Flexible Spending Arrangements and Dependent Care Assistance Program

What is a Flexible Spending Arrangement (FSA), Limited Purpose FSA, or Dependent Care Assistance Program (DCAP)?

The PEBB Program's Flexible Spending Arrangement (FSA), Limited Purpose FSA, and Dependent Care Assistance Program (DCAP) allow eligible employees to set aside money from their paychecks on a pretax basis to pay for qualified expenses each plan year (January 1-December 31). Eligible employees who waive their PEBB medical coverage can still enroll in an FSA, Limited Purpose FSA, and/or DCAP.

For a summary of these benefits, including the CBA FSA contribution for represented employees, IRS maximum contributions, carryover amounts, and deadlines to submit claims and incur expenses, click on each item below.

Flexible Spending Arrangement

What is an FSA?

The FSA allows employees to set aside pretax money to spend on eligible out-of-pocket medical expenses, including annual deductibles, copays, coinsurance, dental expenses and vision expenses.

Employees may use FSA funds for themselves and their qualified dependents, even if their dependents are not enrolled in a PEBB medical, dental or vision plan.

Can an employee have an FSA or Limited Purpose FSA with an HSA in the same plan year?

Employees cannot have both an FSA and a consumer-directed health plan (CDHP) with a health savings account (HSA) or both an FSA and a Limited Purpose FSA in the same plan year. Employees can have a Limited Purpose FSA and HSA in the same plan year.

How much can employees contribute?

The employee decides how much to contribute to their FSA. They may set aside a minimum annual contribution of $120 up to a maximum annual contribution of $3,400 for the 2026 plan year (subject to the annual IRS update).

The amount deducted from an employee's pay is the total annual election amount divided by the number of paychecks the employee will receive during the plan year.

The full amount elected is available on the first day of the month the employee's benefits become effective.

• For example: An employee elects to contribute an annual amount of $1,500. After two months of contributions, the employee incurs an eligible expense of $2,000. Even though the employee has not yet contributed the full amount, they can be reimbursed for $1,500.

Will HCA adopt an increase to the maximum contribution limit?

The annual maximum contribution limit is set by the IRS. An increase to the maximum contribution limit for the following year is usually announced in late fall. If the IRS announces an increase in the maximum contribution prior to the last day of open enrollment, HCA will adopt the new maximum contribution limit for the 2026 plan year. If the IRS announces changes after HCA's annual open enrollment ends, HCA will adopt the increased maximum contribution limit for the 2027 plan year.

What is carryover?

If all the funds in an FSA have not been spent by December 31, and the employee is still eligible to participate, they may be able to take advantage of the carryover feature.

Carryover means certain unspent funds may "carry over" into the following year without affecting annual maximums.

To receive carryover, employees must enroll in an FSA for the following plan year or have at least $120 left in their current year's balance.

• Unused funds from the 2026 plan year (up to $680) will carry over to 2027 but any amount above $680 will be forfeited.
• NOTE: The IRS does not announce the next plan year’s carryover limit until late fall of the previous year, after HCA's annual open enrollment begins. Due to the timing of the IRS announcement, HCA will update the new carryover limit amount at that time. The carryover limit will not decrease.

Find real-world carryover examples on the FSA Enrollment Guide.

What are the deadlines to incur expenses and submit claims?

All eligible FSA expenses must be incurred by the end of the plan year, December 31.

Employees must submit all claims to Navia Benefit Solutions for reimbursement by March 31 of the following plan year.

To learn more, see the FSA Enrollment Guide and visit the FSA webpage for public employees.

CBA FSA contribution for represented employees

Represented employees may receive a $300 FSA benefit

The current collective bargaining agreement (CBA) states that represented employees whose rate of pay is $68,004 a year or less on November 1, 2025, are eligible to receive a $300 FSA contribution in January 2026. Rate of pay is determined by what a position would provide at a full time salary, not including overtime or a bonus.

Employees who work part-time may be eligible for this contribution if their position would provide a salary of $68,004 or less as full-time. For example, if they earn $34,002 and work 20 hours per week, their full-time salary would be $68,004 and they would still qualify.

