Employee Benefits

Employee Reimbursement Account (ERA)

Reimbursement claim form

The Employee Reimbursement Account Program is a voluntary pre-tax program for eligible state and university employees authorized under Section 125 of the Internal Revenue Code and Wisconsin Statute 40.85. This program is administered by the Fringe Benefit Management Company (FBMC).

The Department of Employee Trust Funds' web site on the Employee Reimbursement Account Program includes a list of information which may be helpful. ETF has also created a video explaining the program. View the 2009 ERA Summary Guide for an overview of the program. For a more detailed explanation of the program, review the complete 2009 ERA Benefits Booklet.

The program allows you to set aside pre-tax income to pay eligible medical and dependent care expenses. When you participate, your spendable income increases because less is withheld from your paycheck for federal and state income taxes and social security. During the plan year, with few exceptions, your ERA deduction cannot be cancelled or changed. For further information on rules regarding changes during the year, visit the Department of Employee Trust Funds website regarding common "Change in Status" events.

Important Notice about the ERA Program Grace Period

NOTE: There is a 2 ½ month "grace period" following the end of each plan year for both medical expense accounts and dependent day care accounts. Expenses for services provided through March 15 of the following calendar year may be reimbursed with money remaining from the prior year's ERA medical expense and dependent day care account contributions. However, any unused amounts from the prior plan year that are not used for expenses incurred by March 15 remain subject to the "use it or lose it" rule and will be forfeited.

April 15 is the deadline for filing claims incurred during the prior plan year and through the grace period of March 15.

ELIGIBILITY

Most University of Wisconsin employees who are receiving salary or wages are eligible. Research assistants, graduate interns and trainees, fellows, scholars, post doctoral fellows and trainees, limited term employees (LTEs), and students paid on hourly basis may not participate.

ENROLLMENT

Upon enrollment, FBMC will assign you a unique ID number.

  • New employees must enroll no later than 30 days from their employment begin date for participation during the remainder of the current calendar year.
  • Each fall employees may enroll for coverage during open enrollment for the following calendar year. Enrollment is for one calendar year. Each year employees must re-enroll. You can enroll on-line at www.myFBMC.com or by telephone at 1-800-847-8253.
  • Employees may change benefit elections only when a valid Change in Status event takes place. The IRS defines Change in Status events as those that affect your own, your spouse's or your dependent's coverage eligibility. Some examples include marriage, change in number or eligibility of dependents or change in employment status.*
  • Participation in the Automatic Premium Conversion component is automatic, unless you file a waiver with your employer.

COST

There is no fee for participation in the ERA program. However, you will forfeit any money left in your account after all reimbursements for the plan year have been processed. It cannot be returned to you or carried forward to the next plan year. You must file all requests for reimbursements by April 15 following the end of the plan year. Plan your deferrals carefully!

PROGRAM FEATURES

The ERA program operates on a calendar-year basis and has three distinct parts.

AUTOMATIC PREMIUM CONVERSION

  • For eligible employees, the premiums you pay for the State Group Health, Epic Dental & Excess Medical Insurance, Anthem DentalBlue Dental Insurance, OptumHealth Vision Insurance, and a portion of employee coverage under State Group Life Insurance are automatically deducted from your pre-tax salary unless you opt out of this provision.
  • Participation in Premium Conversion is automatic; you do not have to re-enroll each year.
  • Premiums you pay for other coverage (other special life or income continuation insurance, for example) are not affected by this plan.
  • If you are an LTE or are covering a domestic partner, the IRS does not extend this pre-tax benefit at this time.

    Waiver for Automatic Premium Conversion

    If you wish to continue to pay taxes on your premium amounts, fill out an Automatic Premium Conversion Waiver form (ET-2340) and return it to your payroll office. This can only be done at the following times: within 30 days of the date you are first eligible to participate in the ERA program; during the annual ERA open enrollment period; when you first enroll in the State Group Health or State Group Life insurance plans; or when you experience a Change in Status event. Once you have filed a waiver it will remain in effect for future plan years, unless you file a revocation of waiver with your payroll office.

