There are two different Flexible Spending Accounts (FSAs). You can elect one or both during Open Enrollment.
You fund the accounts with your own money. Your contributions are deducted from your pay before taxes are calculated – reducing your taxable income and saving you money.
Health Care FSA
This account is for eligible health care expenses — medical, dental, vision, mental health and substance abuse expenses the IRS considers eligible for reimbursement.
You can use the account for yourself — and for your dependents’ health care expenses — even if they’re not enrolled in your plan.
You can’t use this account for dependent day care expenses. It’s only for eligible health care expenses.
Note: You cannot use your Health Care FSA to pay for health care coverage or gym memberships or for most cosmetic procedures.
Health Care FSA Contribution Rules
You can set aside up to $2,850 of your before-tax pay for 2023.
The Health Care FSA has a "use it or lose it" rule. However, you can carry over unused balances up to $570 to the next year as long as you're eligible to participate in the Health Care FSA as of January 1 of the next year.
You forfeit unused amounts over $570 at the end of the plan year (for example, if you have an unused balance of $571, you can carry over $570 and you’ll forfeit $1).
You can be reimbursed even before you have money in your Health Care FSA to cover your claim, up to the annual amount you elected to contribute.
You elect to contribute $1,200 for the year. You incur $1,000 in expenses in early February — but you’ve only contributed $200 to your account so far. You can be reimbursed for the full $1,000 right away.
How the Health Care FSA Works
To help you avoid forfeiting unused FSA dollars at the end of the year, your Health Care FSA will always pay claims first, before your Health Account pays claims. Then, when your Health Care FSA is used up, your Health Account will pay claims. No reimbursements will come out of your Health Account until your Health Care FSA is used up, and it’s all handled by your accounts’ administrator.
Your FSA administrator depends on your medical coverage:
If you have a Health Account, you can use it to help pay eligible health expenses, too. Your unused Health Account balance rolls over year after year but you can only carry over up to $570 in your Health Care FSA. You forfeit the rest. Log on to your myPlans Connect account and click Estimate Medical Plan Costs under Tools to help you decide how much to contribute to the FSA and see potential tax savings.
Dependent Care FSA
This account is for eligible dependent care services for your dependent family members so you can work.
The IRS allows you to use the account for child* and elder care while you work — such as day care or adult care, babysitters, at-home caregivers, preschool, before- or after-school programs and summer day camp.
You can’t use this account for your dependents’ health care expenses. It’s only for dependent care services that allow you to work.
Dependent Care FSA Contribution Rules
You can contribute up to $5,000 per person or married couple filing a joint tax return — or $2,500 per person for employees with spouses filing separate returns — but your annual contributions can’t exceed your spouse's income.
If your spouse is a full-time student or mentally or physically disabled, he or she is considered to have an annual income of $3,000 if you have one eligible child — or $6,000 if you have more than one eligible child. The contribution rules for married individuals do not apply to employees with registered domestic partners.
How the Dependent Care FSA Works
You forfeit unused amounts at the end of the plan year. You can’t carry over unused amounts.
* Remember, the Dependent Care FSA is for child care service reimbursements for dependents generally under age 13, while the adult care reimbursements are for a dependent of any age who is physically or mentally incapable of self-care.
Visit the IRS Website for eligibility details.
For details, visit the IRS website an view IRS Publication 502, Medical and Dental Expenses
- Anthem members: Click here for a list of eligible Health Care FSA expenses, and click here for a list of Dependent Care FSA expenses.
- Kaiser members: Click here for a list of eligible Health Care FSA and Dependent Care FSA expenses.
Be sure to keep your itemized receipts or explanation of benefits (EOBs) for purchases made using your FSA – you’ll need them if you have to verify your claims for the IRS.
For Anthem members or waived coverage employees with a Flexible Spending Account (FSA)
*For details on the transition of HealthEquity | WageWorks to Optum, including claim filing deadlines, click here.
There are three ways to get reimbursed:
|Pay Provider||Reimburse Myself||Manually file claims|
Log in to your Optum Financial account and use Pay Provider if you get a bill and you don’t want to use your card.
Pay Provider sends money to your provider for amounts not paid by insurance.
Log in to your Optum Financial account and use Reimburse Myself if you already paid an eligible expense out of your own pocket.
Download the free Optum Financial app for an easy way to use Reimburse Myself.
Optum Financial automatically debits your Health Care FSA, if you elected it, and then your Health Account.
Don’t have enough in your Health Account or Health Care FSA to cover the charge? You’ll need to pay with your own money.
Watch the Reimbursements with Anthem video to learn more about filing a claim.
Tip: Don’t wait!
Send your explanation of benefits (EOB) to Optum Financial when you get it—even if you paid with your Optum Financial payment card. Sending the EOB right away will help avoid having your payment delayed. If you need help filing a claim or reimbursement, call the PG&E Benefits Service Center at 1-866-271-8144, and select option 1 and then option 1 for Optum Financial.
Optum will send multiple reminders if you need to verify expenses. You’ll have 180 days to verify your expenses. After 180 days, if you haven’t verified expenses and they total more than $150, Optum will suspend your card.
Set up your Optum Financial account
To set up your account, log on to your myPlans Connect account and click on the Access Your Health Account link under the Your Health Insurance box. You’ll be able to go straight to your Optum Financial account without creating a username and password.
Alternatively, you can log into OptumFinancial.com or use the Optum Financial mobile app. Optum Financial won’t know who you are—so you’ll need to register your account the first time you visit Optum Financial outside of myPlans Connect. When accessing your account for the first time, you’ll need to create a HealthSafe ID® username and password. HealthSafe ID adds an extra layer of security to your account by using two-factor authentication.
For Kaiser members
File claims with kp.org through June 30, 2023, for 2021 FSA expenses incurred through December 31, 2022. Log into your medical account at kp.org and select My coverage & costs and to file a claim.
If you have questions about the FSA accounts, contact your Health Account and Health Care/Dependent Care Flexible Spending Account (FSA) claims administrator.
Watch the Reimbursements with Kaiser video to learn more about filing a claim.