The employee or employee’s spouse or state registered domestic partner cannot be enrolled in a consumer-directed health plan (CDHP) with a health savings account (HSA) and the employee must meet other eligibility criteria as described in the Health Care Coalition Agreement, including PEBB Program eligibility requirements and eligible medical plan enrollment.

Eligible employees receive this employer-paid benefit even if they do not enroll in an FSA. The contribution does not come out of the employee's paycheck.

Navia will:

• Open an FSA account with the $300 and mail a CBA FSA Welcome Letter to eligible employees.
• Send (in a separate mailing) a debit card to the employee if the employee does not have a currently active FSA debit card, or
• Add the $300 to an employee's existing FSA debit card (expires after 3 years)

CDHP plan with an HSA and/or the Limited Purpose FSA

Employees enrolling in a CDHP plan with an HSA and/or the Limited Purpose FSA for the following plan year will not receive the CBA FSA Contribution.

To learn more about the CBA contribution for represented employees, see the following resources:

• FSA Enrollment Guide 2026
• Letter mailed to employees who may be eligible to receive the CBA FSA contribution.
• FSA webpage for public employees

CBA FSA Toolkit

This content is prepared for benefit administrators to share about the FSA contribution with employees. A goal for implementing this toolkit is to align the way multiple partners (Washington State Health Care Authority’s PEBB Program, unions, and benefits administrators) share about the FSA benefit and ensure common language. Please tailor the materials so they align with your branding or style standards and feel free to use your logo. [Suggestions are included in italics on the toolkit materials.]

Toolkit Materials:

• New hire letter: Please use during a new hire orientation or in a welcome packet to raise awareness about this benefit.
• PEBB Navia Benefits Debit Card Image: Show what the Navia Benefits Debit Card looks like so recipients can keep an eye out for their card.
• Shareable messaging: Pre-drafted messaging to post on social media, copy into the body of an email, or to share on another platform you have available for communicating with employees. We have suggested times of year to share the messaging included in the document.
• CBA FSA Contribution FAQ: This document addresses some frequently asked questions and provides information about the administration of FSAs and the contribution.
• FSA video: Post on social media, copy in the body of an email to employees, play during new employee orientation presentations, or share on another platform you have available for communicating with employees.
• CBA FSA Contribution flowchart images: This chart helps an employee to navigate whether they may be eligible to receive the CBA FSA contribution. Please feel free to use on your website, in an email or social media, or in print materials such as a newsletter.
  • Vertical CBA FSA Contribution flowchart
  • Horizontal CBA FSA Contribution flowchart

Limited Purpose Flexible Spending Arrangement

What is a Limited Purpose FSA?

The Limited Purpose FSA allows employees to set aside pretax money to spend on eligible out-of-pocket dental and vision expenses.

The Limited Purpose FSA is intended for employees who are enrolled in a consumer directed health plan (CDHP) with a health savings account (HSA). Enrolling in a Limited Purpose FSA while in a CDHP plan allows employees to save more of their HSA funds for medical expenses. However, employees can enroll in a Limited Purpose FSA even if they are not enrolled in a CDHP with an HSA.

Employees may use Limited Purpose FSA funds for themselves and their qualified dependents, even if their dependents are not enrolled in a PEBB medical, dental or vision plan.

Participating in an FSA and Limited Purpose FSA

Employees may not participate in a Limited Purpose FSA and an FSA in the same plan year. Employees can participate in a Limited Purpose FSA and a consumer directed health plan (CDHP) with a health savings account (HSA) in the same plan year. It is the employee’s responsibility to know which benefit to enroll in.

How much can employees contribute?

The employee decides how much to contribute to their Limited Purpose FSA. They may set aside a minimum annual contribution of $120 up to a maximum annual contribution of $3,400 for the 2026 plan year (subject to the annual IRS update). The amount deducted from an employee's pay is the total annual election amount divided by the number of paychecks the employee will receive during the plan year.

The full amount elected is available on the first day of the month the employee's benefits become effective.

• For example: An employee elects to contribute an annual amount of $1,500. After two months of contributions, the employee incurs an eligible expense of $2,000. Even though the employee has not yet contributed the full amount, they can be reimbursed for $1,500.

Will HCA adopt an increase to the maximum contribution limit?

