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Flexible Spending Account (FSA)

FLEXIBLE SPENDING ACCOUNT (FSA)

The Flexible Spending Account (FSA) is a way for employees to save money!   FSAs provide a vehicle for employees to reduce their payments for out-of-pocket medical, dental, vision or dependent care expenses without paying federal, state, or FICA taxes.  This means employees can put money aside each pay period on a pre-tax basis in a;    


HealthCare (medical) Reimbursement Account
Dependent Day Care Reimbursement Account 

 Eligible and Ineligible Expenses under the FSA
Cigna administers the FSA plan for The Williamson County Benefit Program.

Information on the $500 carryover provision on your FSA

  How do you enroll:  Employees have the opportunity to enroll as a new hire, during open enrollment, or if a qualifying event occurs.  Complete the appropriate enrollment form and return it to the Williamson County Benefits Department.  If enrolling in both medical and dependent daycare, you will need to complete a separate enrollment form for each.

FSA Medical Enrollment Form

FSA Dependent Day Care Enrollment Form

 

Annual Plan Election: At time of enrollment, you will need to indicate your annual plan election. Your annual plan year election is the estimated eligible expenses that you will incur and spend between your effective date and December 31st.   On the enrollment form(s) you will indicate this annual election.  The Benefits Department will calculate your per pay period deduction based on the annual election you choose. * See below guidelines on how per pay period deductions are calculated.

Maximum allowable election can be:
$2,500 for medical and/or
$5,000 for dependent day care

* Guidelines on how per pay period deductions are calculated
*Board of Education Professional and Classified 12 month Employees, the benefit is deducted out of twenty-four (24) pay periods starting with the first payroll check in January through the December 31st payroll.

*Board of Education Classified 11 month Employees, the benefit is deducted out of twenty-two (22) pay periods starting with the first payroll check in January through the June 30th payroll and the August 15th payroll through the December 31st payroll.

*Board of Education Classified 10 month Employees, the benefit is deducted out of twenty (20) pay periods starting with the first payroll check in January through the June 15th payroll and the August 31st payroll through the December 31st payroll.

*Government Employees, the benefit is deducted out of twenty-six (26) pay periods starting with the first payroll in January through the last payroll in December.

    Cigna Flexible Spending Account Debit Card: Participants enrolled in the medical FSA will receive a Cigna Flexible Spending Account debit card (additional cards can be requested). This card can be used to pay for medical expenses allowed under IRS guidelines during the plan year. When using this card all transactions are subject to an audit and a valid receipt can be requested for any reason at any time. A valid receipt may be the Explanation of Benefits from the insurance company or an actual paper detailed receipt from the vendor the card was used. It is advised that you keep all receipts or EOB’s so that if you are requested by the administrator to provide this information you can access them easily and not receive tax implications at the end of the plan year.   ** This card cannot be used for childcare expenses.

                                     Cigna Flexible Spending Account Health Care Debit Card

  How to file for reimbursement when not using the Debit Card or need reimbursement for Childcare:

You have 2 options in requesting for reimbursement.
1) Go to www.mycigna.com and submit your request or
2) Complete a FSA Reimbursement Request Form and attach necessary receipts and other required documents. Forms can be faxed to (423)553-8953 OR Mail to: CIGNA, P.O. Box 182223, Chattanooga, TN 37422-7223. Remember to sign this form before you send it in.



Questions regarding the Flexible Spending Account program please contact:

 MK Burt
(615)595-1268

(or)

Cigna Customer services: 1-800-244-6224
www.mycigna.com