Frequently Asked Questions

How do I claim reimbursement for a coinsurance HRA?

You must submit a completed HRA Medical Coinsurance Claim Form and provide a copy of each “Explanation of Benefits” (EOB) sheet from the insurance company showing medical charges applied to coinsurance.

I am taking a three-month maternity leave and must pay for parking in order to hold my parking space. Can I be reimbursed from my transportation plan for parking during my leave?

Yes, you are still considered to be an employee during the maternity leave. If you need to pay for parking to hold your spot until you come back; you are eligible for parking reimbursement.

What type of employer can sponsor a Qualified Transportation Plan?

Any employer can sponsor a Qualified Transportation plan for its employees no matter what size. Eligible employers include corporations (Subchapter S or Subchapter C), partnerships, non-profit organizations, government entities, limited liability companies (LLCs) limited liability partnerships (LLPs) and sole proprietorships. (Caution: certain owners are ineligible to participate). Government employers can sponsor plans as can companies in the private sector.

What paperwork will I need to submit to substantiate my claims if I use a Qualified Transportation benefit debit card?

Receipts for transit pass purchases, monthly parking statements or invoices, parking meter’s which provide window tickets, vanpool statements or invoices are all eligible documentation for reimbursement along with the required claim form. When no receipt was provided, a personal attestation/certification regarding the type or amount of expense incurred is required (language included on Transit claim form).

I have a debit card for my transportation plan. How does it work?

Check with your employer to see if they offer a debit card to pay for qualified parking or transit expenses. If yes, the card will work only at transit and parking locations where the card machines are programmed with parking or transit merchant codes. Be sure to swipe the card for no more than you have in your parking or transit account(s). If you swipe the card for more than the balance in your card, or for more than the monthly statutory limit, the whole transaction will fail.

Why am I receiving emails from SBA after I swipe my FSA Debit Card?

When a participant swipes their FSA debit card, it triggers a series of emails from SBA depending on the nature of the swipe. Here is why these emails are important and what a participant can expect to receive. Read the article.

How do I enroll in the POP?

You will be given an enrollment form to complete. The form gives you a choice to either participate in the POP or to waive your right to participate in the POP. If you participate you will receive a copy of the Summary Plan Description which describes how the plan works.

What does it cost me to have an HSA?

The HSA incurs a monthly fee of $3.00. If your employer is paying the fee and you terminate employment, the monthly fee will be taken from your HSA balance following termination.

The HSA may be required to maintain a minimum balance of $10. If the balance falls below this minimum, your account may be closed and applicable account closing fees will apply. Please contact Sound Benefit Administration if you have questions.

What if I don’t use all of the money in my FSA account(s) by the end of the plan year?

You may forfeit any funds left in your account if you do not submit eligible expenses prior to the end of the plan’s run-out period (60 days after the end of the plan year).

NOTE: Some employers have adopted an option to help you spend down your remaining balance at the end of the year ($500 Carry-Over or 2.5 Month Extended Grace Period options). These options come at a risk to the employer. Please check with your employer to see if your plan has adopted one of these options.

What if I should become disabled? Are there any extensions available to my COBRA coverage?

Yes. If you have been “deemed disabled” by Social Security, you will receive an “award” letter. This letter must be submitted to the COBRA insurance carriers within 30 days of the date on the “award” letter. The insurance carriers will extend COBRA eligibility from 18 to 29 months (no extension available if the COBRA participant is already eligible for 36 months).

Can I take both the dependent care tax credit on my tax return AND use the FSA account to pay for my dependent care expenses?

No. Whether or not to participate in the daycare portion of this plan depends on your income, filing status, number of dependents and annual daycare expenses. Contact Sound Benefit Administration at (360) 779-7047 to assist you in determining whether participation in this plan or taking the dependent care credit on your tax return will give you greater tax savings. You cannot do both because it is considered “double-dipping.”

Can an employer limit which employees participate in a transportation plan?

Employers cannot act arbitrarily and should administer it on a uniform and consistent basis. Employers do have considerable discretion to determine which employees will be allowed to participate. Participation could be limited to work location, full-time employees, to a group of employees that is disproportionately highly compensated, or even to employees selected on a discretionary, case-by-case basis.