The maximum contribution limit is set by the IRS, and the amount is usually announced in late fall. If the IRS announces an increase in the maximum contribution prior to the last day of open enrollment, HCA will adopt the new maximum contribution limit for the 2026 plan year. If the IRS announces changes after HCA's annual open enrollment ends, HCA adopts the increased maximum contribution limit for the 2027 plan year.

What is carryover?

If all the funds in a Limited Purpose FSA have not been spent by December 31, and the employee is still eligible to participate, they may be able to take advantage of the carryover feature.

Carryover means certain unspent funds may "carry over" into the following year without affecting annual maximums.

To receive carryover, employees must enroll in a Limited Purpose FSA for the following plan year or have at least $120 left in their current year's balance.

• Unused funds from the 2026 plan year (up to $680) will carry over to 2027, but any amount above $680 will be forfeited.
• Note: The IRS does not announce the next plan year’s carryover limit until late fall of the previous year, after HCA's annual open enrollment begins. Due to the timing of the IRS announcement, HCA will update the new carryover limit amount at that time. The carryover limit will not decrease.

Find real-world carryover examples in the FSA Enrollment Guide.

What are the deadlines to incur expenses and submit claims?

All eligible FSA expenses must be incurred by the end of the plan year, December 31.

Employees must submit all claims to Navia Benefit Solutions for reimbursement by March 31 of the following plan year.

To learn more, see the Limited Purpose FSA Enrollment Guide and visit the FSA webpage for public employees.

Dependent Care Assistance Program

What is the DCAP?

Dependent Care Assistance Program (DCAP) is an employer-sponsored benefit that allows employees to set aside money from their paycheck on a pre-tax basis to help pay for qualified child care or elder care expenses while the employee or their spouse attends school full-time, works, or looks for work. The employee is responsible for providing documentation to the IRS for tax purposes, if requested. Eligible expenses include elder day care, baby sitting, child day care, preschool and registration fees.

Participating in the DCAP and an FSA

Employees may participate in a DCAP account and an FSA or a Limited Purpose FSA in the same plan year.

How much can employees contribute?

The employee decides how much to contribute to their DCAP account. They may set aside a minimum annual contribution of $120 up to a maximum annual contribution of:

• $7,500 for a single person or married couple filing a joint income tax return for the 2026 plan year
• $3,750 for each married person filing separate income tax returns the 2026 plan year

DCAP funds are available once they have been deposited each month. Employees may only be reimbursed up to the dollar amount they have in their DCAP account at the time reimbursement is requested.

What are the deadlines to incur expenses and submit claims?

All eligible DCAP expenses must be incurred by the end of the plan year, December 31 (DCAP has no carryover feature).

Employees must submit all claims for their DCAP account to Navia Benefit Solutions for reimbursement by March 31 of the following year. Any funds remaining in the DCAP account after March 31 cannot be refunded and will be forfeited.

To learn more, see the DCAP Enrollment Guide and visit the DCAP webpage for public employees.

Who is eligible to participate?

Eligible employees of state agencies and higher education institutions, including community and technical colleges, and the State Board of Community and Technical Colleges are eligible to participate in the FSA, Limited Purpose FSA, and DCAP (WAC 182-12-116).

When can employees enroll or make changes?

Eligible employees may enroll in an FSA/Limited Purpose FSA or DCAP when newly eligible, during open enrollment, or when they experience an event that creates a special open enrollment (SOE), such as marriage or birth (WAC 182-08-199, SOE Matrix: Addendum 45-2A).

Employees cannot end participation, change their election amount, or make any other changes to their FSA/Limited Purpose FSA or DCAP once the plan year starts unless they end employment, lose eligibility, or experience a special open enrollment (SOE) event. Visit the When employees can make changes webpage for more information.

Employees do not enroll in an FSA/Limited Purpose FSA or DCAP in Benefits 24/7. They must submit completed forms to their payroll or benefits office.

When newly eligible

Newly eligible employees must submit the PEBB Midyear Enrollment form no later than 31 days after becoming eligible for PEBB benefits.

Enrollment begins the first day of the month following the date the form is received by the payroll or benefits office. If that day is the first working day of the month, enrollment begins that day.

Employees whose benefits begin in the months of November or December

Employees who wish to participate for the remaining months in the year should complete the Midyear Enrollment form during their 31-day initial eligibility period.

