Health Care Flexible Spending Account
The Health Care Flexible Spending Account (HCFSA) is an account from which you can request reimbursement for out-of-pocket health care expenses for you and/or eligible dependents not covered by your medical, dental or vision plans.
In most cases, an employee's flexible spending account money may not be used to reimburse health care expenses for a same sex domestic partner, even if the college provides other domestic partner health care benefits.
For the benefit plan year (June 1 through May 31) you may elect to contribute a maximum of $2,550 ($106.25 per pay period) to the HCFSA.
NOTE: It is important that you carefully estimate your HCFSA expenses. You will have to incur expenses by the end of the 2½-month “Grace Period” which will be August 15th each plan year or contributions will be forfeited. You have until September 30th to turn in eligible health care expenses that you incur during the June1 through May 31 benefit plan year plus the 2½-month Grace Period. Read a detailed description of the Grace Period.
ASIFlex is the benefit administrator responsible for HCFSA claims processing and reimbursement.
Eligible Medical Expense Information - see attached
Flexible Benefit Plan Information & Forms
- Over-the-Counter Drug Reimbursement — PDF
- Claim Forms
- Email Notification Form — PDF
- Direct Deposit/Email Notification Form — PDF
- Release of Information Authorization Form — PDF
- Letter of Medical Necessity Submission Form — PDF
- Debit Card Documentation Form — PDF
You will need Acrobat Reader to open the above PDF files.
Debit Cards for HCFSA
The ASIFlex Card allows you to simply swipe the card at eligible locations for eligible expenses and have the amount deducted from your annual HCFSA election. There is no need for claim forms to be filed and no more having to pay out-of-pocket and await payment for those expenses.
- Participants have the option of using the debit card to pay for the healthcare expenses of medical providers, vision care retailers, dentists, pharmacies, etc. so long as the provider accepts debit cards at their location and there are remaining HCFSA funds available.
- ASIFlex will auto-substantiate all eligible healthcare expenses that equal your medical, dental, vision and RX insurance plan co-pays and multiples up to five.
- The debit card is available for use at most major grocery store and retail pharmacies.
- Auto-substantiation is available at all IIAS merchant locations. The current list can be found at: www.asiflex.com/debitcards. On the right-hand side of the page under "Quick Links," click on "List of IIAS Approved Merchants."
The first time you enroll in the HCFSA and/or DCFSA, ASIFlex will automatically issue and send to you, two debit cards in the name of the employee, for your use. After you enroll in the HCFSA and/or DCFSA, you can request additional debit cards from ASIFlex for additional family members by completing and submitting the order form available at the following website: www.asiflex.com/debitcards. Under Quick Links, select the "FSA Debit Card Application" form, complete and mail or fax to ASIFlex as instructed at the bottom of the form. (Note: The site may indicate a fee for additional cards; however, this fee is waived for JCCC employees.)
Note: For tips on using the ASIFlex card, go to www.asiflex.com/debitcards. Under Quick Links, click on "Tips-How to Use the ASIFlex Card."
Receipts/Validating Debit Charges
Always keep your receipts because you may be asked to validate your debit charges. See the attached debit card documentation form. You will receive a letter or email/text from ASIFlex if validation is required. If you do not validate applicable debit card charges by the due date on the letter, your debit card will be suspended. You can submit debit card receipts via fax or mail:
PO Box 6044
Columbia, MO 65205-6044
If you do not choose to use a debit card, you can complete a claim form and send it to ASIFlex along with copies of any applicable receipt(s) for reimbursement. You can fax or mail your claim form and other documentation to ASIFlex. Reimbursement requests are processed daily and paid within one to three business days. By signing up for direct deposit of your reimbursement requests, funds can be in your account within 1-2 business days.
You can also download the free ASIFlex Mobile Application from www.asiflex.com, or from Google Play or the App Store. Using the mobile app, you can view your account statement 24/7 or file claims.
Monitoring Your HCFSA
Another important resource for you is www.asiflex.com. Click on "Account Detail" in the top right of the page, which allows you to log in and monitor your HCFSA 24 hours a day, seven days a week.
ASIFlex can be reached via email at firstname.lastname@example.org, by phone at 800-659-3035, or by fax at 877-879-9038.