I’m worried about the COVID-19 pandemic. Can I buy disposable face masks as an eligible expense through my HSA or FSA?

Yes, when purchased because there is a current respiratory epidemic or you have a family member who is sick with a communicable illness, a disposable mask is eligible for reimbursement from your HSA or FSA.

If I set aside part of my pay for an FSA or HSA, won’t I make less money?

No. Your net take-home pay will increase by the amount of taxes you did not pay.

Can I decide to stop participating in a POP mid-year?

During the plan year, you may not change your election unless you have a “Change in Status.” Currently, Federal Law considers the following events to be eligible changes in status.

  • Marriage, divorce, legal separation or annulment, death of a spouse
  • Change in the number of dependents including birth, adoption, placement for adoption, or death of a dependent
  • Any of the following events for you, your spouse or dependent: termination or commencement of employment, a strike or lockout, commencement or return from an unpaid leave of absence, a change in worksite, or any other change in employment status that affects eligibility for benefits
  • A change in residence for you, your spouse, or dependent that affected eligibility for benefits
  • One of your dependents satisfies or ceases to satisfy the requirements for coverage due to attainment of age, student status, or any similar circumstance
  • A cost or coverage change in benefits that affected eligibility for you, your spouse or dependent
  • A prospective election change to terminate group coverage for you, your spouse or dependent(s) during the open enrollment period offered by the State Marketplace for individual medical coverage
  • If you work for a large employer and you are a variable-hour employee, you may experience a reduction of hours and loss of benefit status due to the Affordable Care Act’s Look Back Measurement period calculation. This is an eligible change of status reason to end your participation in the Premium Only Plan. Check with your employer to find out if you are in this exact circumstance.

If the cost of the orthodontia treatment is higher than my employer’s annual maximum election limit or my annual election, can I request for the remaining balance to be reimbursed in the next FSA plan year?

Only if the orthodontia treatment continues into the next plan year. If the treatment is completed during the current year, no balances can be carried over to the next plan year.

How do I change my POP election if I have an eligible change in status?

If you need to make a change of election for any eligible reason, you must complete a Change of Status form. This form needs to be completed within 30 days of your event to increase, decrease or stop your payroll contributions on a pre-tax basis.

What can my HSA account be invested in?

If your account balance is at least $1,000, you can begin investing in four carefully selected investment portfolios based on risk or create a custom portfolio of your own from a menu of mutual funds for an additional monthly fee. A self-assessment tool helps you decide which investment option is best for you. Advisor-selected funds include Exchange Traded Funds, target-date funds and index funds. Online research materials for each model and fund, such as investment prospectus and detailed investor statements, are available. You can self-direct your investments with online tools to buy, sell, transfer and rebalance your portfolio.

How are the monthly limits allocated month-to-month in a transportation plan?

The monthly expense must be calculated on a monthly basis.

Example #1: January’s ferry + bus combination = $280. In 2019 the statutory limit is $265. Only $265 can be reimbursed. The unpaid balance of $15 cannot carry over to a future month.

Example #2: January’s transit expenses are $170. July’s transit expenses are $280. July’s reimbursement is $265, the maximum monthly limit in this example. January’s smaller expense total has no bearing on reimbursing more than the maximum monthly limit in July.

Do I need to file any tax forms for my HSA?

All participants must file an IRS Form-8889, which we provide to you, with their taxes.

I am enrolled in my company’s Dependent Care Assistance Plan (DCAP). Can I lower or stop my participation in the plan because my children are at home due to schools being closed during the COVID-19 pandemic?

Yes, DCAPs do allow you to make changes to your contribution due to a change in cost or coverage. Therefore, you can stop your participation because your need for daycare has stopped. Notify your Human Resource Manager as soon as possible and complete a “Change of Status” form within 30 days of the end of your Daycare expenses. When your need for daycare returns, complete another “Change of Status” form within 30 days of your need for daycare returns. You can also change the amount of your pay period contribution so you end the plan year having contributed as much as you need or up to $5,000 as allowed by the IRS.

Will a credit card receipt substantiate my FSA claim?

No. Do not submit copies of cancelled checks, credit card receipts or debit card receipts. This does not meet the IRS requirement of having the date of service, description of service, and patient responsibility. An EOB or Itemized Patient Statement shows all of this required information.

