Only expenses during the plan year (January 1 – December 31) are reimbursable.
    • If there is any remaining money in your Healthcare or Limited Purpose FSA account on December 31st, 2015, up to $500 will carryover to the 2016 plan year.  Anything over $500 will be lost.
    • Any funds left in your Dependent Day Care FSA at the end of the plan year will be lost.
  • All claims for the 2015 plan year must be submitted to TASC by March 30, 2016.
  • You must re-enroll in the plan every year during the Annual Benefit Enrollment (ABE) period.
  • For the claims deadline and carryover provisions for the 2014 plan year, see the UWSA news article.

Automatic Premium Conversion

Any employee eligible for this plan will automatically have premiums for the following benefit plans deducted from earnings on a pre-tax basis:

  • State Group Health Insurance
  • State Group Life Insurance (premium for first $50,000 of coverage)
  • EPIC Benefits+*
  • Dental Wisconsin*
  • VSP Vision Insurance*

You may choose to waive automatic premium conversion and have your premiums taken on a post-tax basis. 

*If you cover a non-tax dependent domestic partner or partner’s children, premiums will be taken on a post-tax basis.

Enrollment

Enrollment – New Employee

You may enroll within 30 days of the start of your first benefits-eligible appointment. Coverage is effective on the first of the month on or following receipt of your paper application. You may not enroll via eBenefits for this program.

Only expenses incurred on or after your coverage effective date are eligible for reimbursement.

UW’s Client/Employer ID (required at enrollment): 4607-6190-4348

Enrollment – Change in Status

If you experience a family or employment change, you may be able to enroll, cancel, or change your election. You have 30 days from the change to submit a Change of Election form to your institution’s benefits office.

Any change to coverage is effective on the first of the month on or following receipt of your Change in Election form by your institution’s benefits office.

See the Change of Election form to view a list of events that allow you to make changes during the year.

Annual Enrollment

Employees must re-enroll each year during the Annual Benefit Enrollment (ABE) period. Coverage is effective on January 1st.

Your enrollment will not carry forward from year to year.

Healthcare FSA

The Healthcare FSA is used to pay for eligible medical expenses that are not covered by your insurance. These expenses can be incurred by you, your spouse (same or opposite-sex spouse), your qualifying child up to age 26, or your qualifying relative.

Minimum Annual Contribution: $100
Maximum Annual Contribution: $2,550

Eligible Expenses

For a list of covered expenses, see TASC’s FSA Eligible Expenses list.

Options at End of Employment

Upon the end of your employment, you have the following options:

  • If you do not contribute your annual election amount, you may incur expenses through the end of the month in which your last paycheck is paid. Any expenses incurred after that date will not be reimbursed.
  • If you contribute your full annual election amount, you may continue to incur expenses through the end of the plan year.
    • You can have the remainder of your election taken pre-tax on your final paycheck(s); or
    • You can continue your coverage and send payment directly to the Department of Employee Trust Funds. Contact your institution’s benefits office for a continuation form. The continuation form and payment must be received by ETF within 60 days of your coverage end date or the date on the continuation notice, whichever is later.
    • You must incur expenses by December 31. There is no carryover provision for inactive employees.

Limited Purpose FSA

The Limited Purpose Flexible Spending Account (LPFSA) is only available to employees who enroll in a High Deductible Health Plan/Health Savings Account for 2015. The LPFSA is similar to the regular Healthcare FSA but it is designed to work in conjunction with your Health Savings Account (HSA). The LPFSA is used to pay for post-deductible medical expenses and eligible vision and dental expenses that are not covered by your insurance. These expenses can be incurred by you, your spouse (same or opposite-sex spouse), your qualifying child up to age 26, or your qualifying relative.

Minimum Annual Contribution: $100
Maximum Annual Contribution: $2,550

Eligible Expenses

For a list of covered expenses, see the LPFSA flyer.

Options at End of Employment

Upon the end of your employment, you have the following options:

  • If you do not contribute your annual election amount, you may incur expenses through the end of the month in which your last paycheck is paid. Any expenses incurred after that date will not be reimbursed.
  • If you contribute your full annual election amount, you may continue to incur expenses through the end of the plan year.
    • You can have the remainder of your election taken pre-tax on your final paycheck(s); or
    • You can continue your coverage and send payment directly to the Department of Employee Trust Funds. Contact your institution’s benefits office for a continuation form. The continuation form and payment must be received by ETF within 60 days of your coverage end date or the date on the continuation notice, whichever is later.
    • You must incur expenses by December 31. There is no carryover provision for inactive employees.

 

Dependent Day Care FSA

The Dependent Day Care FSA is used to pay for eligible dependent care expenses such as after school care, preschool, and adult and child daycare.

Minimum Annual Contribution: $100
Maximum Annual Contribution: $5,000 (restrictions may apply)

Eligible Dependents & Expenses

Eligible dependents include your spouse (same or opposite-sex spouse), qualifying child(ren) up to age 13, or your qualifying relative.  See the Dependent Care eligibility criteria for more information about eligible dependents and covered expenses.

Options at End of Employment

Upon the end of your employment, you cannot continue dependent care contributions. You can continue to request reimbursement for eligible expenses until you exhaust your account or until the end of the plan year, whichever comes first, even if you have not contributed the full annual election amount.

Claims Submission

TASC provides several different methods to submit your claims.

Electronic Claims Submission

Paper Claims Submission (Mail or Fax)

  • Download a personalized Request for Reimbursement form from MyTASC (found under the “Resources” section), complete, and submit with substantiation to TASC.
    • Mail: TASC, PO Box 7308, Madison, WI 53707
    • Fax: 608-663-2762

For more information, see the Participant Reference Guide and TASC Tools Packet.

Forms & Publications