What is Island Flex Flexible Spending Accounts?
How Do I Qualify for Island Flex?
When Does My Coverage Begin?
If I am a New Employee or Become Eligible During the Plan Year, Must I Wait Until Open Enrollment to Enroll?
How Can the Money in Island Flex Be Used?
Is There a Fee for Using This Program?
How Do The Spending Accounts Work?
Is There a Maximum Amount I May Contribute Each Plan Year?
How Do I Get Reimbursed For My Eligible Expenses?
If I Send My Child to a Baby-sitter, Will That Qualify for the Dependent Care FSA?
When May I File a Claim for Reimbursement?
May I Change the Amount of My Contribution During the Year?
What Happens If I Don"t Spend All of the Money by the End of the Plan Year?
What Happens When I Take Paid Leave, Such as Vacation or Sick Leave, or Leave Without Pay?
If I Work for the DOE or UH and Take a Job During My Summer Vacation, Can I Claim for Dependent Care Services During That Period?
Can I Transfer Money From the Dependent Care FSA to the Medical FSA Or Vice Versa?
How Will I Know How Much Money Is In My Account(s)?
How Do I Know If I Will Benefit From the Medical FSA?
How Can I Tell Whether I Should Use the Dependent Care FSA or the IRS Child Care Tax Credit?
Will Participating in Island Flex Affect My Retirement Benefits, Social Security, Deferred Compensation, Tax Sheltered Annuity, or Premium Conversion Plan?
Once I Enroll, How Will I Know if FSA Contributions are Being Deducted From My Paycheck?
Do All of My Receipts Need to be Turned in by the End of the Plan Year - June 30th?

Must I Complete a New Compensation Reduction Agreement Each Year?
What Happens If I Terminate My Employment?
What Rights Do I Have If the Third-Party Administrator Does Not Pay My Claim?
What Other Services Can the Third-Party Administrator Provide Me at No Cost?
Who Do I Call If I Have Questions?
Examples of Eligible Medical Expenses
Examples of Medical Expenses That May Not Be Reimbursed
Personal Expenses Worksheet








 

Island Flex flexible spending accounts is an employee benefit program that provides you with a way to pay for your eligible health care expenses (Medical FSA) and dependent care expenses (Dependent Care FSA) with TAX FREE money. By directing "before tax" money from your paycheck into one or both of these accounts, you can put up to 41% of the money you are spending on eligible expenses back into your pocket.

 

 

 

 

 

 

You must be an employee of the State of Hawaii and be eligible to participate in the Employees' Retirement System.


 

 

 

 

 

 

 

For employees who turn in their Compensation Reduction Agreement form (enrollment form) to the third party administrator, Comprehensive Financial Planning, Inc. (CFP), during the open enrollment period, coverage will begin July 1st. For employees who become eligible during the plan year, coverage begins on the 1st day of the month following CFP's receipt of the Compensation Reduction Agreement, provided the Compensation Reduction Agreement is received within 90 days of the employee becoming eligible.

 

 

 

 

 

 

No. As soon as you become eligible (become a member of the Employees' Retirement System), you are eligible to enroll right away. You must complete a Compensation Reduction Agreement form and send it to CFP within 90 days of becoming eligible. Your date of participation will begin on the first day of the month following CFP's receipt of your Compensation Reduction Agreement. However, if you choose not to enroll within 90 days of becoming eligible, you will have another opportunity during the next annual open enrollment period.

 

 

 

 

 

Medical FSA
The money in your Medical FSA can be used to reimburse yourself for medical, dental, drug and vision expenses incurred by you or your family members, which aren't covered by your health insurance plans. Examples of items not covered by your health insurance plans that could be covered under Medical FSAs include such things as: co-payments, deductibles, glasses, contacts, orthodontic work, fees to doctors and hospitals, etc. See the section entitled Examples of Eligible Medical Expenses for a more detailed list.

Dependent Care FSA

The money in your Dependent Care FSA can be used to reimburse yourself for dependent care expenses incurred. You must be working in order for these expenses to qualify for reimbursement. If you are married, both you and your spouse must both be working, or your spouse must be a full-time student or disabled. To be considered a “dependent,” the person receiving care must be eligible to be claimed as your dependent on your federal income tax return and be either:

Examples of eligible dependent care expenses include:

Yes. You will be charged a nominal administration fee each month. The fee will be deducted from your paycheck each pay period on a BEFORE-TAX basis. You pay one fee whether you enroll in one or both accounts. Generally, if you expect your annual, out-of-pocket expenses to exceed $160 annually, you will probably save taxes even after paying the administration fee.

 

 

 

 

 

 

 

First, you establish a Dependent Care FSA, Medical FSA, or both if you have both types of expenses. You do this by completing a Compensation Reduction Agreement form and turning it into CFP during the open enrollment period. Or, if you become eligible during the plan year, you have 90 days to complete and submit your Compensation Reduction Agreement.

The amount you designate on the Compensation Reduction Agreement will be deducted from your pay check before taxes are calculated, and deposited into your account. This makes your contributions TAX-FREE.