Can I increase or decrease my monthly contribution to a transportation plan according to my needs?

Yes, check with your employer to see how frequently they allow changes.

How do I claim reimbursement for a medical deductible HRA?

You receive reimbursement by submitting a completed HRA Medical Deductible Claim Form and provide a copy of an “Explanation of Benefits” (EOB) or “Benefit Summary” from the insurance company showing you have met your out-of-pocket employee deductible responsibility.

How do I find out what I have paid toward my deductible or coinsurance for HRA purposes?

Since each insurance carrier has a different Explanation of Benefits form and lists the deductible expenses and coinsurance expenses in different places on the form, we’ve provided samples of EOBs from some of the major medical providers in Washington, Oregon and Alaska for your convenience. Click on a sample EOB below (based on your medical insurance carrier):

What type of employee can participate in a transportation plan?

Only individuals who are “currently employees at the time the Qualified Transportation plan is provided” are eligible to participate. The term “employee” includes only common-law employees (receiving W-2), other statutory employees (such as officers of corporations), and leased employees.

How long do I have to respond to the COBRA Election Notice?

You have 60 days from the loss of coverage date or the date the COBRA Election Notice was mailed (whichever is the later) to respond by mailing your COBRA Election Form.

How long do I have to submit my FSA healthcare claims for reimbursement?

You should submit claims for reimbursement during the plan year, but in no event later than 60 days after the end of a plan year. For a terminated employee or any participant who is no longer eligible under the terms of this plan, claims will still be reimbursed but only if such reimbursement requests are made by the earlier of (1) 60 days following the date that I ceased my employment or eligibility; or (2) the end of the 60-day period following the close of the plan year in which the expense arose. Any claims submitted after that time will not be considered.

If your employer has adopted either a $500 carry-over provision or an extended grace period provision in your plan documents, see below for details:

  • $500 Carry-Over provision– sixty days after a plan year has ended, any remaining balances up to a maximum of $500 will carry-over into the new plan year and be made available in addition to your new year election (if any). Claims incurred in that new plan year may then be applied to the old plan year’s unused balance until it is fully reimbursed.
  • 5 month extended grace period provision– if a plan year ends and a participant has an unused balance of any amount, it will be available in the following 2.5 months. A typical 12 month plan year would have a total of 14.5 months for a participant to incur charges to spend down an unused balance.

Please consult your employer to confirm if your Flexible Spending Account plan has adopted either the $500 carry-over provision or the 2.5 month extended grace period provision. Neither provision is available to terminated employees.

Why should I participate in the Flexible Spending Healthcare Account when I already have medical, dental, and/or vision insurance?

This account is used to pay for expenses not covered by insurance (see Forms Library for a list of possible eligible expenses). For example:

  • Deductibles, Co-pays, and Prescription Drugs
  • Eligible expenses not covered by insurance
  • Dental Services & Orthodontics
  • Eyeglasses, Contacts, Solutions & Eye Surgery
  • Chiropractic, Naturopathic, Acupuncture services
  • Massage – when prescribed by a medical doctor
  • Mental Health Services – for individuals in your family–not marriage or family therapy
  • Weight-Loss Programs – when prescribed to treat a specific medical condition
  • Over-the-Counter items such as blood sugar testing kits and strips, flu shots, etc.
  • Over-The-Counter items
  • Over-the-Counter medications when accompanied with a “prescription” from a medical doctor describing the medical condition the medication is for
  • Over-The-Counter items

What paperwork is required for an FSA medical, dental or vision claim reimbursement?

With a completed Claim for Reimbursement Form, it is important to send the proper documentation to substantiate your claim. The Internal Revenue Service requires that the documentation include:

  • Service provider information to include name, address and phone number
  • Patient information to include name, address and phone number
  • Date of service
  • Description of service or item
  • Charges or patient responsibility

Itemized Patient Statements from service providers and Explanation of Benefits (EOB’s) from insurance carriers are perfect forms of documentation. You do not need to show proof of payment.

Dual-purpose items such as massage therapy, membership to a weight loss program, over-the-counter medicines, vitamins, herbs or supplements, require a medical practitioner’s referral that includes the diagnosis of the specific medical condition for which it is prescribed. We require a copy of that referral each time you request reimbursement for that item. Over-the-counter medications, vitamins, minerals and supplements used for general health are not eligible for reimbursement.

