Flexible Spending Account (FSA) Sourcebook 2019-20

Flexible Spending Account (FSA) Sourcebook 2018-19

What is it?

Flexible Spending Accounts (FSA) are an IRS approved, employer sponsored benefit that allows you to pay for eligible medical and/or dependent care expenses on a pre-tax basis. You authorize per pay period deposits to your FSA from your salary before taxes. As you incur eligible expenses, you request tax-free withdrawals from your accounts to reimburse yourself. There are two kinds of FSAs:

• Medical expense FSA
• Dependent care FSA

For a list of eligible expenses, please go to PayFlex.com

Why do I need it? TO SAVE MONEY! An FSA saves you money by reducing your taxable income. Your contribution to your FSA is deducted from your salary on a pre-tax basis. Over a year's time, you will most likely spend some of your salary on medical or dependent care expenses. You can save money on taxes by contributing that amount directly into your Flexible Spending Account.

Unless your itemized medical expenses exceed 7.5% of your adjusted gross income, you cannot claim them on your IRS Form 1040. But you can save taxes by paying for your out-of-pocket medical expenses not covered by your health benefits plan through a tax-free Medical Expense FSA.

What is it at Mason?

Medical Spending Accounts may be used to pay for expenses that are not covered under your medical, dental, vision and prescription plans. Items such as co-payments, deductibles, some over-the-counter medications that you would otherwise pay for out of your pocket with after-tax dollars can be paid for with your medical reimbursement account. This will not only save you money, but will give you access to your entire reimbursement account on the first day of the fiscal year. The maximum annual amount which may be put in a medical reimbursement account is $2,700. You will receive an Elite Visa Benefit Card, which may be used to pay for eligible health expenses. Please note that you may be asked to provide supporting documentation even when you use your Elite Visa Benefit Card.

The maximum deduction per pay period for 12-month employees is $112 and $150 for 9-month faculty.

NOTE: For COVA HealthAware participants, please remember that your Health Reimbursement Arrangement (HRA) pays first and then your FSA.

Dependent Care Spending Accounts may be used to reimburse yourself for expenses incurred in the care of your child (age 12 years or under), disabled spouse, elderly parent, or other dependents who are physically and/or mentally incapable of self-care so that you (and your spouse) can work or actively seek work. The maximum annual amounts which may be put in a dependent care flexible reimbursement account are:

• $2,500 for an employee who is married and is filing a separate tax return.
• $5,000 for an employee who is married and is filing a joint return or who is single with dependents.

The maximum deduction per pay period for 12-month employees is $208 and $277 for 9-month faculty.

• The minimum payroll deduction is $10 per pay period.
• A monthly administrative fee of $2.10 ($2.80 for 9-month faculty) will be deducted from your salary on a pre-tax basis for one or both accounts (Medical and/or Dependent Care). Whether you have one account or both, the fee will be $2.10 (or $2.80) per month.
• Enrollment is not automatic and is only for the current plan year. If you wish to participate next plan year, you must re-enroll during the annual open enrollment period.
• Employees may enroll within 30 days of their hire date or within 60 days of a life event change.
• "Use It or Lose It" Rule - Any money contributed to these accounts during the plan year must be used during the plan year -- any balances remaining are forfeited. Employees may file reimbursement claims until 90 days after the end of the plan year.

How to submit a claim?

You may file a claim to request reimbursement of your eligible expenses by completing a claim form and submitting it along with supporting documentation to PayFlex. The easiest way to do this is to log into your account on the PayFlex website. You may also submit a claim by filling out the claim form found on our Forms Page. Please contact PayFlex at 855-516-8595 for assistance.

Note: for eligible expenses incurred during the 2018-19 plan year, please submit the claims to Anthem. Claim forms are found on our Forms Page For assistance, please call Anthem FSA at 877-451-7244.

For Separating Faculty and Staff

You may be reimbursed for eligible FSA expenses incurred through the end of the month in which you separate. You have a three-month run-out period from the end of your coverage period (end of the month in which you separate) to apply for reimbursement.

Insurance is a way to mitigate some of the risks faced in every day life and helps provide financial security and protection for you and your family. Benefitted employees (50% appointment time or greater) have access to a range of insurance products including:

• Life Insurance
• Long-Term Care Insurance
• Disability Insurance

Leave permits faculty and staff to take approved time off from their positions. It includes annual leave, sick leave, family & personal leave (VSDP participants only) and holidays, as well as a range of other topics such as the Family & Medical Leave Act (FMLA), military issues, Short and long term disability, and leave without pay.

A negative leave balance will stop any additional leave accrual and payment back to the University will be required before any changes in employment status. Leave can recommence once payment is received.

For more information on leave topics, move your mouse over the "Topics" list above and select the topic you would like to know more about from the drop-down menu.

Optional Plans

Optional plans are available to salaried employees and include savings bonds and the Virginia Education Savings Trust (VEST). VEST and the Virginia Prepaid Education Program (VPEP), offer families the opportunity to participate in an IRC Section 529 qualified state tuition program with both prepaid and savings trust investment options to cover future costs of college fees and tuition.

• Savings Bonds
• Virginia Education Savings Trust

Workers' Compensation

Workers' Compensation is a special kind of medical insurance. If you suffer a work-related injury or illness, your employer (the Commonwealth of Virginia) must pay for both the medical expenses and, if appropriate, a percentage of lost wages in all compensable claims.