MEDICAL EXPENSE REIMBURSEMENT ACCOUNT

  • Tax-free dollars pay for eligible uninsured medical expenses incurred by you, and/or your spouse and dependents.
  • Expenses you incur during the plan year are reimbursable.
  • Annual contribution limits for 2008 & 2009: $100 minimum and $7,500 maximum.
  • Reimbursable medical expenses must be primarily for the prevention or alleviation of a physical or mental defect or illness. A complete list of eligible expenses appears in IRS Publication 502.
  • Insurance premiums are not reimbursable.
  • Certain over-the-counter drugs are eligible to be reimbursed.
  • Coverage is effective on the first of the month on or after your benefits office receives your enrollment form.

DEPENDENT DAY CARE REIMBURSEMENT ACCOUNT

  • Tax-free dollars pay dependent care expenses for eligible child, adult and elder care expenses enabling you and your spouse to work, actively look for work or attend school full-time.
  • The minimum annual contribution is $100 for 2008 and 2009. The general contribution maximum limit is $5000 but it may be less due to earnings level and income tax filing status. See Summary Guide for details.
  • Eligibility requirements are explained in IRS Publication 503.
  • Coverage is effective on the first of the month on or after your benefits office receives your enrollment form.

View the 2008 ERA Summary Guide or the 2009 ERA Summary Guide

REIMBURSEMENT INFORMATION

You will need to submit a completed reimbursement claim form with supporting documentation directly to FBMC. You can mail the form or submit it via toll-free fax to 1-888-326-2658. View an informational flyer about submitting a claim. You can also set up "Rapid Refund" to have reimbursements sent directly to your bank account.

If you have questions or concerns about claims processing or the eligibility of specific expenses for reimbursement, call or write Fringe Benefits Management Company, the program administrator, at:

Fringe Benefits Management Company
P. O. Box 1878
Tallahassee, FL 32302-1878
Customer Service Department: 1-800-342-8017
TDD: 1-800-955-8771
Fax: (850) 425-4608
website: www.myFBMC.com

You may also call Benefits On-Line 24 hours a day at 1-800-865-FBMC (3262) to review your current benefit information or request claim forms or visit Fringe Benefit Management Company Customer Service Center to check on your account information.

Facts you should know about your ERA account when your employment terminates or during an unpaid leave of absence:

Medical Expense Accounts

  • You can prepay. If you terminate employment during the year or go on unpaid leave of absence, you may pay all or part of your remaining ERA deductions ahead from your last paycheck. (You can also pre-pay your medical expense account contributions by personal check through your employer, but the payment would be after-tax.) In some cases you are eligible to reduce your pledged amount.
  • When coverage ends. If you pre-pay your full annual election amount, your coverage continues until the account is exhausted or until March 15 of the next year, and you can continue to submit claims for reimbursement. If you do not submit entire annual election amount, coverage ends at the end of the month in which your last deduction was taken. You would not be eligible for reimbursement for medical services received after that date. Plan carefully for your medical expenses account when terminating employment.
  • Reinstatement. During an unpaid leave of absence, if you do not prepay, your eligibility for reimbursement is suspended. Money remaining in your account will be forfeited unless you return to work and reinstate your account during the same plan year. When you return, you can change your contribution amount or begin an account.

Dependent Care Accounts

  • You can pre-pay. Some or all of your annual election amount can be deducted pre-tax from your last paycheck. After-tax contributions by personal check are not permitted.
  • When coverage ends. Even if you do not pre-pay, your dependent care coverage continues until the account is exhausted or until March 15 of the next year. You can continue to submit claims for services received until that date.
  • Reinstatement. If you return to work after an unpaid leave of absence, you can change your contribution amount or begin an account.

 

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This document was last revised on November 19, 2008

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