What type of event will entitle me to COBRA eligibility and for how long?

  1. Termination of Employment – an employee has terminated employment. The employee and covered dependents are entitled to 18 months of COBRA eligibility.
  2. Reduction of Hours – an employee has reduced hours to the point where they no longer qualify for benefits under the group healthcare plans. The employee and covered dependents are entitled to 18 months of COBRA eligibility.
  3. Divorce –a COBRA Election Notice will be mailed to the ex-spouse based on the court-appointed date of the dissolution of marriage entitling him/her to 36 months of COBRA eligibility.
  4. Legal Separation – Based on the court-appointed date of the legal separation. A COBRA Election Notice will be mailed to the legally separated spouse entitling him/her to 36 months of COBRA eligibility.
  5. Loss of Dependent Status – a covered dependent child turns age 26 and will lose coverage at the end of their birthday month. A COBRA Election Notice is mailed to the 26 year old entitling him/her to 36 months of COBRA eligibility.
  6. Death of Employee – an employee has died. A COBRA Election Notice will be mailed to the surviving dependents that were covered on the employer’s group benefits entitling them to 36 months of COBRA coverage.

What happens if I pay for expenses that aren’t eligible?

Ineligible withdrawals are subject to income tax plus an additional 20% tax unless the account holder is 65 or older, is disabled or deceased.

Note: Per IRS requirements, you should always keep your receipts on file for any purchases made with your HSA card.

What type of event will entitle me to COBRA eligibility and for how long?

Can Sound Benefit Administration pay a provider directly?

No. You pay providers directly and are reimbursed for those eligible expenses.

What are the HSA Eligibility Guidelines?

You must be enrolled in a qualified High-Deductible Health Plan (HDHP). You cannot be claimed as a Tax Dependent.

You cannot be enrolled in Medicare, Tricare, another group medical plan (your spouse’s plan, for example), a Health Flexible Spending Account, or a Health Reimbursement Arrangement.

Domestic Partners of the account holder must set up a separate account and may contribute up to the family limit; the account holder cannot use their account to pay a Domestic Partner’s expenses.

If unsure about your eligibility, please consult your tax advisor or IRS publication 969.

Do I need to mail original receipts for my FSA claim?

No. If you fax photocopied claims to us you do not need to mail originals. Additionally, if you mail your claims instead of faxing them, PLEASE keep original receipts for your records and mail us photocopies. We do not want the responsibility of storing your originals.

What type of employee cannot participate in a transportation plan?

The following employees are excluded from participating in the plan: contract workers, independent contractors, temporary employees, former employees, individuals paid by an employment agency, collectively bargained employees, self-employed individuals, partners, and more-than-2% shareholders of a Subchapter S corporation.

Is a Qualified Transportation Plan a COBRA-eligible plan?

No. If there are any unused funds in the account, they are forfeited at termination of employment.

I pay for a 3-month transit pass in advance. How does that work with the allocated monthly limit?

The value of the multi-month pass may be divided by the number of months for which it is valid for purposes of determining whether the monthly statutory limit has been exceeded.

What paperwork do I need to submit an FSA daycare claim?

We have two daycare claim forms for you to use. The first is when you use a licensed provider who supplies monthly invoices for daycare services. The monthly invoice should include the contact information and the Federal Tax ID number of that provider. The second form is for non-licensed providers who do not provide a monthly invoice. Complete this form and request the signature of the daycare provider. No additional receipt is necessary when you use this form. Remember, it is not necessary that you pay your daycare provider before you submit a daycare claim. Both claim forms are available in the forms library.

What do I need to do if I terminate employment and I’m an FSA participant?

You have 60 days after your last day at work to submit claims incurred during the plan year up to your last day worked. After 60 days your run-out period has ended unless you work for a COBRA eligible employer and have elected the FSA as a COBRA benefit. NOTE: The 2.5 month extension or $500 carry-over balance does not apply if you terminated employment.

How should I store my HSA eligible expense records?

