The Tax Saver Flexible Benefits Plan provides eligible employees the choice of participating in one or more of the options listed below.

Spending Account Plan

Eligible employees may establish one or both of the following spending accounts, which allow them to use tax-free dollars to pay for eligible expenses:

1. Health Care Spending Account: allows employees to set aside, on a tax-free basis, up to $2,750 per year for eligible non-reimbursable (i.e., out-of-pocket) medical expenses for the employee and his/her dependents. Here are examples of eligible and ineligible expenses.
2. Dependent Care Spending Account: allows employees to set aside, on a tax-free basis, up to $5,000 per year per family (or $2,500 if married filing separately) for those dependent care expenses (i.e., day care) incurred in order for the employee and his/her spouse (if married) to work.

LSU System has partnered with Diversified Benefit Services, Inc. (DBS) to offer employees Flexible Spending Accounts. This program will allow employees to put tax-sheltered dollars in an account for out of pocket medical and/or dependent care expenses that are incurred each calendar year for the employee and any eligible dependents.

This benefit provides the opportunity to set aside tax-exempt dollars for out-of-pocket health care or dependent care expenses incurred by you and/or your eligible dependents. LSU offers two different plans through our Tax-Saver Flexible Benefits that allow you to reduce your taxable income, the Heath Care Reimbursement Plan and the Dependent Care Reimbursement Plan.

Important Information About Your Prepaid Benefits Card (FSA)

Eligibility

Any active employee of LSU is eligible for benefits provided the following:

• Employed at 75% of full-time effort per pay period (avg. of 30 hours/week) or greater;
• Appointed for a duration of at least one semester or 120 days or greater

**Please note - Employees who participate in the Pelican HSA 775 option administered through BlueCross BlueShield are not eligible to participate in the Flexible Spending Account Program.

Health Care Flexible Spending Account

• The minimum contribution to participate in this Program is $100.00.
• The maximum contribution to participate in this Program is $2,750.00.

Dependent Care Flexible Spending Account

You may receive tax-exempt reimbursements for the care of certain individuals in your household, which includes your dependent children age 12 or younger and any other individuals who reside with you and who rely on your for at least half of their support or are physically or mentally unable to care for themselves.

• The minimum contribution to participate in this Program is $100.00 per Plan Year.
• The maximum contribution to participate in this Program is $5,000 or $2,500 if married and filing separately, or such other amount as may be established by law from time to time.

Eligible Dependent Care Account expenses include:

• Day-care costs
• Schooling costs, not including food and clothing, for either private or public schools, for children not yet in kindergarten
• If expenses for food and clothing cannot be separated from the total cost of child care, then they are eligible expenses
• Before/after-school care
• Babysitting and licensed day-care center costs
• Housekeeping services in your home that include day care
• Elder care if dependent is claimed on your tax return
• Costs of transportation, overnight camping, nursing care facilities, and the schooling costs of children in the first grade or above are generally ineligible expenses

Participation in Dependent Care Flexible Spending Accounts:

1. If you are married, both you and your spouse must be employed in order to use this Plan.
2. Your contribution may not exceed the lesser of your income or the income of your spouse.
3. If you are married and file separate returns, your maximum contribution is $2,500.
4. If you are married and file a joint return, your maximum contribution is $5,000.

Using the Money in Your Flexible Spending Account

You must determine an annual target amount (maximum limits apply) to be withheld by forecasting your out-of-pocket health care and/or dependent care expenses for the entire plan year (January 1 - December 31). If you enroll in the FSA, you will be provided with a Debit Card that is pre-loaded with your elected amount to use throughout the Plan Year. Dependent Care participants must file manual claims.

Your annual target is then deducted from your paycheck in equal installments. The deduction is made before taxes are computed, thus making the spending account dollars tax-free. There is no tax liability on the money put into either the health care or dependent care spending account or on the money reimbursed through these spending accounts.

There is a $5.00 monthly administrative fee for this plan.

To access the money in your account, you can either use your FSA Debit Card at the time of service, or you can file a claim form requesting reimbursement for eligible, out-of-pocket expenses. Please be aware that reimbursement checks issued from DBS have a 180-day expiration date.

Reimbursements for Dependent Care expenses can be accessed by mailing/faxing claim forms to DBS, submitting claim information online or submitting via DBS’ mobile phone application.

You can only make mid-year changes to these accounts if you experience a qualifying event as defined by the IRS.

Note: Remember, you must re-enroll in the Flexible Spending Account (FSA) each year during Annual Enrollment. Your FSA enrollment will not automatically carry over from year to year. If you choose not to re-enroll during annual enrollment, your account will automatically CANCEL on December 31.

Grace Period

There will be a grace period immediately following the end of the Plan Year for both Health care and Dependent Care Spending Accounts. This extension will provide participants additional time to incur expenses for reimbursement from the previous year’s account. The grace period will be available after the end of the Plan Year from January 1st through March 15th.

Filing FSA Claims

Filing a claim is as easy as completing a claim form and attaching a receipt. Timely filing of a claim will result in a timely reimbursement. All claims incurred during the grace period must be filed no later than April 30th.

Enrollment and Effective Date of Coverage

Timely Applicant: If you enroll within your first 30 days of full-time employment, your coverage will be effective the first of the month following your first full calendar month of employment.

Existing Employee: Employees may enroll during annual enrollment which is within the month of October. Benefits will be effective January 1.

If you experience a life qualifying event, contact HRM (225.578.2258) about making appropriate changes in Workday within 30 days of the event. Benefits will be effective the month following the date of the event.

How to Change Benefits in Workday

Cancel Coverage

To cancel your Flexible Spending Account during the plan year, it must be due to a Qualifying Life Event. Contact HRM (225.578.2258) about making appropriate changes in Workday within 30 days of the event.

Terminating Employment

If you leave LSU employment, you can continue to submit claims. However, you may only submit claims for expenses incurred on or before the last day of your employment. Claims must be filed within 30 days of the end of the month in which you terminate or within 30 days following the end of the plan year, whichever is sooner.

Plan Details and Helpful Documents

Interested employees should review plan details carefully as the Tax Saver Plan isn't for everyone, but for many employees, it can save hundreds of tax dollars each year.

• LSU System Tax Saver Flexible Benefits Plan Document
• Over-the-Counter Product Guide
• Frequently Asked Questions (FAQ's)
• Online Account Instructions
• FSA Direct Deposit Application
• FSA Claim Form