Employee Reimbursement Account (ERA)

You are eligible to enroll in the Flexible Spending Accounts for 2015 during the Annual Benefit Enrollment period from October 6 to October 31, 2014. You must re-enroll each year! Visit the Annual Benefit Enrollment (ABE) website for more information on upcoming changes and enrollment information for 2015.

Plan Summary

The Employee Reimbursement Account (ERA) program offers two Flexible Spending Accounts (FSAs):

  • Health Care FSA allows you to set aside money on a pre-tax basis for medical, dental, vision, and prescription expenses that are not covered by your insurance.
  • Dependent Day Care FSA allows you to set aside money on a pre-tax basis for dependent care expenses.

You decide how much to set aside and that amount is deducted from each paycheck before your Federal, State, and FICA taxes are calculated so you save money on taxes.

This program is administered by WageWorks.

Eligibility

All employees, including rehired annuitants, are eligible for this program, except:

  • Classified Limited Term employees (LTE's),
  • Student Assistant with one of the following titles: fellows, scholars, trainees, and
  • Employee-in-Training with one of the following titles: grad intern/trainee, post-doc fellow/trainee.

Important Health Care & Dependent Day Care FSA Restrictions

  • You cannot change your election after you enroll for the plan year unless you have a qualifying Change in Status event (see page 18 of the ERA booklet for details).
  • Only expenses for services provided to you and your eligible dependents during the plan year are reimbursable.
    • The plan year is January 1st to March 15th of the following year.
    • Any unused amounts not incurred by the end of plan year will be lost.
  • You must submit all claims by the April 15th following the end of the plan year.
  • You must re-enroll in the plan every year during the Annual Benefit Enrollment (ABE) period.

Automatic Premium Conversion

Any employee eligible for this plan will automatically have premiums for the following benefit plans deducted from earnings on a pre-tax basis:

  • State Group Health Insurance
  • State Group Life Insurance (premium for first $50,000 of coverage)
  • EPIC Benefits+*
  • Dental Wisconsin*
  • VSP Vision Insurance*

You may choose to waive automatic premium conversion and have your premiums taken on a post-tax basis. See page 16 of the ERA booklet for details.

*If you cover a non-tax dependent domestic partner or partner’s children, premiums will be taken on a post-tax basis.

Enrollment

Enrollment – New Employee

You may enroll within 30 days of the start of your first benefits-eligible appointment. Coverage is effective on the first of the month on or following receipt of your paper application. You may not enroll via eBenefits for this program.

Only expenses incurred on or after your coverage effective date are eligible for reimbursement.

Enrollment – Change in Status

If you experience a family or employment change, you may be able to enroll, cancel, or change your election. You have 30 days from the change to submit a Change in Status form to WageWorks.

Any change to coverage is effective on the first of the month on or following receipt of your Change in Status form by WageWorks.

See pages 19-20 of the ERA booklet to view a list of events that allow you to make changes during the year.

Annual Enrollment

Employees must re-enroll each year during the Annual Benefit Enrollment (ABE) period. Coverage is effective on January 1st.

Your enrollment will not carry forward from year to year.

Health Care FSA

The Health Care FSA is used to pay for eligible medical expenses that are not covered by your insurance. These expenses can be incurred by you, your spouse (same or opposite-sex spouse), your qualifying child up to age 26, or your qualifying relative.

Minimum Annual Contribution: $100
Maximum Annual Contribution: $2,500

Eligible Dependents

See the WageWorks HC Eligible Dependent Checklist to ensure your dependent(s) qualifies.

Eligible Expenses

For a full list of covered expenses, see WageWork’s Health Care Eligible Expenses.

Options at End of Employment

Upon the end of your employment, you have the following options:

  • If you do not contribute your annual election amount, you may incur expenses through the end of the month in which your last paycheck is paid. Any expenses incurred after that date will not be reimbursed.
  • If you contribute your full annual election amount, you may continue to incur expenses through the end of the plan year.
    • You can have the remainder of your election taken pre-tax on your final paycheck(s); or
    • You can continue your coverage and send payment directly to the Department of Employee Trust Funds. Contact your institution’s benefits office for a continuation form. The continuation form and payment must be received by ETF within 60 days of your coverage end date or the date on the continuation notice, whichever is later.

Dependent Day Care FSA

The Dependent Day Care FSA is used to pay for eligible dependent care expenses such as after school care, preschool, and adult and child daycare.

Minimum Annual Contribution: $100
Maximum Annual Contribution: $5,000 (restrictions apply – see page 12 of ERA booklet)

Eligible Dependents

Eligible dependents include your spouse (same or opposite-sex spouse), qualifying child(ren) up to age 13, or your qualifying relative.

See page 12 of the ERA booklet and the WageWorks DC Eligible Dependent Checklist to ensure your dependent(s) qualifies.

Eligible Expenses

For a full list of covered expenses, see WageWork’s Dependent Care Eligible Expenses.

Options at End of Employment

Upon the end of your employment, you cannot continue dependent care contributions. You can continue to request reimbursement for eligible expenses until you exhaust your account or until the end of the plan year, whichever comes first, even if you have not contributed the full annual election amount.

Claims Submission

WageWorks offers several convenient ways for you to request reimbursement of your expenses.

All claims for the plan year must be submitted by the April 15th following the end of the plan year. Any claims submitted after April 15th will be denied.

If you have any questions regarding claims, contact WageWorks customer service line at 1-855-428-0446.

Online Claims

You can file a claim online to request reimbursement for your eligible expenses:

  • Go to WageWorks, log into your account and select the “Submit Receipt or Claim.”
  • Select “Pay Me Back” and fill in the requested information and attach supporting documentation.

Smartphone Claims

WageWorks® Health Care Card

When you enroll in the Health Care FSA, you will receive a WageWorks® Health Care Card:

  • Use your WageWorks® Health Care Card instead of cash or credit at health care providers and pharmacies for eligible services, goods, and prescriptions at qualified merchants.
  • Save your receipts – you may be required to submit receipts and other documentation to verify your claim is eligible.
    • If requested documentation is not submitted, the card will be suspended.

Pay My Provider

You can pay many of your eligible health care and dependent care expenses directly from your FSA account to your provider.

To pay a provider:

  • Go to the WageWorks website, log into your account and select the “Submit Receipt or Claim.”
  • Select “Pay My Provider” and follow the directions.
  • When you’re done, WageWorks will send a check directly from your account.

Paper Claim Form

You may also mail or fax a paper claim form directly to WageWorks. See the claim forms for the fax number and mailing address.

Forms & Publications

  • Application - Complete and submit to your institution’s benefits office to enroll in the plan.
  • Change in Status Form - Complete and submit to WageWorks within 30 days of a change in status if you want to enroll, increase, decrease or cancel your coverage.
  • Health Care FSA Claim Form - Complete and submit form to WageWorks to request a reimbursement for eligible medical expenses for you or your eligible dependents.
  • Dependent Day Care FSA Claim Form - Complete and submit form to WageWorks to request a reimbursement for eligible dependent care expenses for your eligible dependents.
  • Automatic Premium Conversion Waiver/Revocation of Waiver Form - Complete and submit form to your institution’s payroll office if you do not want benefit premiums taken on a pre-tax basis. If you waived participation in Automatic Premium Conversion, you may also use this form to elect to start having your premiums deducted on a pre-tax basis again.
  • Health Care FSA Continuation Form - Contact your benefits office if you need a continuation form.