All participants are responsible for retaining the proper documentation to verify the eligibility of a distribution. You can maintain these records yourself, or you can use the ClaimsVault™ feature of your HSA account to conveniently keep copies of your documentation.

Can I submit FSA daycare expenses for reimbursement if my spouse is not employed?

If a spouse does not work, and is not disabled or a full-time student, daycare expenses are not reimbursable. If your spouse is either a full-time student or not able to care for himself or herself, your spouse will be considered to have earned income of $250 a month if there is one qualifying dependent in the home, or $500 a month if there are two or more qualifying dependents in the home. Therefore, qualified daycare expenses are reimbursable.

How long will it take for my FSA claim to be processed?

Claims received between Monday and Friday are processed during that week received. The following Tuesday we will notify your employer that you need to be reimbursed and the amount (never details about your claim). Check with your employer to find out what their reimbursement method is because each employer may reimburse participants differently.

Am I limited to the amount I can contribute in my HSA?

IRS limits for 2019 are $3,500 per year if you have Employee Only coverage, or $7,000 for Family coverage. If aged 55 or older, you can also make “catch-up” contributions of up to $1,000 per year above those limits.

Once you have an account, you can stop, re-start or change your contribution amount at any time.

Contribution limits assume the account holder is “eligible” for the entire tax year. If the account holder is not eligible for the entire tax year they can still contribute the maximum as long as they remain eligible for the entire following tax year (through December 31); otherwise, they will be taxed like normal with an additional 10% penalty on a prorated amount of the contribution.

Contributions can be made up to the day federal income taxes are due for the previous plan year.

My employer contributes part of my transportation expense and I contribute the rest. How is the limit applied?

The combination of both employer and employee contributions to this benefit cannot be more than the monthly statutory limit.

What is the definition of “transit passes”?

“Transit pass” means any pass, token, farecard, voucher, or similar item that entitles a person to transportation on mass transit. There are different types of mass transit facilities – busy, ferry, rail, subway, monorail, streetcar, and tramcars, among others. Vanpool expenses may also have transit pass expenses if the vanpool is in the business of transporting persons for compensation or for hire and if the seating capacity of the vehicle is at least six adults (not including the driver).

How much can I spend each year in my HSA?

You can withdraw up to the amount in your account at that point in time. Any unused funds roll over from year to year.

What are the benefits of COBRA coverage over Individual coverage or Exchange coverage?

If you have already met your deductible or out-of-pocket maximum on the group plan before being eligible for COBRA, it might be advantageous to stay on the COBRA plan until the end of the calendar year. If you move to an individual plan or Exchange plan mid-year, your deductible will reset to zero when that individual policy or Exchange policy begins. While all plans are different, it is common for COBRA coverage to have greater benefits due to being a group plan. Individual and Exchange coverage can be more expensive for older individuals because rates are based on age.

I received an old bill and paid it in a new plan year. Is this an eligible FSA claim during this new plan year?

No. It doesn’t matter when you pay the bill. Payments for something that occurred before your plan year are not eligible. The date you incurred the expense must fall within the current plan year to be eligible to be reimbursed under the plan.

What happens to my HRA if I leave the company mid-year?

For a terminated employee or any Participant who is no longer eligible under the terms of this Plan, claims will still be reimbursed but only if such reimbursement requests are made by the earlier of (1) 60 days following the date that you ceased employment or eligibility; or (2) the end of the 60-day period following the close of the Plan Year in which the expense arose. Termination of employment concurrently terminates your eligibility and participation in the plan. Any claims submitted after that time will not be considered.

What if I have a financial hardship, can I stop participating in a POP then?

Unfortunately, no. Financial hardship is not an acceptable/eligible change of status reason. If enrolled in the Premium Only Plan, you may not change your salary reduction election by terminating insurance coverage for you, or your covered dependents, mid-plan year if you are responsible for a portion of the insurance premium.

What are the limits to how much I can be reimbursed in each transportation account?

Each year, the IRS sets the limit for the calendar year limit. Click this link to see the maximum monthly limit for each benefit.

Do you accept credit card payments?

No. We have in the past but the bank fees we must pass along to COBRA participants are too cost prohibitive. We do offer Electronic Funds Transfer from your bank account. Please note there is a $2.50 fee to use this service.

Are there alternative benefits I may be eligible for in addition to COBRA coverage?

