2015 Flexible Benefit Plan
Flexible Spending Account benefit change – Effective 01/01/2011
the cost of over-the-counter medicines are not reimbursable through your USI
medical expense Flexible Spending Account unless the medicine is prescribed by a
Premium Only Plan - Employee contributions for medical insurance may be deducted on a pre-tax basis.
Flexible Spending Account (FSA) – FSAs allow employees to set aside pre-tax dollars to pay for certain unreimbursed medical and dental expenses and for dependent care expenses.
Per the IRS, you cannot enroll in the medical flexible spending account if you
have a Health Savings account; at USI, this applies to all participants in a
Lumenos CDHP/HSA health plan. However, CDHP/HSA Participants can enroll in a
dependent care flexible spending account.
To learn more about the FSA programs and how they work, read the
The Nyhart Company administers the University's flexible benefit plans. Nyhart will provide employees with a secure identification and password to access their FSA(s) on-line at www.nyhart.com. Nyhart also will provide participants with a debit card to be used for eligible expenses.
Contributions for the calendar year may be used for purchases through March 15 of the following year for unreimbursed medical, vision, and dental expenses only. The dependent care FSA must be exhausted by the end of the calendar year for that year’s election.
Employees must complete a new
Nyhart Election Enrollment Form each calendar year to participate in the flexible benefit plan(s).
You must enroll in this plan annually and cannot make changes during the plan
year unless there is a change in status as defined by Federal law.
Changing FSA Elections During the Plan Year
Generally, you cannot change the elections you have made after the beginning of
the Plan Year. However, you are permitted to change elections if you have a
"change in status" as defined by Federal law and you make an election change
that is consistent with the change in status. Currently, Federal law considers
the following events to be a change in status:
- Marriage, divorce, death of a spouse, legal separation or annulment;
- 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;
- One of your dependents satisfies or ceases to satisfy the requirements for
coverage due to change in age, student status, or any similar circumstance; and
- A change in the place of residence of you, your spouse or dependent that would
lead to a change in status, such as moving out of a coverage area for insurance.
In addition, if you are participating in the Dependent Care Flexible Spending
Account, then there is a change in status if your dependent no longer meets the
qualifications to be eligible for dependent care.
Forms and Documents
2015 Flexible Spending Account Election Form
Health Care Cost Estimation Worksheet
Dependent Care Cost Estimation Worksheet
2011 FSA Plan
2011 FSA Summary Plan Description
Specific questions about Flexible Spending Accounts can be addressed by contacting Benefits at