Flex Plan (Section 125 Flexible Benefits Plan)

The Section 125 Flexible Benefits Plan (Flex Plan) is a benefit plan that enables an employee to be reimbursed for qualifying expenses tax free.

The Flex Plan includes two features: Automatic Enrollment & Voluntary Enrollment.  This summary is not intended to thoroughly portray the Flex Plan. Details regarding the Flex Plan program are contained in the official plan documents: Summary Plan Description, and Flexible Spending Account (FSA) Plan Document.

If there is a conflict between this information and the formal language of the plan, the plan will prevail.

Employees participating in ISD 728's employer sponsored medical and dental plans are automatically enrolled in the Pre-Tax Premium Benefit Option.  Therefore, any portion of medical and dental premiums paid by the employee via payroll deduction is deducted pre-tax, resulting in a savings of state, federal, Social Security and Medicare taxes that would otherwise be paid on this amount.  However, this also restricts an employee's ability to drop coverage at will.  When medical and dental premiums are deducted on a pre-tax basis, an employee may terminate coverage only when a qualified life event has occurred (see Life Events and Midyear Changes below).  An employee who does not want premiums deducted on a pre-tax basis must sign a flex-benefits waiver form at the time of coverage enrollment, or during open enrollment for a new plan year.

The qualifying expenses included in the "voluntary" portion of the Flex Plan are outlined below.  The participating employee decides an amount to set aside for the Flex Plan Year, which is then deducted from the employee's paychecks pre-tax, resulting in a savings of state, federal, Social Security and Medicare taxes that would otherwise be paid on this amount.  The employee submits claims as expenses are incurred and receives reimbursement, up to the amount elected.  Funds do not rollover from one Flex Plan Year to the next.  The employee must submit claims for expenses incurred during the Flex Plan Year no later than 90 days after the Flex Plan Year end date, or the funds are forfeited.

The District's Flex Plan year runs from July 1 through June 30.  Individuals wishing to participate from year to year MUST "re-enroll" each year during the District's annual open enrollment period, which is held in the last few weeks of April each year.  Participation does NOT roll over from year to year automatically.

This portion of the Flex Plan allows the employee to be reimbursed for daycare services for children under age 13, care of adult dependents, and preschool tuition.  ($5,000 maximum or $2,500 if married filing separately).

This portion of the Flex Plan allows the employee to be reimbursed for certain limited policy insurance premiums including cancer, hospitalization, specific illness, accidental death and dismemberment, vision, dental and disability premiums.  For plans renewing on or after Jan. 1, 2014, flexing for individually owned health insurance premiums and for policies purchased on a public exchange is prohibited. The District discontinued offering an Outside Health Insurance FSA effective 06/30/2023.

This portion of the Flex Plan allows the employee to be reimbursed for qualifying medical, dental, and vision expenses incurred by the employee, employee's spouse or dependent children that are not reimbursed by insurance (such as deductibles, co-pays, prescriptions, dental care, prescription eye glasses, etc.). The IRS maximum amount for the 2024 calendar year is $3,200.

ISD 728 has contracted with a third-party administrator, Optum, to adjudicate and reimburse Flex Plan claim requests.

• To access and reimburse yourself with your FSA funds, log onto: optumbank.com/
• To learn how to submit a claim to Optum, watch this video: https://players.brightcove.net/1475651770001/H1DiB48Rb_default/index.html?videoId=6041977885001. 
• If you have any problems filing a claim, or have questions about your online account information or expense reimbursement, contact Optum at: (800)243-5543, or accountholderservices@optum.com.

Click here be directed to the FSA Eligibility list and access to the Optum FSA Store.

This portion of the Flex Plan is offered in conjunction with enrollment in an IRS qualifying high-deductible medical insurance plan with a Health Savings Account (HSA) component.  When contributions are being made to an HSA, IRS regulations prohibit reimbursement of medical expenses through a flex plan; however, a participant may receive reimbursement for vision and dental expenses.  The Limited-Use category may be used for vision and dental expenses only, and the employee may not participate in both the Full-Use and Limited-Use areas of the Flex Plan.  The IRS maximum amount for the 2024 calendar year is $3,200.

This portion of the Flex Plan is available only to an employee who is enrolled in ISD 728's employer-sponsored qualifying high-deductible medical insurance plan with a Health Savings Account (HSA) component.  Unlike the other categories of the Flex Plan, HSA contributions may be started, stopped or changed anytime during the Flex Plan Year.

An employee who does not elect participation via HRInTouch (ISD 728's online enrollment portal) during the annual open enrollment period is ineligible to participate for the plan year, unless a qualifying life event has occurred.  Likewise, an election cannot be changed during the year, unless a qualifying life event has occurred.  Some examples of qualifying events include, but may not be limited to:

• A change in marital status
• Acquisition or loss of dependent
• Significant change in employment or spouse’s employment
• Dependents' loss of eligibility
• Commencement of or return from a leave of absence
• Change in dependent care provider or fees.
   

The request for enrollment or modification must be consistent with the qualifying event (for example, birth of a baby would enable an individual to elect medical and/or day care for the baby only, but no new amounts for the rest of the family). Time restrictions apply; therefore, interested employees are encouraged to contact the Benefits Team punctually when a life event occurs by emailing benefits@isd728.org.

ISD 728 has contracted with a third-party administrator, Optum, to adjudicate and reimburse Flex Plan claim requests.

Optum has great information regarding FSA accounts on their website: https://www.optumbank.com/. 

Optum has a video on how to submit for claims at the following link: https://players.brightcove.net/1475651770001/H1DiB48Rb_default/index.html?videoId=6041977885001. 

Optum also has a video on how to upload a receipt: https://players.brightcove.net/1475651770001/H1DiB48Rb_default/index.html?videoId=6089014838001

Optum FSA reimbursement tips and reminders: https://www.optum.com/content/dam/optum/consumer-activation/PRJ2070/FSA_reimbursement_tips.pdf

Optum's Qualified Medical Expense Tool: https://store.optum.com/expense-eligibility/?utm_source=optum-bank&utm_medium=digital&utm_content=qme&utm_campaign=optum-store-of-partner-banners-2022

Optum can always answer your questions regarding your FSA account at: (800)243-5543, or accountholderservices@optum.com.