Yes. Having one of these events will qualify you to apply for Individual insurance and/or the State or Federal Exchange. It is important to consider the benefits of COBRA, individual coverage or exchange coverage and the costs. If you elect COBRA coverage, you will not have an opportunity to apply for individual coverage or Exchange coverage until the next open enrollment period (typically January 1st).

My COBRA Election Notice included several healthcare benefits; do I have to elect all of them?

No. You can pick the benefit(s) you want. You may also drop dependents at this time but you cannot add dependents unless it is open enrollment for that particular benefit.

What if I become eligible for Medicare while on COBRA?

The insurance carriers will terminate your coverage under COBRA due to your Medicare entitlement the first day of your birthday month even if you wanted to keep COBRA coverage.

How do I store HSA claims in the ClaimsVault™?

Click on the link for ClaimsVault™ in the top menu bar once you’ve logged into your HSAToday account, and choose “Add an Expense.” From there you can enter details about your qualified expense, and choose to either:

1. Upload a scanned copy of your documentation.
2. Download our mobile phone app (or search for DataPath Summit) at Google Play Store for Android products and iTunes for Apple products. Use the app to take pictures of your claims receipts, then upload directly to the ClaimsVault™.
3. Fax it in with a provided cover sheet.

Can I change my FSA contributions during the year?

Only if you have a change in status such as the addition or loss of a dependent.

When will I be reimbursed for my HRA claim?

All faxed/mailed claims received between Monday and Friday are adjudicated as they are received, with reimbursements generated the following week.

Can I carry over amounts remaining in my transportation plan account to future months?

Yes, a plan may permit employees who remain employed by the employer to carry over unused amounts to subsequent months for an indefinite period, so long as the amounts are used solely for qualified transportation benefits (parking, transit passes and vanpooling). You cannot get your account balance back in cash.

How do I set up an HSA?

Click here to enroll now. This is a secure website so all the information you enter will be protected.

Follow the prompts to set up your new HSA.

Do I need to show proof of payment to get reimbursed for an FSA claim?

No. You do not need to show proof of payment. You only have to show you have incurred the expense. In some cases proof of payment may help substantiate patient responsibility.

Can COBRA be extended for my dependents?

Yes. If a covered dependent incurs a qualifying secondary event. Such an event includes, a covered dependent experiences a divorce, a legal separation, a loss of dependent status, or a death during the 18-month COBRA eligibility period. This entitles the covered dependent to a total of 36 months of COBRA eligibility.

Where do I submit my HRA claim?

Fax (866) 320-1932
Mail: 18887 State Highway 305, Suite #600
Poulsbo, WA 98370
Email: [email protected]

How do I terminate my COBRA coverage before the end of my COBRA eligibility?

Provide written notification that you want to terminate your coverage. If you fail to pay your premium within the 30-day grace period, your coverage will be retroactively terminated for failure to pay premiums.

What is the grace period to pay my COBRA premiums once I’m enrolled?

The monthly premium is due the first of every month with a 30-day grace period. Payment must be postmarked no later than the 30th day of the month in which the COBRA premium is due. If NOT postmarked by the 30th day in which it is due, your coverage will be terminated back to the first of the month you failed to pay the premium on time.

What expenses are considered eligible for HSA or FSA reimbursement?

You can use a HSA/FSA to pay for many medical, dental and vision expenses tax-free. Click here to see what expenses are eligible.

What types of benefits are available with a transportation plan?

Parking, transit passes and vanpooling (bicycle commuting reimbursements removed from eligibility in 2018). See more information here.

How will I pay my monthly COBRA premiums?

You will be mailed payment coupons until the next benefit renewal month. The coupons will list the benefits you’ve elected, how much they cost, and where to mail your payment. You may use these coupons to mail a check every month or if you use your bank’s bill-pay service, no coupon is needed. Alternatively, you can pay via Electronic Funds Transfer using this link. Please note there is a $3.00 fee to use this service.

Why should I participate in the Flexible Spending Healthcare Account when I already have medical, dental, and/or vision insurance?

