Home / Flexible Spending Accounts / Medical FSA

The Medical Flexible Spending Account (FSA) enables the employee to pay for expenses allowed under Sections 105 and 213(d) of the Internal Revenue Code, and which are not fully covered by the group medical plan,  with pre-tax dollars. The Medical FSA allows the employee to be reimbursed for expenses incurred by the employee and the employee's dependents. Visit irs.gov or ASIFlex for a full list of qualified medical expenses. 

Annual maximum contribution per employee per Plan Year is $2,650. An employee has the ability to rollover $500 from the previous Plan Year's contributions if unused. The Medical FSA can be used for:
  • Deductibles, copays, and coinsurance not covered by health insurance
  • Out of pocket prescription drug costs such as copays
  • Medical, prescription, dental and vision non-covered expenses
  • To see a complete list of qualified medical expenses at ASIFlex
Other Restrictions:
  • $120/year minimum contribution 
  • $2.26/month fee for one or both types of FSA

The employee may forfeit amounts to the State of Montana if the employee does not fully use the contributions that have been made. It is important the employee decide how much to place in their Medical FSA account before the Plan Year begins. See the medical flex calculators on the ASIFlex website for assistance in determining your appropriate contribution amount. 

During the course of the Plan Year, the employee may submit requests for reimbursement of expenses the employee or their eligible dependents have incurred. Expenses are considered "incurred" when the service is performed, not necessarily when it is paid. The entire yearly Medical FSA contribution may be used starting on the FSA effective date.

For the Medical FSA, the employee must submit claims no later than 120 days after the end of the Plan Year, unless the employee intends to rollover funds to the next Plan Year. A terminated employee has 120 days from the date of termination to submit claims for medical expenses. Failure to submit claims within 120 days will result in any available contributions being forfeited. In some circumstances an employee may have the ability to elect COBRA for Medical FSA due to termination. For more information contact Allegiance COBRA Services at (800) 259-2738. 

See the Wrap Plan Document for more details about ASIFlex flexible spending accounts. Contact ASIFlex if you have any questions regarding eligible expenses or how to submit a claim for reimbursement. 

Administered by ASIFlex

Phone 1.800.659.3035
Fax 1.877.879.9038
Email asi@asiflex.com
Website asiflex.com