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Health Care FSA

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Stanford Benefits is partnering with Fidelity Investments to administer the health savings account (HSA) and flexible spending accounts (FSAs), including our tax-free Child Care Subsidy Grant (CCSG) and the dependent day care FSA, effective Jan. 1, 2024.

Learn more about this transition by visiting Fidelity's website

Set aside before-tax funds to pay for eligible out-of-pocket expenses, such as over-the-counter items, orthodontia, vision care and more. 

With this FSA, you can pay for eligible medical expenses incurred by you, your spouse or dependent children. The IRS limits how much money you may contribute to your FSA in the plan year and limits the amount of unused funds you can carry over into the new plan year.

Set contributions every year: Each year during Open Enrollment, you must actively elect your contribution amount for the following plan year as your previous election amount will not automatically carry over.


Contribution limit for 2024: $3,050
Carryover from 2023 to 2024: $640

Plan Information

Eligibility

Benefits-eligible employees, with these restrictions:

  • You or your spouse don’t participate in a health savings account (HSA)
  • You live in the United States

If you already have an HSA: The money in your HSA is yours to use on eligible expenses at any time, but you can’t actively contribute to an FSA and an HSA, or submit the same claim to both accounts.

If your spouse has a health care FSA: You may each contribute to your respective accounts up to the maximum limit but you cannot submit the same claim to both accounts.

How to Enroll

You must enroll in the FSA during your new hire enrollment window or wait until Open Enrollment, unless you experience a qualifying life event.

Each Open Enrollment, you must actively elect your contribution amount for the following plan year. When you enroll in either (or both) the health care FSA or dependent day care FSAs, you’ll be issued a debit card.

If you are a current participant and fail to re-enroll during open enrollment, your health care FSA will not carry over into the next plan year. 

How it Works

NOTE: An FSA is a non-interest bearing bookkeeping account that keeps a record of contributions and reimbursements made during the plan year. No actual account is established.

  • Estimate the amount of unreimbursed health care expenses you and your eligible family members expect during the plan year. Plan wisely; you can only carry over up to $640 of unused funds to the next plan year.
  • You cannot adjust your contributions mid-year, unless you experience a qualifying life event. At that time, a change in contribution cannot be retroactive, or less than what you’ve already contributed to date.
  • Stanford makes your contributions in equal deductions from each paycheck, starting as soon as is administratively possible after you enroll. The full annual amount will be available to you Jan. 1 (or, for new hires, the day after your first paycheck from which a deduction is taken).
  • Payment can be made directly to providers using your FSA debit card. Not all providers will accept the debit card, in which case you pay for services and then submit a claim for reimbursement.
  • Use your FSA to pay for eligible expenses for you, your spouse or dependent children – even if they aren’t covered on your health plan. However, IRS rules do not allow you to use your FSA for your domestic partner’s expenses (even if qualified).
  • In California, you can cover your partner on your medical plan but you can’t submit health care FSA claims unless your partner is considered a “qualifying relative” and a “tax dependent” according to the IRS. For guidance, consult your tax advisor. You can submit eligible claims for children of your registered domestic partner who depend on you for support and who live with you in a regular parent/child relationship.
  • Services must occur before the end of the plan year on Dec. 31; however, you have until April 30 to submit for reimbursement for services from the previous plan year.
  • Carry over up to $640 in unused funds to the next plan year; remaining unused dollars are forfeited. In mid-May, you can log into your account to view your balance with carry over.
Eligible ExpensesSearch an expansive database of expenses that are allowed by both FSA and HSA participants on the Health Equity website.
How to Submit Claims

You have three options for submitting your Health Care FSA claims:

  1. Pay directly using your Stanford FSA debit card
  2. Submit your claim through the Fidelity Health app
  3. Follow the NetBenefits Flexible Spending Accounts Service Guide 

You may be asked for proof of payment on some claims. Be sure to save all receipts, even when using your FSA debit card. You can send in an itemized receipt and your medical, dental or vision plan’s Explanation of Benefits. The IRS does not allow cancelled checks, credit card statements or balance-due statements as supporting documentation with your claim form. Your reimbursement will be deposited into your Fidelity account, or direct deposit into your regular bank account. NOTE: Starting in 2024, the FSA administrator will be Fidelity. 

When Coverage Ends

Leaves of absence: For paid leave, you cannot cancel your health care FSA; it operates the same while you’re on leave as it does when you’re active. For unpaid leave, you have the option to cancel it within 31 days of your leave start date; when you return, you can elect coverage again. Or, if you continue it while on leave, you’ll be billed on an after-tax basis for your contributions.

When your employment ends: Learn more about what happens to funds in your FSA when you leave Stanford within these resources:

Resources

Get started with the FSA Quick Start Guide

FSA Quick Start Guide (Spanish)

Visit Fidelity to learn more about how to file FSA claims

Read the Summary Plan Document for your FSA

Frequently Asked Questions

Below are answers to the most frequently asked questions regarding health care FSA.

View the complete list of FAQ

View Health Care FSA Carryover FAQ

Health Care FSA

Who can I cover?

If you enroll, you and your eligible dependents are covered under your Health Care FSA even if you do not cover them under other Stanford benefit plans. For details on who is considered your dependent, see enrollment and eligibility.

NOTE:

Federal law only recognizes opposite-sex and same-sex spouses as being eligible for this program.

Can I cover my domestic partner under the Health Care FSA?

Current IRS rules do not allow you to be reimbursed for domestic partner expenses through an FSA. Even if you cover your registered domestic partner under Stanford benefit plans, you may not submit Health Care FSA claims. The exception is if your partner is considered a “qualifying relative” and a “tax dependent” according the Internal Revenue Code rules. For further guidance, please consult your tax advisor.

NOTE:

You can submit eligible claims for children of your registered domestic partner who depend on you for support and who live with you in a regular parent/child relationship.

Why do I have to prove payment when I use the Stanford FSA debit card?

The IRS requires the FSA administrator to request proof of payment on some claims to ensure they are part of the list of IRS approved expenses. Be sure to save all receipts when using your Stanford FSA debit card. You can send in an itemized receipt and your medical, dental or vision plan’s Explanation of Benefits. The IRS does not allow cancelled checks, credit card statements or balance-due statements as supporting documentation with your claim form.

How do I receive a payment from the FSA?

Your reimbursement will automatically be placed in your Fidelity account which is associated with your debit card. If you would like your funds to go into a bank account, set up direct deposit through the Fidelity website (netbenefits.com/Stanford). For questions about your claims payment, call Fidelity at 888-793-8733 Monday-Friday 8AM-5PM. Claims for reimbursement are processed daily. Reimbursement monies are payable to you, not to the provider.

Can I use my Stanford FSA debit card to pay for mail order pharmacy purchases?

Yes, you can use your debit card for these purchases. Unfortunately, not all mail order pharmacies have implemented the IRS-required technology that proves the purchase is valid without submitting a receipt. Keep your receipts since you may be asked to provide documentation.

You can submit these receipts online through the Fidelity website (netbenefits.com/stanford). 

Are medical devices and supplies eligible for reimbursement?

Equipment and supplies such as crutches, bandages and blood sugar test kits still qualify for reimbursement, even if purchased without a prescription. For additional information, please refer to www.irs.gov.

Are there advantages of a health care FSA versus the federal income tax deduction?

Because FSAs give you the opportunity to pay for your eligible expenses using before-tax dollars, there is no need to itemize your expenses on your tax return. You can also use it throughout the year instead of waiting until tax time. Please consult your tax advisor to determine which method is best for you.