This account is used to pay for expenses not covered by insurance (click here for a list of possible eligible expenses). For example:

  • Deductibles, Co-pays, and Prescription Drugs
  • Eligible expenses not covered by insurance
  • Dental Services & Orthodontics
  • Eyeglasses, Contacts, Solutions & Eye Surgery
  • Chiropractic, Naturopathic, Acupuncture services
  • Massage – when prescribed by a medical doctor
  • Mental Health Services – for individuals in your family–not marriage or family therapy
  • Weight-Loss Programs – when prescribed to treat a specific medical condition
  • Over-the-Counter items such as blood sugar testing kits and strips, flu shots, etc.
  • Over-the-Counter medications when accompanied with a “prescription” from a medical doctor describing the medical condition the medication is for

I participate in a vanpool. How is my monthly vanpooling expense calculated for a transportation plan?

The fair market value of vanpooling expenses is based on all the facts and circumstances. Vanpooling benefits may be valued under the automobile lease valuation rule, the vehicle cents per mile rule or the commuting valuation rule. If one of these special valuation rules is used, however, the employer must use the same rule to value the use of the commuter highway vehicle by each employee who shares the use.

What if I am already enrolled in Medicare Part A or both Part A & B when I have a COBRA qualifying event?

You are eligible for 18 or 36 months of COBRA coverage depending on your “COBRA qualifying event.” Becoming eligible for COBRA has great impact on your Medicare coverage. It would be wise to consult with an insurance broker with specialized Medicare training in order to review the facts and circumstances of your situation. Enrolling in COBRA coverage could have unintended Medicare consequences.

How long must I wait to receive a COBRA Election Notice?

It must be mailed within 44 days from your “COBRA Qualifying Event” date.

How do I get reimbursed for my FSA expenses?

Once you have completed the Flexible Spending Account Enrollment Form, you will receive a claim form and instructions on how to file a claim. Simply complete the form, attach a copy of the itemized healthcare or dependent care statement and send it to Sound Benefit Administration via fax, email, or mail. You may also complete an online claim form (logging into the SBA website is required for this) and upload your claim backup securely.

What information can I find on the Mobile MyRSC app?

Once you log in, you are on the Home page. This page lists all available options you have on the mobile site:

  • View Accounts: view the balance and details of your Health Reimbursement Account (HRA), Health Savings Account (HSA), or Flex Spending Accounts (FSA). You may have one or or more of these accounts available to you, depending on your company’s benefit package
  • Card Activity: view all card transactions and card details
  • Personal Information: view or edit your personal information
  • Manage Subscriptions: change the emails and notifications sent by myRSC
  • Logout: logs you out of your account
  • Home and Help: Home brings you back to this screen and Help provides contact information regarding your benefits

What is the new Seattle City Transit Ordinance?

The City of Seattle has passed a Commuter Benefits Ordinance, which becomes effective on January 1, 2020. Businesses with 20 or more employees will be required to offer their employees the opportunity to make a monthly pre-tax payroll deduction for transit or vanpool expenses. The ordinance encourages commuters to use transit options other than single occupancy vehicles, thus reducing traffic congestion and carbon emissions. Because the deduction is pre-tax, the law has the added benefit of lowering the tax bills for both workers and businesses.

Official City of Seattle Links:

Ordinance Main Page


Seattle Ordinance Code Link

Can I only claim the amount up to what has been deposited into my FSA Healthcare Account?

No, you are eligible to receive reimbursement for your entire patient responsibility up to your plan year election regardless of what’s been deducted from your pay to date.

What happens after I elect COBRA?

If you’ve paid the premium, your healthcare coverages will be reinstated back to the loss of coverage date. Your medical ID card will begin working again (in most cases) and you will not be mailed a new one (in most cases). Any medical deductible you may have met earlier in the plan year will be credited to your COBRA coverage.

What is the HSA ClaimsVault™?

The ClaimsVault™ offers you and electronic way to manage your claims. You can use the ClaimsVault™ to store documentation for purchases made with your HSA card, and for HSA distributions you have taken to reimburse yourself for qualified expenses paid out-of-pocket. You can also use the ClaimsVault™ to keep documentation for qualified expenses that you have paid out-of-pocket, and for which you have not yet taken a distribution, so that your invested funds can continue to earn interest.

How can I find out my account information on the Mobile MyRSC app?

