Public Schools offers a Plan 125 Flexible Benefit Program. The Flexible
Benefit Program is not an insurance plan, but a government-sanctioned
program to allow all full-time employees to set aside before-tax dollars
to pay for certain insurance premiums, un-reimbursed health care
expenses and dependent care expenses.
dental and life insurance premiums you pay are automatically deducted
on a pre-tax basis for you as part of the District's Plan 125 program.
We offer two separate reimbursement accounts:
Un-reimbursed Medical Care Expenses, which includes out-of-pocket
medical and dental expenses for you and your dependents. This includes
medical, dental and prescription co-pays, eyeglasses, contacts, etc.
The minimum annual election is $250; maximum annual election is $2,550.
Dependent Care Expenses, which includes expenses for the care of a child
or dependent family member while you are employed. The minimum annual
election is $250; maximum annual election is $5,000.
To participate, current full-time employees must enroll in one or both of these accounts before September 1 each year. The Plan Year is September 1 through August 31. You must enroll each year to participate.
For new employees, all Flexible Benefit Program enrollment forms for the Plan Year must be returned to the Compensation & Benefits office within 30 days of your employment date. The effective date of your flex plan enrollment will be the 1st of the month following 30 days of employment. Your first payroll deduction will also begin that month.
Please read your Plan 125 Summary Plan Description booklet thoroughly. Remember, the accounts you select on your enrollment form will be in effect for the entire plan year. Your election is irrevocable, except as stated in the Plan 125 booklet. THERE CAN BE NO EXCEPTIONS, AS THIS PLAN IS GOVERNED BY INTERNAL REVENUE SERVICE REGULATIONS.
Should you have questions concerning this benefit plan prior to your enrollment, please contact the Compensation and Benefits Department at 531-299-9805.
FAILURE TO COMPLETE AN ENROLLMENT FORM INDICATES YOU DO NOT WISH TO PARTICIPATE IN THE REIMBURSEMENT ACCOUNTS FOR THIS PLAN YEAR.
Reimbursement from your Plan 125 Health Care or Dependent Care Expense Account is available by many options.
1. Setup an online account through Payflex.com. Track your balances, request reimbursements etc.
2. Download the Paylex App for your smartphone. Use your smart phone to scan receipt and provide supporting documentation.
3. Obtain a Flexible Spending Account Claim Form by printing it at payflex.com, or check with the school office.
a) Submit the completed Claim Form via U.S. mail to Payflex Systems, Inc., P.O. Box 981158, El Paso, TX 79998-1158 or fax to (855) 703-5305.
b) A reimbursement check will be mailed to your home or your reimbursement can be directly deposited into your account with prior authorization.
2. Use the Flex Convenience Card
a) All flexible spending participants will receive a Flex Convenience Card upon enrollment into the Health Care and/or Dependent Care accounts.
b) Use the card for prescription or office-visit co-pays, out-of-pocket medical, dental, vision and hearing expenses, etc. A list of eligible/ineligible expenses can be found at payflex.com.
Refer to the Plan 125 Summary Plan Description booklet or www.payflex.com for more details.
HOW TO FILE A FSA CLAIM
PayFlex Reimbursement Quick Reference