Let's look at an employee example: Employee Leilani has one child attending pre-school, for which she pays the pre-school $400 per month. Leilani also has approximately $50 per month of unreimbursed health care expenses. Leilani is married, claiming two exemptions.

$1,200 Per Check

Currently

With
Island Flex
Gross Pay
$
1,200.00
$
1,200.00
Medical FSA
$
0.00
$
25.00
Dependent Care FSA
$
0.00
$
200.00
Taxable Income
$
1,200.00
$
975.00
Federal Withholding
$
76.53
$
45.18
State Withholding
$
55.03
$
40.18
FICA (Social Security)
$
91.80
$
74.59
Net Pay
$
976.64
$
$815.05
Medical Expenses
$
25.00
$
0.00
Dependent Care Expenses
$
200.00
$
0.00
Spendable Income
$
751.64
$
815.05





Savings Per Paycheck

$
63.41
Savings Per Month

$
126.82
Savings Per Year

$
1,521.84

Yes. Maximum amounts are set for Medical FSA and Dependent Care FSA as follows:

Medical FSA

Dependent Care FSA

 

 

It's simple. Once an eligible service is provided by a doctor, hospital, pharmacy, etc., or for dependent care expenses performed by your dependent care provider, you pay that expense as usual. Then you:

It’s that easy. Medical reimbursement claims are processed on a daily basis, and Dependent Care reimbursement claims are processed on a monthly basis at the end of each month. Please keep in mind that the service has to be “completed ” before a claim can be submitted. Your check will be mailed once the claim is verified and processed. With your check, you will receive a statement showing your account balance(s) and a new claim form. And best of all, you don’t pay taxes on the money you use to reimburse yourself.

 

 

Yes. As long as your child is under 13 years old and the baby-sitter:

 

 

 

 

 

 

 

As soon as you have accumulated a minimum of $25 in eligible expenses for each account, you may file for reimbursement.

However, at the end of the Plan Year (June 30th), you may file aclaim for reimbursement even if your receipts total less than $25.

 

 

 

 

 

The IRS requires your enrollment in Island Flex to continue for the entire plan year. However, you may modify your contributions if you have a valid "status change." Examples of valid status changes include, without limitation, marriage, divorce, birth or adoption of a child, death of a spouse or dependent, or spouse's change in employment. If you have a valid "status change," you must complete a status change form and return it to CFP within 90 days of the status change event. Approved changes are effective on the first day of the month following CFP's receipt and approval of the required status change forms. Cancellations are effective on the last day of the month following CFP's receipt and approval of the required status change forms. Any increase, decrease, or cancellation of your Island Flex payroll deduction must be consistent with the status change. If CFP does not receive the status change form within 90 days of the status change event, you will not be allowed to make a change.

 

 

 

 

Any money left in your Dependent Care account after September 30th, (after all claims have been processed for that plan year), will not be reimbursed and will be forfeited to the State pursuant to the Internal Revenue Code (IRC). After September 30th, any amount left in your Medical Spending account, up to $500, will carry over to the new plan year to be used towards expenses incurred in that new plan year. Any money which exceeds $500 after September 30th, (after you have claimed all eligible expenses for that year), will not be reimbursed to you and will be forfeited to the State pursuant to the IRC. The IRS considers the date of a claim as the date the service is rendered, not when the bill is actually paid.

 

 

 

 

 

 

 

 

Medical FSA
As long as you are on paid leave, your payroll deductions will continue, your eligibility to participate in
Island Flex will continue, and any eligible medical, dental, drug, and vision services performed will be eligible for reimbursement. However, if you are on leave without pay, you must make arrangements with CFP to pay your contributions and administration fees on an out-of-pocket basis. If you do not pay your contributions and administration fees, you will be canceled from the plan. Only services performed prior to the cancellation will be eligible for reimbursement. Unused balances cannot be returned to you.

Dependent Care
As long as you are on paid leave, your payroll deductions will continue and your eligibility to participate in
Island Flex will continue. However, services performed during any paid leave period, such as vacation, sick, funeral, sabbatical, industrial injury, accidental injury, family leave or compensatory time off will not be considered eligible expenses and, therefore, you may not be reimbursed for those expenses during those periods.

If you are on leave without pay, you must make arrangements with CFP to pay your contributions and administration fees on an out- of- pocket basis. If you do not pay your contributions and administration fees, you will be canceled from the plan. Unused balances cannot be returned to you.
Services performed while you are on leave without pay will not be considered eligible expenses and, therefore, you may not be reimbursed for those expenses during those periods.

Yes. If you work for a public or private employer you may claim for eligible dependent care services during that period. However, if you attend school/classes to enhance your skills, you may not claim for services during that period.

 

 

 

 

 

 

No. The Internal Revenue Code does not allow monies to be moved from one account to the other.

 

 

 

 

 

 

 

 


You will receive statements from the Island Flex claims processor within 30 days of the end of each calendar quarter. Additionally, you will receive a statement showing your contributions, reimbursements, and account balance(s) each time you receive a reimbursement.

