***What’s New***
FSA
- 2023-24 plan year began on July 29, 2023 and will go through July 26, 2024
- 2024-25 plan year will begin on July 27, 2024 and will go through July 25, 2025
- The maximum employee contribution is $3,200 for the 2024-25 plan year
- The maximum amount eligible to be rolled over to the 2024-25 plan year has increased to $640
DCAP
- 2023 DCAP plan year began on January 1, 2023 and will end on December 31, 2023
San Bernardino County offers two flexible spending accounts (Health and Dependent Care) that provide tax-savings. FSAs allow employees to take a pre-tax deduction from their income to pay for eligible health and/or dependent care expenses. Employees are eligible to participate in the FSAs if they are covered under a Memorandum of Understanding, Compensation Plan, or Employment Contract.
Enrollment
Employees are eligible to enroll into the FSA and/or DCAP during:
- Open enrollment
- If the employee experiences a mid-year change-in-status event
Plan Year Periods
FSA | DCAP |
---|---|
July 27, 2024 – July 25, 2025 | January 1, 2024 – December 31, 2024 |
Contributions & Roll Over
Below is the IRS maximum contribution amount for the FSAs and the County’s eligible roll.
- The maximum employee contribution is $3,200 for the 2024-25 plan year
- The maximum amount eligible to be rolled over to the 2024-25 plan year has increased to $640
How the Plans Work
Eligible employees elect an annual contribution amount to be placed in their FSA and/or DCAP account. The annual contribution is made via bi-weekly payroll deductions in equal installments throughout the year. Participants can access their FSA and/or DCAP contributions through the following ways:
- Using their FSA benefit card.
- Submitting a claim for approval (see “How to File a Claim” section)
Eligible Expenses:
Eligible health care expenses include:
- Coinsurance, Copays and Deductions
- Medical and Prescriptions
- Dental and Orthodontia
- Eye Exams, Eyeglasses and Lasik Eye Surgery
Eligible dependent care expenses include:
- Licensed nursery schools, qualified childcare centers, after school programs, summer camps, preschool
- Adult daycare facilities
How to file a claim
Step 1
Fill out the correct claim form
FSA
Medical Expense Reimbursement Form
Note: If claiming mileage, a print out of an online map source (i.e. google maps) that includes the starting and ending destination points and total miles traveled will need to be provided.
The form has to have the following information for claims:
- Date of services/ products incurred
- Name of the person who the expense was incurred for
- Dollar amount being claimed
- Provider name
- Expense category
DCAP
DCAP Reimbursement Request Form
Note: If claiming mileage, a print out of an online map source (i.e. google maps) that includes the starting and ending destination points and total miles traveled will need to be provided.
The form has to have the following information for claims:
- Name, date of birth, and relation of dependent
- Name, address, and taxpayer ID or social security number of dependent care provider
- Date(s) of services
- Amount claimed for reimbursement of dependent care expenses incurred
Step 2
Determine if you will be submitting a claim
- Electronic: Submit claim and upload supporting documentation (e.g. receipts) online via the FSA/DCAP Participant Portal
- Manual: Submit a paper reimbursement claim form and copies of supporting documentation to:
- Mail: Employee Benefits and Services (EBSD) – 175 W. Fifth Street, First Floor, San Bernardino, CA 92415
- Fax: 909.387.5566
- Email: hrfsadcap@hr.sbcounty.gov
Step 3
Attach all supporting documentation from the provider, vendor or merchant (i.e. receipt, statement, or bill) that includes all of the following:
- Description of service or product rendered
- Payment received for expense
- Amount paid to other part (i.e insurance) for expense
Step 4
Submit claim through the FSA/DCAP Participant Portal OR directly EBSD via mail, fax, or email
Note: Claims for eligible expenses incurred within the plan year can be submitted for reimbursement no later than ninety (90) days after the end of the plan year.