Samford University

Flex Spending Accounts

Flexible Spending Account Forms

2015 Plan Year Forms 
  • Samford offers two flexible spending accounts: medical spending and dependent care spending.
  • Payroll deductions for the flexible spending accounts are made pre-tax.
  • You do not have to be enrolled in the Samford University Health Plan to participate in the flex spending accounts.
  • Effective January 1, 2014 BlueCross/Blue Shield of Alabama is our flex plan provider.
  • Once enrolled, BCBS will issue you a contract number(s) for your Flex Account(s).
  • Effective January 1, 2014 the IRS will allow participants to roll up to $500 of your unused account balance into the next plan year.    

Medical Spending Account

The medical spending account allows participants to contribute money before federal taxes to an account which can then be used to reimburse medically necessary expenses that are not covered by your medical and dental insurance plan.

The maximum yearly contribution to medical spending for 2015 is $2,550.00

Examples of eligible expenses include but are not limited to calendar year deductibles, co-pays, lab fees, prescription medications, and first aid.  Click here for a more in-depth listing of eligible expenses. 

Dependent Care Spending

Dependent care spending is an account which allows participants to contribute money before taxes to an account which can then be used to reimburse dependent care expenses.

Maximum per household contribution for the 2015 dependent care spending account is $5000.00

Examples of eligible dependent care expenses include care provided: 

  • Inside or outside the home, the care must be provided by someone other than:
    • The Participant's spouse
    • A person listed as the participant's dependent for income tax purposes: or
    • A participant's child under age 19
  • In a dependent care center or a child care center, which meets all applicable state and local regulations
  • By a housekeeper whose services include, in part, providing care for a qualifying individual.
An eligible dependent must share his or her principle place of residence with the participant and be one of the following: 
  • A qualified dependent child under age 13 who lives with the participant for more than half of the year.
  • A qualified dependent child, a qualified relative dependent or your spouse who is physically or mentally unable to care for him or herself.
  • An elderly parent and qualify as an eligible dependent.
Examples of ineligible expenses include: child support payments, food/clothing/entertainment, cleansing and cooking services provided by the care giver, over night camps.

NOTE: Please refer to the IRS Publication 503, "Child and Dependent Care Credit" as a guide to covered and non-covered expenses.   

Flex Spending Accounts Frequently Asked Questions

How do I file for reimbursement? 

  •  2015 Plan Year:
    • Medical Flexible Spending Account
      • If you are a participant in the Samford University Health Plan, reimbursements from your Medical Flexible Spending Account are automatic.  When a claim is received from your healthcare provider, BCSB will first apply the Health Plan benefits to your claim.  Any portion that is your responsibility (co-pay, deductible) will automatically be reimbursed from your Flexible Spending Account.  
      • If you have coverage with another carrier you should contact BCBS Customer Service at 1-800-213-7930 to document this information on your account.  Under IRS guidelines all medical plans must pay before Health FSA funds can be used.  You can either file a Reimbursement Request Form, which must include all required documentation as well as your contract number and the other carrier's Claims Processed Report; or you may file your claims online via myBlueCross Member Login.  You will need an electronic copy of your documentation in order to file online.  
      • You may elect to have your reimbursements directly deposited into your checking or savings account.  You may begin the direct deposit service at any time by completing the BCBS direct deposit enrollment form
    • Dependent Care Flexible Spending Account
      • You may complete a Reimbursement Request Form and submit it to BCBS or you may file your claims online via myBlueCross Member Login.  
      • You will need your provider's Tax ID number and your contract number to file your claim.
      • If filing online you will also need an electronic copy of your receipt.  

Where do I send my completed form?   

  • 2014 Plan Year: Please send your reimbursement forms to BCSB via fax at 1-877-889-3610.  (remember you may also file your claims online via myBlueCross Member Login). 

Can I file for reimbursement at any time or do I have to file as the expense is incurred?
You can file for reimbursement anytime during the plan year.  

  • Please note:
    • You can receive up to the full amount of your annual election in the Health Care Spending Account at the time the expenses are incurred even if the payroll deductions have not been taken. 
    • You can only receive the amount that has been payroll deducted into your Dependent Care Account.  If your expense is greater than your payroll deductions, you will only receive reimbursement for the amount that is in your account.  The expenses over your payroll deductions will be credited and reimbursed to you after the next payroll deduction.  

How can I find out my account balance?

  • Plan Year 2014 & 2015
    • Login to myBlueCross Member.  Under "Manage My Contract" click on Flex Spending/Health Reimbursement.  This will pull up your account information including annual election, total amount reimbursed, and year to date payroll deductions.  

What is the plan year?
January 1 to December 31.

What happens to money in my account that is not claimed by the end of the plan year? 

  • Plan Years 2014 & 2015: Participants may roll up to $500 of your unused account balance into the next plan year.  

How long do I have to submit claims?
You must submit claims for services rendered during the plan year within 3 months of the close of the plan year.

What is the benefit of participating in the flexible spending account?
Spending accounts reduce your taxes by reducing your taxable income.  Using these pre-tax accounts can make a significant difference in your take-home pay.