Flexible Spending Accounts
Enroll in a Flexible Spending Account to save on taxes for eligible health care and dependent day care expenses!
You elect an annual amount to contribute to your account. Your contributions:
- are made by payroll deduction
- are pre-tax, and
- are taken out of your paycheck in equal amounts over the course of the year
The KSU Flexible Spending Accounts are provided by HSA Bank.
HSA Bank will provide a Debit Card to participants in the Health Care, Limited Purpose and Dependent Accounts. The Debit card can be used at medical and dental offices, hospitals, healthcare clinics and pharmacies and at child day care centers that accept MasterCard as a form of payment. Always keep your receipt! Documentation may be required in some instances to substantiate the eligibility of a Debit Card purchase. To request a new card or to replace a lost or stolen card, call 1-877-470-1771.
For information on eligible expenses and how the plans work, visit the HSA Bank website at: myaccounts.hsabank.com/Login.aspx
Health Care Flexible Spending Account - Health Care FSA
The Health Care Flexible Spending Account helps you pay for medical related expenses not covered by the health benefit plans or any other insurance plan. Some eligible expenses are:
- Out-of-pocket medical and dental expenses such as co-payments, co-insurance, deductibles, eyeglasses, etc.
- Over-the-counter medications such as Advil or Claritin (does not include vitamins, dietary supplements, or topical applications)
- Vision Care expenses such as glasses and contacts
- Hearing aids or hearing tests
In general, reimbursable medical expenses must be incurred primarily for the prevention or improvement of a physical or mental defect or illness. The plan does not include reimbursement for any type of cosmetic procedure.
If you contribute to an HSA, you may not contribute to the Health Care FSA
Limited Purpose Flexible Spending Account - Limited Purpose FSA
The Limited Purpose Flexible Spending Account helps you pay for dental and vision related expenses not covered by the benefit plans or any other insurance plan. This account is only available if you are enrolled in the BCBS Consumer Choice HSA (High Deductible Plan) and works in conjunction with your Optum Bank Health Savings Account.
Dependent Care Flexible Spending Account - Dependent Care FSAYou may use the Dependent Care Flexible Spending Account to be reimbursed for work-related expenses for any Qualifying Individual described below whom resides with you:
- A dependent age 12 or under who entitles you to a personal tax exemption; or
- A spouse or other tax dependent that is physically or mentally unable to care for himself/herself.
How to submit a ClaimTo submit a claim, complete the correct form below and e-mail or mail to HSA Bank.
- To Submit Claims by e-mail, e-mail to: email@example.com
- By Mail to: HSA Bank Healthcare Payment Solutions, c/o Health Account Services, P.O. Box 6122, Fargo, ND 58108-6122
- Or you may log into your personal account and complete an on-line claim reimbursement request at: myaccounts.hsabank.com/Login.aspx
Important facts about your FSA account
- When you submit a claim for medical care expenses, you can be reimbursed for the claim up to the total amount you have elected to deposit for the year.
- When you submit a claim for dependent day care expenses, you will be reimbursed up to the current balance of your account.
- Medical care, dependent care, or eligible medical purchases must be made by March 15 of the following year. Claims must be submitted by March 31 to be reimbursed for the prior plan year's funds. You must indicate between January 1 and March 15 that you are submitting a claim for the prior year remaining contributions.
- Money remaining in your FSA account(s) will not be returned to you at the end of the grace period (March 15). Any amount remaining after the end of the runoff or grace period will be forfeited. Because of this “Use it or Lose it” rule, it is important for you to carefully estimate your out-of-pocket expenses.
If you leave Kennesaw State University
- Your participation in the plan ends on the last day of the month following the date you separate from KSU and you will no longer be able to incur expenses for your reimbursement.
- You have 90 days from your last date of eligibility to file a claim for either account for your eligible expenses occured on or prior to your last date of eligibility.
Resources - HSA Bank FSA Forms
Login to HSA Bank to register or access your account and click on the 'Tools & Support' tab to request additional debit cards, submit reimbursement requests, online bill pay and FAQ's!
HSA Bank Customer Service: 1 (833) 228-9352 or 1 (800) 357-6246
HSA Bank Fax Number: 1-888-403-5029
HSA Bank Website: https://myaccounts.hsabank.com/Login.aspx
HSA Bank Email: firstname.lastname@example.org