Health Care and Limited Use FSA
Health Care FSA plan benefits
Reimburses health care expenses, incurred by you and your tax dependents, not eligible to be paid by insurance. Maximum annual election of $2,700 for 2020 and $2,750 for 2021. Available to individuals enrolled in the Premier PPO, Select PPO or HMO Illinois plans, or without health coverage through Northwestern University. For more information, view the FSA Quick Reference Guide .
Limited Use FSA plan benefits
Reimburses dental and vision services. It may also be used for healthcare and prescription expenses after the Value PPO annual deductible has been met. The deductible will be considered met on the date the claim for services is processed through insurance; not the date of service. Maximum annual election amount is $2,700 for 2020 and $2,750 for 2021. Available to individuals who enroll in the Value PPO plan.
Newly eligible employees may enroll online through myHR within 31 days of hire. An individual may change his FSA contributions within 31 days of a qualifying change in family status. During Open Enrollment, an individual must re-enroll through myHR to continue participation in the FSA the following year. Learn how to activate your Payflex Card.
File a claim
You can be reimbursed for expenses with service dates from January 1, 2020 through March 15, 2021, while actively making contributions to the plan. The date you pay for an item or service is irrelevant.
- Submit claims directly to Payflex using Express Claims or a paper claim form.
- Attach the appropriate documentation including: an explanation of benefits (EOB), receipt or invoice.
- Documentation must include: provider or full name of product, patient name, amount and date(s) of service.
- Canceled checks will not be accepted in lieu of an itemized bill or receipt.
- Statements showing only a previous balance are not acceptable documentation.
- Individuals may be reimbursed up to the full annual election amount regardless of the amount contributed to the account.
All eligible funds for plan year 2020, for claims incurred on or before 3/15/2021, must be claimed by March 31, 2021. If an individual retires or ceases participation in the plan, dates of service must be prior to the active participation end date. Under Internal Revenue Service (IRS) regulations, any monies not claimed from the FSA as of March 31, 2021 are forfeited.
You may only submit claims for expenses incurred through the last day of the month of your last day worked. If you elect to continue the FSA under COBRA, contributions are made on an after-tax basis and must be the same monthly amount made during active employment.