When you select the View Accounts option, the page displays only the benefits for which you are subscribed. Select the benefit you wish to view to see unresolved transactions, benefit summary data, and details of claims and reimbursements.

If I am not covered under my company’s health insurance plan(s) can I still contribute to an FSA?

Good News! If you are eligible for your employer’s group healthcare plans but waive enrolling in them, then you and your family (legal dependents) can still participate in the Healthcare, Dependent Daycare, or Transit FSA Accounts.

Do I have to pay the orthodontia charge in full before it can be reimbursed to me through the FSA?

No. It is not necessary to pay the entire amount up-front in order to be reimbursed for the total contracted amount. Remember, we can only reimburse you for the total cost up to your annual election, less previous reimbursements. Read more here.

Can I view my debit card activity on the Mobile MyRSC app?

The Card Activity page gives you the option to view the transaction details or account details of your debit card.

Selecting View Transaction Detail takes you to the Transaction Overview page. Select the month and year for the card activity you want to view. Only the
transactions for the month and year you choose will be displayed. Clicking on a particular transaction lets you see the details of that card swipe.

Selecting View Account Detail lists all cardholders on your plan. You can then select the person’s name and see the account details associated with that card. You also have the option of blocking a card.

What do I need to do if my claim is denied?

Ineligible or duplicate claims need not be resubmitted. Some denied claims for reimbursement require more information. A new claim form must be completed with the additional documentation being requested.

How often can I file claims on my FSA Healthcare Account?

As often or as seldom as you choose throughout the plan year.

What is the definition of “parking”?

If an employee commuting to work has parking expenses associated with that commute, those expenses can be paid by either the employer, the employee or a combination of both.

How do I log in to the Mobile MyRSC app?

Open the Mobile myRSC® app or point your browser to:

The first page that loads is the login screen. Use the same username and password that you use to log in to the full myRSC website.

NOTE: The mobile site is optimized to work on Safari on an iOS, the default Android Browser, or Chrome on Android 4.x. If you are using an older browser, you will automatically be redirected to the classic myRSC site.

Who is a legal dependent?

A legal dependent is classified as your spouse, your child(ren), your adopted child(ren), or anyone else you are legally responsible for. For federally-regulated IRS employee benefit plans incurred by domestic partners and/or their children (not your biological children) are not eligible for reimbursement under this plan. You may not submit charges incurred by anyone other than yourself, your spouse, or your children, otherwise known as your legal dependents.

Do I have to mail the COBRA Election Form with payment?

No, however you will not be enrolled in benefits without payment. If you elect COBRA by mailing the COBRA Election Form without payment, you will have an additional 45 days to make all retroactive premium payments from the postmark date of the COBRA Election Form.

Can the cost for orthodontia treatment that lasts longer than the current plan year be reimbursed by the FSA up-front?

Yes. Submit a claim form requesting your out-of-pocket expenses along with a copy of the orthodontia contract and we will reimburse the total amount of the treatment up-front up to your annual election, less previous reimbursements. You will no longer have to submit a Claim Form each month as services are rendered for reimbursement.

What happens if I remain on COBRA until the end of my 18 or 36 months of eligibility?

You cannot stay on COBRA after your eligibility period ends. You must find other coverage. You will be mailed a Conversion Letter six months before the end of your COBRA eligibility to remind you that your COBRA coverage cannot be extended and you must convert to an Individual, Exchange or other group policy.

My doctor and dentist cancelled my appointments due to the COVID-19 outbreak. Can I lower my Health FSA election during this pandemic?

On May 12, 2020, the IRS issued guidelines allowing employers to amend their FSA plans to permit changes to annual elections or allow new elections. Refunds of previously contributed contributions are not permitted. Check with your employer to see if your plan to allows for mid-year changes to your healthcare FSA. If allowed, you will need to complete a change of status form.

Keep in mind that even if you had an elective procedure planned and/or a doctor’s appointment scheduled, we are hopeful that you will be able to use your full election prior to the end of the plan year. You might also consider other procedures/services/products that could utilize un-used funds. Remember, the CARES Act now allows for OTC medications to be eligible for reimbursement without a prescription – but be careful not to stockpile.

Please note that if you are an HSA participant, you can increase, decrease or cease your contribution at any time.

Still have questions?