Flex Spending Account
- FlexComp Plan Enrollment Agreement
- FlexComp Status Change Form
- FlexComp Medical Spending Account and Dependent Care Spending Account Worksheet
- ASIFlex Claim Form
- ASIFlex Contact 1-800-659-3035
Plan Document and Information
- FlexComp Plan Document and Plan Summary
- Premium Conversion Summary Plan Description
- Premium Conversion Plan Document
- ASIFlex Dependent Care FSA Information
- ASIFlex Wallet Card
- ASIFlex Medical Eligible Expenses Listing
- ASIFlex Medical FSA Information
- FSA Debit Card Documentation Requirements
- Dependent Care Eligible Expense Listing
- OTC Eligible Health Care Products Listing
- Overview of Plan
This Publication is intended to assist taxpayers in determining tax deductions, not which expenses are reimbursable under a health care flex account. Some of the statements in the Publication do not apply to these accounts. For example, it states a tax deduction is based on when you pay for it. A health care reimbursement account, an expense must be incurred during a Period of Coverage to be eligible for reimbursement for that Period of Coverage, regardless of when paid for. Insurance premiums and certain long-term care expenses - are not reimbursed from these accounts.
This form is a guide only and is subject to change. Receipts must "clearly" state what over-the-counter medications were purchased to be reimbursed from FSA.
Section 125 is part of the Internal Revenue Code that allows for Flexible Benefits Programs (Cafeteria Plans).
Frequently Asked Questions
What is the FlexComp Plan?
FlexComp is a Cafeteria Plan. It allows you to save taxes on the amount you pay for eligible insurance premiums, medical expenses, and dependent care expenses.
How can this be beneficial to me?
The biggest advantage is the tax savings. Since the dollars you contribute to the plan are deducted before income and social security tax are deducted, you will pay less taxes which means you have more money to spend or save. However, you should be aware you are reducing the social security taxes paid which could slightly reduce your social security benefits.
If I take pre-tax dollars out of my pay, won't I make less money?
Generally, your net take home pay will increase by the amount of tax savings, which will typically be 25-39% of your contribution. The amount of tax savings will depend on other deductions you may have and your income tax bracket.
Once I enroll can I change or terminate my elections during the Plan year?
You may change your election only if there is a change in your family status that causes your FlexComp plan expenses to change. This includes marriage, divorce, death of a spouse or child, birth/adoption of a child, termination or commencement of a spouses employment, and other events that the administrator determines, will permit an election change in accordance with IRC (Internal Revenue Code) Section 125 regulations.
What is the turn-around time for FlexComp reimbursement?
What form needs to be completed for medical/dependent care reimbursement?
The ASIFlex Claim Form can be submitted. You can also submit your claims online at https://asiflex.com.
What documentation is needed to be reimbursed for expenses?
Complete a claim form, attach the required itemized billings or receipts and send to ASIFlex.
PO Box 6044
Columbia, MO 65205-6044
1-877-879-9038 Toll Free
When submitting claims online, be sure to save your receipts in case ASIFlex needs further substantiation.
I do not feel comfortable with others seeing some of the information on an Explanation of Benefits statement from Blue Cross/Blue Shield. Is it acceptable to white or black out any of the information?
Yes, the only information that is needed for audit purposes is the name of the patient, date of service and charges. The name of the doctor is not needed.
What do I need from my day care provider?
You need to have your day care provider sign the claim form certifying that he/she provided the service.
May I submit photocopies of my receipts instead of the originals?
Where do I get the reimbursement forms needed?
May I submit for more medical reimbursement than what has been deducted from my paychecks so far?
Yes. You may submit up to your annual limit at any time throughout the plan year.
How often can I submit claims for medical/dependent care expenses? Am I limited to submitting one claim a month?
You may submit claims as frequently or as infrequently as you wish, just as long as the dates-of-service have occurred. Whatever works best for you.
Why didn't I receive the full reimbursement check for the day-care expenses I submitted?
Your reimbursement from your dependent care account will not exceed the amount of your payroll deduction to date.
There is an error on my payroll deductions for FlexComp. Who do I contact to correct it?
FlexComp Specialist in the Payroll Office 701.777.4423.
What if I don't use all my account balance?
The IRS requires that any unused funds at the end of the grace period be forfeited. We recommend that you be conservative in your elections.
What is the grace period?
It is the time period from January 1 through March 15 in which expenses can be incurred in order to use up any remaining balance from the prior Plan Year.
Who will benefit from the grace period?
Those participants who were unable to use their full election amount in the prior Plan Year.
Does the grace period apply to both flex plans?
Yes, it applies to both medical and dependent care expenses.
Can I pick what plan year I want to be reimbursed from?
No, claims will be paid in the order in which they are received. Eligible expenses incurred during the grace period and approved for reimbursement will be paid first from available amounts that are remaining in the previous Plan Year and then from amounts that are available for the current Plan Year.
What is the last day to submit vouchers for expenses that were incurred in the plan year or during the grace period?
April 30th of the year following the plan year.
Can I get the balance in my Flex Account on Self Service?
No. Balances can be seen on https://asiflex.com rather than on UND's Self Service site.
Does our FlexComp have the $500 carry over?
No. We do not have the $500 carryover. Instead, we have the 2 1/2 month grace period each year.