FLEXIBLE BENEFITS PLAN OPTIONS

  • General-Purpose Health Care Flexible Spending Arrangement (GPFSA) – Allows an employee to use pre-tax dollars to pay eligible out-of-pocket medical, dental and vision care expenses for himself or herself, his or her spouse and any other federal tax dependents – even if they are not covered by an OGB health plan. An employee cannot participate in the GPFSA and the Health Savings Account (HSA) options at the same time. This is a HIPAA-excepted benefits plan.
  • Limited-Purpose Dental/Vision Flexible Spending Arrangement (LPFSA) – Allows an employee to use pre-tax dollars to pay for eligible out-of-pocket dental and vision expenses only for yourself, spouse and any other eligible federal tax dependents. An employee cannot participate in the GPFSA and the LPFSA options at the same time. However, an employee who enrolls in the Pelican (HSA) 775 can participate in the LPFSA option. This is a HIPPA-excepted benefits plan.
  • Dependent Care Flexible Spending Arrangement (DCFSA) – Allows an employee to use pre-tax dollars to pay eligible dependent care expenses for a child, disabled spouse, elderly parent or other dependent incapable of self-care, while the employee is at work.
  • Health Savings Account (HSA) – Allows a plan member and their employer to contribute pre-tax dollars to an HSA. Active employees can contribute to the Health Savings Account option only when they choose the Pelican HSA 775 health plan and are not covered by other disqualifying non-high-deductible health plan coverage. The deductible amount for plan members enrolled in the Pelican HSA 775 will reset at the beginning of each plan year. For more information on the Pelican HSA 775 visit our Health Plans page or visit the Blue Cross website.

The chart below describes each Flexible Spending Arrangement and when you should consider choosing that option:

Option

Description

Consider if:

Re-enroll each year?

Premium Conversion

Your eligible premiums are paid with pre-tax dollars through payroll deductions.

You want to increase your take-home pay.

No

General-Purpose Health Care Flexible Spending Arrangement (GPFSA)

Allows you to pay with pre-tax dollars certain qualifying medical care expenses for you, your spouse, and your eligible dependent children.

You pay out-of-pocket medical expenses, such as health plan co-pays, health plan deductibles, vision expenses, dental expenses, etc.

Yes

Limited-Purpose Dental/Vision Flexible Spending Arrangement (LPFSA)

Allows you to pay with pre-tax dollars dental and vision expenses for you, your spouse, and your eligible tax dependent children, while you maintain your eligibility to contribute to your HSA.

You are enrolled in the Pelican HSA 775.

Yes

Dependent Care Flexible Spending Arrangement (DCFSA)

Allows you to pay with pre-tax dollars eligible dependent care expenses for your child or children under age 13 who reside in your household, or for a spouse, parent, or other dependent who is incapable of self-care and spend at least 8 hours a day in your household.

You pay for the care of your eligible dependent(s) while you are at work.

Yes

Employees can participate in the General-Purpose Health Care FSA, the Limited-Purpose Dental/Vision FSA or the Dependent Care FSA benefit even if they are not enrolled in an OGB health plan or the Premium Conversion benefit!

COBRA and FSA COBRA

COBRA is offered to OGB health plan members, who have been termed due to employer lay-off, resignation, dismissal, retirement, or other qualifying events. FSA COBRA is offered to participants in the GPFSA or LPFSA, who have monies left in their FSA account. TASC administers COBRA and FSA COBRA. Once the plan member is termed in the OGB system, an electronic file is sent to TASC, who sends the COBRA Specific Rights Notice Letter directly to the termed participants.