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Reimbursement Options

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Below are the ways in which you can access your contributions to both Medical and the Dependent Care FSA's. 

You cannot select both Joint Processing and Debit Card.
You can always file electronically or with a paper form even if you select Joint Processing or the Debit card.

1. Electronically through Allegiance's site:  http://www.allegianceflexadvantage.com/ 

2. Paper form submission:
Medical FSA Form
Dependent Care Form

3. Joint Processing:
Cost: $0
Sign up electronically, or send in a paper request.

Since Allegiance serves as the State Plan's medical plan TPA, the amount you are responsible for on a medical claim can be automatically forwarded to Allegiance for processing. This eliminates the paperwork of filing a claim or the time spent online submitting a claim. The key here is every claim is automatically forwarded until your flex funds are gone. So if you want to save flex funds to pay for items later in the year – like a child’s braces – this option may not be the best for you.

You cannot elect Joint Processing if you or your dependents are covered by multiple health plans.

4. Debit Card: 
Note:  Debit cards are only available during Plan Years in which you have an active FSA election. If you do not elect to participate in FSA for the current Plan Year, your debit card will be terminated as of January 1 of the current Plan Year.

$1/month 
Sign up electronically or send in a paper request.

Can be used just like a regular debit card to pay for any qualified medical expense. You are responsible for providing documentation such as receipts and explanations of benefits (EOB) upon request.  Allegiance will ask you for the documentation after you have used the Debit Card unless you used the Debit Card for:

  • Vision expenses;
  • Copays;
  • Mail order drugs through a State Plan approved mail order vendor; or
  • Prescription drugs at a pharmacy with the Inventory Information Approval System (IIAS).  Visit Allegiance's website to see a list of pharmacies with IIASMost chain pharmacies, grocery store pharmacies, and large box stores like Shopko and Wal-Mart have IIAS. 

If you have both types of flex (Medical and Dependent Care) and you select the Debit Card for one, you automatically select the Debit Card for the other. However, if you do select the Debit Card option, you can always file paper or online forms for either type of FSA. 

Administered by Allegiance Benefit Plan Management 

(866) 339-4310 
Fax (406) 523-3149 or 
(877) 424-3539

https://www.askallegiance.com/