Flexible Spending Accounts (FSA) Summary - a brief description of the FSA plans.  

FSA Informational PowerPoint Presentation    FSA Q's & A's

Wondering If Your Health Care Expense Qualifies for Reimbursement?

FSA Enrollment Form - send completed forms to MCCCD Benefits Office

FSA Open Enrollment Form 2010 - send completed forms to MCCCD Benefits Office

FSA Claim Form - send completed forms to Zenith Adminstrators

My Flex - monitor your FSA Account online at www.zenithfsaphoenix.com

When setting up your account make sure to use your Employee ID number and add a zero at the end.  Do not use your social security number.

FSA O.E. News - plan information for Calendar Year 2010

Flexible Spending Accounts (FSAs) help save you taxes when paying for certain health care and dependent care expenses.  Money is deducted from your paycheck and put into your accounts before federal, state and Social Security taxes are calculated.  During the plan year, you incur eligible expenses in health care and dependent care.  You submit a claim for reimbursement and you are paid back out of your accounts.  Because you are “paid back” out of an account that is never subject to taxes, the bottom line is that you pay less taxes on your total earnings.  In short, you save money that otherwise would have been eaten up in taxes!

If you have a change in family status, Health and Dependent Care Reimbursement Accounts may be added or increased. Please see the change of status guidelines for qualifications.  All claims must be incurred after the effective date of the qualifying event.

A new enrollment form must be completed each calendar year to continue participation even if you are not changing amounts. 

Health Care Flexible Spending Account

An employee must be a Board Approved regular employee who has worked for a minimum of two years and currently works a minimum of 20 hours per week to participate. Enrollment is during the FSA Open Enrollment period in October of each calendar year.  

Claims may be submitted for expenses incurred during the calendar year by submitting the FSA claim form with expense receipts attached.  Claims must be received by the Benefit Office the Friday before payday. 

Dependent Care Flexible Spending Account

An employee must be a Board Approved employee working a minimum of 20 hours per week to participate.  Enrollment may be done when initially hired or during the FSA Open Enrollment period in October of each calendar year.  

Claims may be submitted for expenses incurred during the calendar year by submitting the FSA claim form with expense receipts attached.  Claims must be received by the Benefit Office the Friday before payday.

My Flex - monitor your FSA Account online at www.zenithfsaphoenix.com

As a participant, you have access to your current Flexible Spending Account balances through the Zenith Administrators flexible spending account web site.  The FSA web site offers additional features to manage your FSA Accounts.

Health care and dependent care worksheets to help participants estimate expenses for the plan year.

Qualifying expense information.

View account balances, election amounts, and claims reimbursement details.

Participants will also have access to account balances, election amounts and claims reimbursement details through the Interactive Voice Response System (IVR).  To access the IVR system, call 1-866-206-2345 and follow the step-by-step instructions to access your Flexible Spending Account information.  You will need to use your employee ID number plus zero even though the system will prompt you to use your social security number.

Participants preferring to speak with a live person will always have the option of contacting Zenith Administrators by phone at 602-336-2241 or 1-800-553-2801.

When setting up your account make sure to use your Employee ID number and add a zero at the end.  Do not use your social security number. 

Claiming Expenses

Automatic Reimbursement:

Zenith Administrators provides an option for participants who are covered under Maricopa Community College's medical plan to be automatically reimbursed for out-of-pocket medical expenses. Participants selecting this option will not have to submit reimbursement claim forms for eligible medical expenses submitted to Zenith Administrators by their medical providers. Examples of these expenses include co pays for physician office visits and coinsurance. Checks will be generated when the total reimbursement amount meets or exceeds the minimum $50.00 requirement.

Acceptable forms of proof of incurred expenses include the following:

• Insurance company Explanation of Benefits (EOB) statement, pharmacy receipt or OTC (over-the-counter) receipt or a legible, detailed statement from the provider that includes the name of the provider, date service was provided, type of service, your out-of-pocket expense (amount not covered or reimbursed elsewhere), and the name of the employee or dependent for whom the service was provided.  When submitting dental receipts, those on Assurant, or any dental plan not sponsored by MCCCD, should supply a legible provider receipt (EOB if applicable), and those with MetLife dental should supply the Explanation of Benefits (EOB). 
  • Canceled checks and credit card statements are not acceptable as supporting documentation. 
  • The services must have already been provided.
  • Write your name and employee ID number on all documents.

Grace Period for submitting claims:

The IRS has recently established a new ruling (Notice 2005-42) to allow employers to grant FSA participants an additional 2 1/2 months (grace period) after the close of a plan year to use contributions that were unused during that plan year.

Example: The FSA participant has a $300 remaining balance in their health care FSA on December 31, 2007.  The FSA participant incurs a $350 health care expense on March 2, 2008.  The FSA participant can submit their $350 health care expense and $300 of the health care expense will be reimbursed from the 2007 health care FSA remaining balance.  The remaining $50 health care expense will be reimbursed from the participant's 2008 health care FSA if elected.

The deadline to file prior year claims is April 15th of the following year for eligible expenses incurred through the previous plan year (including the grace period). After April 15th, any remaining dollars are deleted from your prior year account.

All FSA CLAIM forms must be submitted to Zenith Administrators:

            Zenith Administrators

            2001 W. Camelback Road, Ste. B350

            Phoenix, AZ  85015

            Fax numbers:

            602-248-8301 (claim forms only)

602-589-5376 (claim forms only)

(Faxed claim forms are acceptable)

All FSA ENROLLMENT forms must be sent to MCCCD Compensation Office:

            MCCCD Compensation Dpt.

            2411 W. 14th Street

            Tempe, AZ 85281

            Fax: 480-731-8484

            (Faxed enrollment forms are acceptable)

Last modified: October 22, 2009

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