Also, employees who wish to enroll for the following year should either:

• Complete enrollment during the Open Enrollment period by completing the Navia Open Enrollment form, or
• If their initial 31-day newly eligible employee enrollment window either extends beyond the OE period, or begins after the OE period, then complete the following year's Midyear Enrollment form:
  • Indicating enrollment status of "new hire", and
  • A benefit effective date of January 1.

During annual open enrollment

To enroll in an FSA and/or DCAP for the following plan year, employees may use Navia's online portal or complete and submit the Navia Open Enrollment form no later than the last day of annual open enrollment (OE). Employees can follow these instructions to enroll online.

• Online enrollment and the OE form are only available during OE.
• Enrollment begins January 1 of the following year.

Employees must reenroll during annual open enrollment each year to continue participating for the following year. Enrollment does not automatically continue from plan year to plan year.

Late enrollment requests

If an employee submits an FSA/DCAP Open Enrollment form outside of Open Enrollment, the BA sends the form to Navia to process. The form is submitted to Navia even if the BA knows that the form was submitted outside of the enrollment window.

Navia will review the form and work with HCA Outreach & Training to determine enrollment. If the form is confirmed to have been submitted late, HCA will send the participant either a denial or ineligible enrollment letter.

What if an employee elects both a CDHP plan with an HSA and a FSA during annual OE?

Outreach & Training will notify BAs in mid-December if they have any employees who elected both a CDHP plan with an HSA and a FSA during annual open enrollment. Employees will have the following options:

1. Keep the CDHP plan and disenroll from the FSA, or
2. Keep the FSA and disenroll from the CDHP plan, or
3. Keep the CDHP plan and switch to a Limited Purpose FSA and lower their election amount.

Employees have a one-time offer to choose one of the options above before December 29 and cannot make changes after the decision is received by HCA.

If the employee does not make a choice by December 29, they will remain enrolled in the CDHP plan with an HSA and will be disenrolled from the FSA. However, if they qualify for carryover of funds from the previous year, the funds will be transferred to a Limited Purpose FSA.

What if an employee elects both an FSA and a Limited Purpose FSA during annual OE?

Employees who are not enrolled in a CDHP plan with an HSA that elect both an FSA and a Limited Purpose FSA during annual OE will be enrolled in the FSA, but will not be enrolled in the Limited Purpose FSA.

When a special open enrollment event occurs

Employees requesting to enroll or make a change due to a qualifying event that creates a special open enrollment (SOE) must complete and submit the PEBB Change in Status form and proof of the event no later than 60 days after the date of the event (PEBB SOE matrix - Policy 45-2A).

The enrollment or change begins the first day of the month following the event date or the date the form is received by the payroll or benefits office, whichever is later. If that day is the first of the month, the enrollment or change begins that day.

• Exception: If the SOE is due to birth or adoption, or assuming legal obligation for a child in anticipation of adoption, the enrollment or change will begin the first day of the month in which the event occurs.

It is the employer’s responsibility to ensure the SOE event is valid and in compliance with IRS rules. This includes collecting and approving the SOE proof documentation. By signing the Change in Status form, the employer is affirming they have done these steps. Once complete, submit the form to Navia by uploading it to the Navia Employer Portal.

If there is no SOE qualifying event, or if the BA does not receive proof of SOE, the BA would deny the request and provide written documentation (WAC 182-08-199).

Change requests outside of Open Enrollment or an SOE event

Requests to make changes outside of Open Enrollment or an SOE event should be denied by the employer, with guidance provided to the employee that they can appeal the decision via the steps in WAC 182-16-2050.

Changes outside of OE or an SOE event can include the employee enrolling in the wrong benefit (i.e. Limited Purpose FSA instead of FSA), enrolling in error (i.e. enrolling in DCAP with no dependents), requests to change the election amount, or no longer wanting the benefit.

The rules regarding when an employee can enroll or revoke an election and make a new election under the premium payment plan, FSA, Limited Purpose FSA or DCAP are found in WAC 182-08-199.

