Flexible Spending Accounts


Benefits-eligible employees may choose to participate in the Flexible Spending Accounts Plan (FSAs) allowed under Section 125 of the Internal Revenue Code. Under the FSA Plan, eligible employees may redirect a portion of their paycheck each month (except July and August) to their own personal Health Care FSA and/or Dependent Care FSA. The money redirected to the FSA will never be subject to Federal, State, Social Security or Medicare taxes. As a participating employee incurs eligible out-of-pocket health or dependent care expenses, they simply pay the bill and submit a claim to the FSA Plan administrator (American Fidelity Assurance) for reimbursement.

Employees selecting a Health Care FSA do have the option to receive a debit card which is linked to their Health Care FSA account. This allows an employee to pay for eligible medical expenses directly instead of paying out-of-pocket first. It is very important to keep a copy of all receipts for FSA reimbursable expenses. A reimbursable expense cannot be claimed under both an FSA and the Health Reimbursement Account (HRA) issued with either the UnitedHealthcare SignatureValue Alliance HMO or UnitedHealthcare Journey-Harmony HMO medical plans. Please review the following documents to determine if a Flexible Spending Account might work for you:

Understanding Your Employer's Section 125 Plans

Using Your Health FSA Debit Card

Using a Dependent Day Care FSA

Fully Executed (FSA) Plan Document

FSA Enrollment Information:

The Health Care FSA annual maximum contribution limit for 2020 is $2,700 and the Dependent Care FSA annual maximum contribution limit for 2020 is $5,000 ($2,500 maximum if married filing separately). Please complete the 2020-FSA Election Form below and return to the Employee Benefits Department. We do not need an original. The form may be scanned and sent to, faxed to (619) 725-8132 or dropped off at our office (Ed Center - Room 1150). FSA elections can only be made during the Open Enrollment period (Oct/Nov) for the following plan year or for the current plan year if there is a qualifying event.

2020 - FSA Election Form

How to Access your FSA Account Electronically:

To create your account or login to manage your FSA account online to file claims, view account activity and establish direct deposit of reimbursements, please click on a link below:

Accessing Your FSA Account Online/Mobile App

American Fidelity Assurance may be reached directly by calling (800) 662-1113 or by email at

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