 

 

 

 

 

 

 

If you and your family members have predictable out-of-pocket medical, dental, drug, and/or vision expenses, this account will benefit you. The actual dollar amount you will save depends on your income tax bracket. For assistance in determining your personal tax savings benefit, please call Comprehensive Financial Planning, Inc. at 596-7006 or neighbor islands may call toll free at 1-877-550-5552. You may also e-mail Comprehensive Financial Planning, Inc. at cfpii001@hawaii.rr.com. For further information, see Is There A Fee For Using the Program? and the Personal Expenses Worksheet.

 

 

 

 

 

 

Each person's tax situation is different, so the benefit is not the same for everyone. Generally, though, if your family's taxable income is more than $28,000, you may save more money using the Dependent Care FSA. The IRS child care tax credit only allows a maximum benefit of $3,000 for one child and $6,000 for two or more children, per year. Also, depending on your total income, only a certain percentage may be allowed on your tax return. Through the Dependent Care FSA, you can benefit up to $5,000 per year regardless of the number of children in child care or your income. Plus, the tax savings are realized on a monthly basis in your paycheck instead of having to wait to file your tax return at the end of the year. You still must file the IRS Form 2441 for either benefit. You should use caution in enrolling in the Dependent Care FSA if your dependent care expenses are not consistent or are unpredictable. You may wish to consult with your tax advisor on this matter.

 

 

 

 

 

Your paycheck stub will show two or three of the following codes under the "DEDUCTIONS/ REDUCTIONS" column:
    "FA200" (Administration Fee)
    "FD200" (Dependent Care FSA)
    "FM200" (Medical FSA)

 

 

 

 

 

No. You have 90 days after the end of the plan year, June 30th, to turn in your receipts. However, it is advised that you turn in your claims well before the end of the 90 day grace period following the end of the plan year or your termination date. No corrections to claims are allowed after the 90 day grace period under the IRS guidelines, even though your claims are received before the end of the 90 day grace period. In addition, the services must have been performed during the plan year. If you have monies left in your account(s) during the 90 days, the administration fee will be deducted from your account balance.

 

 

 

 

 

 

 

Yes. If you do not complete a new Compensation Reduction Agreement each plan year, your enrollment will not continue.

 

 

 

 

 

 

 

 

Your participation in Island Flex will end on your termination date. Eligible expenses for services performed up to your termination date may be reimbursed to you. And, you have 90 days after your termination to turn in receipts to the Island Flex claims processor for eligible expenses incurred prior to your termination. The administration fee will still be deducted from your account balance during this 90 day period.

In addition, you may be eligible to continue in the Medical FSA under COBRA. Be sure to check with CFP to see if you are eligible for COBRA.

 

 

 

 

 

If you are not reimbursed after filing your claim form or reimbursed for an amount less than you requested, you may appeal their decision. You have 60 days from the date you receive notification to send an appeal to the Director of the Dept. of Human Resources Development at 235 S. Beretania St. 14th Floor, Honolulu, Hawaii 96813.

 

 

 

 

 

 

 

CFP will be providing the following additional services at no cost to you upon request. They are:

Details of these services will be provided at additional workshops to be announced at a later date or you may call CFP for additional information. For further details, please see Free Services.

 

 

Please call Comprehensive Financial Planning, Inc. at 596-7006 or e-mail us at cfpii001@hawaii.rr.com. Neighbor islands may call toll free at 1-877-550-5552.

 

 

 

 

 

 

 

Acupuncture
Alcoholism treatment
Ambulance service
Artificial limbs
Artificial teeth
Birth control pills
Braille books & magazines for use by a person with a visual impairment
Car controls for use by a person with a disability
Chiropractic care
Contact lenses, solutions, and enzyme cleaners*
Co-payments
Crutches, amount paid to buy or rent
Dental fees, includes x-rays, fillings, braces, extractions, dentures, etc.
Dental implants
Diagnostic tests
Doctors' fees
Drug addiction treatment at a therapeutic center for drug addiction
Experimental medical treatment
Eye glasses and eye examinations
Guide dogs/trained animals used to assist persons with a physical disability
Hearing aids, batteries to operate them, and hearing exams
Hospital services
Injections
Inpatient therapy for mental or nervous disorders
In vitro fertilization
Lab fees that are part of your medical care
Laser eye surgery (RK, PRK, LASIK, etc.)
Learning disability tuition for a child who has severe learning disabilities
Nursing services
Operations
Optometrist fees
Orthodontic treatment*
Orthopedic shoes
Oxygen
Parking fees while visiting a doctor
Periodontal fees
Prescription drugs
Psychoanalysis
Psychologist fees
Special schools for individuals with disabilities
Sterilization
Surgery
TDD phones for individuals who are deaf or hard of hearing
Therapy
Transplants
Transportation for medical care
Vaccinations
Wheelchairs
X-rays
*Must be medically necessary to alleviate, treat, mitigate, or prevent a medical condition.
This is a partial listing of expenses that are payable tax free with your Medical FSA.
IRS Publication 502 contains a more complete list.

Health insurance premiums
Cosmetic procedures
Hair growth drugs
Diet foods
Lamaze class fees
Ear piercing
Amounts paid by your medical plan
Nicotine patches (over-the-counter)
Weight-loss programs
Health club dues
Funeral expenses
This is not a complete list.