Transferring to another state agency or institution of higher education

Employees who enroll in an FSA/Limited Purpose FSA or DCAP and later transfer to another state agency or higher-education institution, may continue their enrollment in an FSA/Limited Purpose FSA or DCAP if:

• The employee will be benefits eligible in the new position, and
• There is no more than a 30-day gap between employments, and
• The employee submits the PEBB Agency Transfer form to the new employer no later than 31 days after the first day of work at the new employer.
  • Employers should set up payroll deductions before signing and submitting the form to Navia.

Learn more by reviewing the FSA/Limited Purpose FSA and DCAP enrollment guides available on Navia's Forms and Documents webpage.

Loss of eligibility or ending employment

An employee is no longer eligible to participate in a DCAP account when they lose eligibility for the employer contribution toward PEBB benefits. There are no continuation options available for the DCAP. The employee may be eligible to continue participating in an FSA/Limited Purpose FSA; see the following section for information.

Navia debit cards will be deactivated by the last day of the month in which an employee loses eligibility. However, the employee may still submit claims for reimbursement after that.

FSA and Limited Purpose FSA

Employees enrolled in an FSA or Limited Purpose FSA who end employment or retire during the plan year must complete and submit the PEBB FSA/Limited Purpose FSA Termination form to their payroll or benefits office within 30 days of coverage ending.

The form requires that the employee choose one of the following options:

Stop participation: Employee declines to continue participation but retains access to their full election amount.

• The full annual election may be claimed for expenses incurred before the PEBB benefits end date, which is the last day of the month in which the employee lost eligibility.
• Claims may be submitted to Navia, up to the available account balance, through March 31 of the following plan year.
• An employee's account balance may include FSA/Limited Purpose FSA contributions from their final paycheck.

Continue participation: Employee may continue participation through accelerated contributions or COBRA.

• Accelerate contributions (if offered by the employer)
  • Employee pays the remaining contributions for the plan year from their last paycheck.
  • Allows eligible expenses to be incurred through December 31.
  • Claims can be submitted to Navia through March 31.
• COBRA: Continue payments post tax
  • Available if employee has claimed less than they have contributed to the FSA/Limited Purpose FSA.
  • Navia will mail a COBRA election notice to the employee.
    • Navia must receive the employee's Navia COBRA election form no later than 60 days from the date PEBB benefits ended, or from the postmark date on the election notice, whichever is later.
  • Contributions paid directly to Navia for the rest of the plan year.
  • To elect COBRA, employees must complete the election process included in the COBRA mailing noted above. They cannot use the PEBB FSA/Limited Purpose FSA Termination form to elect COBRA.

Dependent Care Assistance Program

Employees who terminate employment and have unspent DCAP funds may continue to submit claims for eligible expenses as long as the expenses allow them or their spouse/state registered domestic partner to attend school full-time, look for work, or work full-time.

Expenses may be incurred through December 31 of the year the employee terminates employment. Claims may be submitted to Navia, up to the available account balance, through March 31 of the following plan year.

Correcting errors and filing appeals

Errors made by the employer or vendor

When an employing agency or contracted vendor (Navia) makes an enrollment error, they must correct the error as described in WAC 182-08-187 and Public Employees Benefits Board (PEBB) Program Administrative Policy 11-3.

The benefit administrator will notify Navia and HCA Outreach & Training of the error and the correction needed and send any necessary forms. For more information regarding correcting errors made by the employer, see the Correcting employer errors webpage.

Note: The lower limit calendar does not apply to enrolling in FSA/Limited Purpose FSA or DCAP. Even if the effective date of the correction falls within the lower limit, the process must be handled by the PEBB Program Error Correction team.

Errors made by the employee

If an employee makes a mistake on their enrollment form, such as mistakenly enrolling in an LPFSA instead of an FSA or enrolling in the wrong contribution amount, those requests are considered a change. See the When employees may make changes webpage for more information.

Filing appeals

Employee disagrees with employer decision

If an employee disagrees with an employer’s decision, they have the right to appeal a denial decision to the employer. The employer may approve or deny the appeal. If the appeal is denied, the employee has the right to appeal the decision to the Health Care Authority PEBB appeals unit (WAC 182-16-2050).

If the benefit administrator agrees that a wrong decision or action occurred, the BA and employee would complete their sections of the Employer Review/Notice of Appeal form and submit it to the HCA PEBB appeals unit.

For information regarding the appeals process, see the Appeals webpage.

