The Flexible Spending Account (FSA) is a way for you to save income taxes when paying for eligible Health Care OR Dependent Care expenses. The FSA is a use it or lose it plan and any unused funds are forfeited.

• Health Care FSA
  Related expenses may include medical, prescription, vision and dental insurance co-pays, coinsurance, and deductibles not covered by insurance.  The first time you enroll in a Health Care FSA, you will receive a FSA debit card, which allows you to pay directly from your FSA account without having to wait to be reimbursed. Review the IRS Rules regarding undocumented FSA debit charges.
  
  • 2023-calendar year Health Care FSA maximum contribution limit is $2,850.
    
    
• Limited Purpose Flexible Spending Account (LFSA) - Non-Represented & SEIU Employee Groups ONLY
  Non-Represented and SEIU employees who have an Health Savings Account (HSA)— must be enrolled in Moda Plan 6 or Kaiser Plan 3 to have an HSA—are eligible to enroll in a Limited Purpose Flexible Spending Account (LFSA) similar to the traditional Health Care FSA.  An LFSA allows you to pay for eligible out-of-pocket preventive care for dental, orthodontic, and vision expenses.
  
  • 2023-calendar year Limited FSA maximum contribution limit is $2,850.
    
    
• Dependent Care FSA
  May be used for a qualifying dependent under the age of 13 or an eligible dependent who is physically or mentally incapable of self-care.  You can access account information online and set up recurring payments for reimbursement of dependent care expenses. 
  
  • 2023-calendar year Dependent Care FSA maximum contribution limit is $5,000.
    
    

Additional FSA Information:

How do I enroll the FSA?

You must elect to participate in the FSA for the first time within 31-calendar days of your start date.  You will elect to participate in the FSA through your online benefits enrollment event in PeopleSoft Employee Self-Service (ESS). 

New Employee Benefits Webpage: https://www.pps.net/Page/1635
Once your employment information has been processed in the HR computer system, you will receive the Benefits Enrollment Notification to your PPS email account and personal email account (if on file), letting you know your online benefits enrollment event is ready for you to complete and submit in PeopleSoft ESS.  You may then follow the Online Benefits Enrollment Instructions to complete and submit you benefits enrollment.

How do I request reimbursement from my FSA?

PacificSource Administrators is the Flexible Spending Account (FSA) administrator.  They can provide you with additional information on the FSA and answer any FSA questions you may have.

Phone: 800-422-7038 (toll free) or 541-485-7488
Email: psacustomerservice@pacificsource.com
Fax: 866-446-6090 (claims ONLY)
Website: https://psa.pacificsource.com/PSA/
User Account Login: https://psa.consumer.pacificsource.com/

Non-Represented | SEIU

• • OEBB - FSA Enrollment form (fillable PDF) - 2022-2023 Plan Year ONLY
    (10/01/2022 - 09/30/2023)
    
    

ATU | DCU | PAT | PFSP

• • Health & Welfare Trust - FSA Enrollment form (fillable PDF) - 2023 Plan Year ONLY
    (01/01/20223 - 12/31/2023)

OEBB - Non-Represented | SEIU

• • OEBB FSA Handout 10/2022-09/2023
  • Summary Plan Description for plan year 10/2022-09/2023
  • Plan Document for plan year 10/2022-09/2023
  • Appendix B - Plan Restructuring

Health & Welfare Trust - ATU | DCU | PAT | PFSP

• • Trust FSA Handout 2023
  • Summary Plan Description for plan year 01/2023-12/2023
  • Plan Document for plan year 01/2023-12/2023