Responsibilities of the Employee:

1. Select a treatment provider from the list of Panel Physicians
2. Adhere to your physician's instructions and treatment plans
3. Comply with the established policies & procedures
4. Keep all parties informed of your status

Unlike normal illnesses/injuries that are treated on a client- physician basis, Workers' Compensation closely involves the University, the your supervisor, and the insurance carrier. The following paragraphs provide policies and procedures for your information.

Select a Panel Physician

Employees must select a Panel Physician(s) or medical facility provided by the Workers' Compensation Office for treatment unless there is an emergency situation or prior release has been obtained. Employees must comply with all treatment protocols and appointments as prescribed. In the event the individual is not satisfied with the care, notify the Workers' Compensation Specialist and request a change in the physician or facility.

The Panel Physician Selection form should be signed and returned to the Workers' Compensation Specialist.

Use of Sick Leave

In order to maintain consistency with the original leave accrual system and the Virginia Sickness and Disability Program (VSDP), all employees will be required to use sick leave for the first seven (7) calendar days to cover time off for a claim of work related injury or illness. In cases when an employee is out of work for more than 7 calendar days on a compensable claim, the use of WT (worker's compensation leave) will commence on day 8. All use of the WT code must be authorized by the Workers' Compensation Specialist. *All* time off for a work related injury must be established in writing by the treating health provider. The written release must denote a specific time period along with the physician's signature and must be presented to the Workers' Compensation Specialist. The treating physician must also verify the return to work status in writing to the Workers' Compensation Office prior to reinstatement. Any time missed from work that has not been prescribed by your physician will be charged to annual leave, sick leave, or Leave Without Pay (LWOP) as appropriate.

VSDP Participants Notify Reed Group

VSDP participants must also notify Reed Group at 1-877-928-7021 if the injury results in a physician releasing them from work.

Continuation of Salary

If the claim is accepted as a workers' compensation claim, the employee will be paid 66 2/3% of his/her average weekly wage.  This benefit is non-taxable.  A VSDP participant may be eligible to receive more than the 66 2/3% depending on his/her length of service.  Continuation of salary at 100%, while a compensability decision is being made, is contingent on the amount of available sick leave balance (accrual system) and the establishment of a Short-Term Disability Status (STDS) by Reed Group.

Where should bills, doctor's notes, disability slips, etc be sent?

Any bills, doctor's notes, disability slips, and other documents received by the employee must be forwarded to the Workers' Compensation Specialist, Human Resources, 4400 University Drive, MSN 3C3, Fairfax, VA 22030-4444. During your appointment(s), please impress upon the physician's staff the importance of having accurate coding and written information on statements sent to MC Innovation (MCI) for payment. All medical provider's invoices must be complete with appropriate medical notes and insurance codes and should reference your claim number and date of injury. Invoices may be sent directly to MC Innovations, Inc., PO Box 1140, Richmond, VA 23218, phone (804) 649-2288. Any invoices received by Workers' Compensation will be forwarded to MCI on your behalf for payment.

Temporary Total Short-Term Disability

If entitled to Temporary Total Short-Term Disability (TTD) payments under Workers' Compensation, the funds will be paid to you through payroll during regular payroll runs once the University receives payment from MCI. Workers' Compensation payments for lost wages are not subject to federal income tax.

Wage employees are not paid through the University for time off due to injuries. Should the work related temporary total disability exceed seven days, the percentage of lost time wages will be forwarded directly to the employee from MCI. All employees (faculty, classified and wages) must provide written notification to the Workers' Compensation Office of a physician medically releasing them from work and prior to their reinstatement.

What if the injury/illness recurs?

If the injury/illness recurs after your physician has certified you as recovered, please notify the Workers' Compensation Office immediately. Do not simply return to the attending physician and assume that the treatment will automatically be covered by the worker's compensation insurance.

Some injuries and illnesses are not compensable

In some cases, the insurance carrier may determine that the injury/illness is not compensable. For personnel covered under one of the State's medical insurance plans the State Workers' Compensation Program may pay for the initial visit, provided the Assignment of Benefits form is returned within thirty days of receipt of the denial letter. This form allows MCI to reimburse carriers and medical providers at the allowable rate. It is the employee's responsibility to complete and file the Application for Benefits form with MCI.

Family Medical Leave Act

In accordance with GMU policy, leave is also covered under the Family Medical Leave Act (FMLA) and runs concurrent with all time out due to the injury and/or illness.

Americans With Disabilities Act

Compensability is not a determinate factor for an employee to be considered protected under the Americans With Disabilities Act (ADA). If you feel that your injury/illness qualifies you for accommodation, please call, Ruth Townsend, Associate Director/ADA Coordinator 703.993.8730 to discuss your concerns.

The Virginia Workers Compensation Commission

Please read carefully the information provided by the The Virginia Workers' Compensation Commission. The Application for Benefits is entirely employee driven and in a compensable claim continues the applicable benefits beyond the statute of limitations. In the event you feel that you have not been treated fairly regarding your claim for a work-related injury/illness or for the compensation for lost time and wages, you may appeal the matter to the Virginia Workers' Compensation Commission. The Commission will conduct a hearing and issue a binding decision. The appeal process is outlined in the booklet and on the reverse side of the blue Application for Benefits. If you have any questions regarding the Commission's form, contact the Workers' Compensation Specialist.