Employee disagrees with Navia decision regarding claims

The employee has the right to appeal a denial decision made by Navia regarding claims processing. Navia may approve or deny the appeal. The Health Care Authority will work with Navia to process the appeal request.

If the appeal is denied, the employee has the right to appeal the decision to the Health Care Authority PEBB appeals unit.

Processing enrollments and changes

When BAs receive forms, they should verify that the forms have been completed in full, including any necessary documentation such as proof of the qualifying SOE event. An incomplete form may result in missed deductions or the employee may experience problems with accessing their FSA/Limited Purpose FSA and/or DCAP benefits.

Processing enrollment forms

1. Date-stamp the form(s) with the date received.
2. Complete the employer portion on the form(s). Include the following information along with the enrollment forms:
   • The name of the agency or institution of higher education.
   • The benefit administrator's name, phone number and email.
   • Include any important information about the form or employee/participant as needed.
3. Upload the form(s) through the Navia employer portal.
   • Each FSA/DCAP employer has specific BAs with access to the PEBB employer portal.
   • If you need assistance with the upload process, please contact Navia’s dedicated team of Account Managers to help you Monday through Friday 7 a.m. and 5 p.m. (Pacific) at PEBBAdmin@naviabenefits.com or 424-452-3488.
   • If you are unable to upload documents via the PEBB employer portal, please send the cover sheet and form to Navia Benefit Solutions via:
     • Fax: 425-233-6366
     • Email: Navia Benefits Solutions - PEBB
     • Mail: Navia Benefit Solutions, PO Box 5179 Fresno, CA 93755

Processing change is status forms

1. The employer confirms the SOE event is valid, collects and approves the SOE proof documentation, and confirms the form was submitted no later than 60 days after the date of the SOE event. If there is no SOE qualifying event, or if the BA does not receive proof of SOE, the BA would deny the request and provide written notification to the employee of the decision.
2. Date-stamp the form(s) with the date received.
3. Complete the employer portion on the form(s). By signing the Change in Status form, the employer is affirming they have completed Step 1.
4. Upload the form(s) through the Navia employer portal.
   • Each FSA/DCAP employer has specific BAs with access to the PEBB employer portal.
   • If you need assistance with the upload process, please contact Navia’s dedicated team of Account Managers to help you Monday through Friday 7 a.m. and 5 p.m. (Pacific) at PEBBAdmin@naviabenefits.com or 424-452-3488.
   • If you are unable to upload documents via the PEBB employer portal, please send the cover sheet and form to Navia Benefit Solutions via:
     • Fax: 425-233-6366
     • Email: Navia Benefits Solutions - PEBB
     • Mail: Navia Benefit Solutions, PO Box 5179 Fresno, CA 93755

Navia Employer Portal

Benefits administrators use the Navia Employer Portal to securely upload member forms to enroll, change status, or terminate enrollment in an FSA/Limited Purpose FSA and/or the DCAP. All signed forms must be submitted through the portal, which allows for faster processing times and provides a confirmation email once a form has been successfully uploaded.

Benefit administrators must be given approved access by Navia and HCA before logging into the PEBB employer portal.

Employers must inform Navia’s dedicated BA help team immediately if there is a change in benefit administrator contact information. Navia will then notify HCA of the changes needed.

For instructions on how to register for the portal and upload files:

• Read the PEBB Navia admin portal guide, and/or
• View the New Navia Employer Portal recorded webinar

Navia Employer Portal FAQs

Can PEBB organizations have more than one BA with access to the portal?

• Yes. No more than three, but no less than one.

How can BAs transfer access to a new user or remove a current user?

• Contact Navia to have a user added or removed.

Do BAs need to use the same setup (username, password, and work email address) they have in SAW when accessing the portal?

• Yes.

Can BAs add the Navia Employer Portal as a service in SAW?

• Yes.

Can multiple forms be submitted at the same time when using the portal?

• Yes, multiple forms can be submitted at once, up to the maximum file size allowed (10 MB).

Will employees still be able to enroll on the Navia website during open enrollment?

• Yes.

What are the other file types in the drop menu on the Send a File page?

• There are file types used by non-PEBB employers. The only file type PEBB will use when uploading files is “Enrollment, Change in Status, or Termination forms.”

Will the PEBB billing still be handled by HCA?

• Yes. Navia and HCA will be in communication for employee enrollment, changes and terminations so HCA knows what to bill for.

Can BAs see basic employee enrollment information in the portal?

• No, the portal does not offer this functionality at this time. Navia is exploring this as an option for BAs to use in the future.

Payroll deduction guidelines

The amount deducted from an employee's pay is the total annual election amount divided by the number of paychecks the employee will receive during the plan year (January 1-December 31).

If an employee enrolls midyear, the amount deducted is the total annual election amount divided by the number of paychecks they will receive for the remainder of the plan year.

When an employee transfers from one PEBB employer to another, and continues their FSA/Limited Purpose FSA/DCAP, the per-paycheck deductions can increase to meet the annual contribution amounts by the end of the plan year. A transfer is not a qualifying event to change FSA/Limited Purpose FSA or DCAP elections.

Administrative fees and responsibilities

The employer administrative fee for the FSA, Limited Purpose FSA, and DCAP, as well as the CBA FSA contribution is included in the total funding rate paid to the PEBB Program by the employer for each eligible employee.

The administration of FSA/Limited Purpose FSA and DCAP benefits is a team effort between the employer, Navia Benefit Solutions, and the Health Care Authority.

Responsibilities of the employer

• Understand and provide accurate information to members regarding:
  • How FSA, Limited Purpose FSA, and DCAP accounts work and the difference between these and HSAs;
  • Enrollment instructions; and
  • Timelines and requirements for enrollment and making changes.
• Manage enrollment changes throughout the year and make the corresponding updates to payroll.
• Provide FSA/Limited Purpose FSA and DCAP enrollment forms and educational materials to employees upon request. These materials can be downloaded and printed from the Navia's website.
• Provide timely and accurate reconciliations of all employees' eligibility and enrollment discrepancies upon Navia's request.
• Participate in evaluation meetings held by HCA, if appropriate, to discuss Navia's performance.

State central payroll and higher-education payroll systems will:

• Provide eligibility documentation related to employees directly to Navia.
• Receive and process payroll deduction files from Navia.
• Deposit actual dollars collected from an FSA/Limited Purpose FSA and/or DCAP payroll deductions in account 165.
• Transmit FSA/Limited Purpose FSA and/or DCAP payroll deduction detail information to Navia.
• Provide all employee data needed to complete the annual IRS-mandated nondiscrimination testing to Navia.
• Workday users will adopt processes to notify and accept changes from members if the IRS announces an increase to the maximum contribution limit by the last day of open enrollment.

Responsibilities of Navia Benefit Solutions

• Assist with enrollment activities by providing general information and customer support to employees on Navia's website and toll-free phone number (1-800-669- 3539).
• Provide paper and online enrollment (via their website) during the PEBB Program annual open enrollment period.
• Accept employees’ eligibility documentation from their employers.
• Accepts enrollment forms and payroll reporting (via file) from the PEBB employer to update their employee’s FSA/Limited Purpose FSA/DCAP accounts.
• Checks enrollment form is for the correct plan year (either OE form, Mid-year Election form, or Change in Status form).
• Offer an FSA/Limited Purpose FSA debit card (Navia Benefits Card) for participants to use when they incur qualifying expenses.
• Offer fax numbers (1-425-451-7002 or toll-free 1-866-535-9227) to send claims and other correspondence.
• Process and pay claims.
• Provide the HCA with monthly bank account reconciliations, annual forfeiture reports, and other reports as needed.
• Participate in all HCA sponsored PEBB Program annual open enrollment benefit fairs.

Responsibilities of the Health Care Authority

• Manage the administration of the FSA/Limited Purpose FSA and DCAP programs consistent with Chapter 41.05 RCW.
• Communicate FSA/Limited Purpose FSA and DCAP programs and the PEBB Program annual open enrollment information to all eligible employees.
• Provide an FSA/Limited Purpose FSA and DCAP summary in the Employee Enrollment Guide.
• Pay to Navia the administrative fee in the contract between Navia and HCA.
• Monitor monthly bank account reconciliations and annual forfeiture reports produced by Navia. The HCA will pay any deficits that might occur from the state's FSA.
• Schedule evaluation meetings, if appropriate, with employers to discuss Navia's performance.