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2009 FSA Claims

Flexible Spending Accounts (FSA): Reimbursement and Account Management

Flexible spending accounts run on a January through December calendar-year cycle. In order to be reimbursed, expenses must be incurred during the particular calendar year in question, and claims must be submitted by the following March 31. Remember: federal law stipulates that funds not used during the calendar year or not submitted by the following March 31 will be forfeited.

Claims may be submitted online through the EBPA reimbursement portal. Claims submitted by noon Tuesday will be reimbursed (direct deposit or check mailed) by the following Monday.

EBPA, a third-party provider, administers UVM's Flexible Spending Account program. If your claims processing is delayed, call EBPA at 800-525-8788. Customer service is available 8 am to 5 pm EST. Alternatively, you may be able to find help by e-mailing fsa@ebpabenefits.com, or see their website.

Look below for the following information about FSA reimbursements:

  • How to File a Claim for Your Health Care Reimbursement Account
  • How to File a Claim for Your Dependent Care Reimbursement Account
  • How to Manage Your Flexible Spending Account Online

How to File a Claim for Your Health Care Reimbursement Account

You can be reimbursed for health care claims (but not dependent care claims) in excess of your accrued balance to date. However, you may not be reimbursed through a Flexible Spending Account for any health care expenses you itemize on your Federal Income Tax Return.

Account Information

  1. You must have itemized bills or health plan statements for each expense. The itemized bill must contain the name of the patient, provider, show the date(s) and the type of service. Canceled checks and balance forward statements cannot be used for claim purposes.
  2. All reimbursements will be made payable to you.
  3. Each reimbursement check stub serves as a statement of account.
  4. Statements of account will be issued quarterly. Statements/account information is available online.

Filing Your Health Care Claim

  1. Complete the personal information requested on the Health Care Reimbursement Request Form (name, address, employee ID number). Your employee ID number is the 7-digit number from PeopleSoft which may be found in PeopleSoft Human Resources under Self Service > Payroll and Compensation > View Your Paycheck. This number should be placed after the 99- which is pre-printed on the reimbursement form.
  2. If an expense is covered in part by a health plan, the balance may be submitted for reimbursement only after all health plan benefits from all sources have been paid. List expenses and attach the itemized bill or health plan payment.
  3. If no health plan applies, write none in the plan payment column.
  4. Calculate the amount of reimbursement due by subtracting the plan payment from the actual billed amount.
  5. Sign and date the reimbursement request.
  6. Scan the completed form and documentation into a file (a .pdf file, for instance), and submit the file online through the EBPA reimbursement portal. If you prefer not to submit online you may mail or fax the completed form and documentation to:
  7. EBPA
    PO Box 2365
    So. Burlington, VT 05407-2365
    ph: (800) 525-8788
    fax: (802) 864-8115


How to File a Claim for Your Dependent Care Reimbursement Account

You cannot be reimbursed for dependent care claims in excess of your accrued balance to date.

Dependent care expenses are eligible for reimbursement if they meet the following criteria:

  • The maximum reimbursement is the lowest of the following:
    1. The employee’s earned income for the plan year;
    2. The spouse’s earned income for the plan year;
    3. $5,000 (or $2,500 for married employees who file separate tax returns).
  • The expenses are necessary to enable you and your spouse to work.
  • Your dependent must be under age 13 or physically or mentally incapable of caring for himself or herself.
  • Your dependent is eligible to be claimed as a dependent on your Federal Income Tax Return.
  • Your payments are not made to a person you claim as a dependent.

Filing Your Dependent Care Claim

  1. Complete the personal information requested on the Dependent Care Reimbursement Request Form (name, address, employee ID number). Your employee ID number is the 7-digit number from PeopleSoft which may be found in PeopleSoft Human Resources under Self Service > Payroll and Compensation > View Your Paycheck. This number should be placed after the 99- which is pre-printed on the reimbursement form.
  2. Attach an itemized bill, copy of a cancelled check or have the provider sign the form.
  3. List the tax ID Number for each person providing the care.
  4. List each provider on a separate line.
  5. Scan the completed form and documentation into a file (a .pdf file, for instance), and submit the file online through the EBPA reimbursement portal; or if you prefer not to submit online you may mail the completed form and documentation to:
  6. EBPA
    PO Box 2365
    So. Burlington, VT 05407-2365
    ph: (800) 525-8788
    fax: (802) 864-8115

Note: On your Federal Income Tax Return, you will be required to supply the name, address and taxpayer identification number of the dependent care provider.


How to Manage Your Flexible Spending Account Online

EBPA's website allows employees to review general FSA information, print forms, or e-mail EBPA's FSA customer service department with inquiries.

To access your claim history and account balance:

  1. Visit www.ebpabenefits.com.
  2. Under My EBPA Member Access, select Click here to log in.
  3. Enter UVM as the Employer Name, and click Submit.
  4. Click on "Flexible Spending Account."
  5. Click on "Login."
  6. Under "To access your personal Claim History and Account Balance Information," select "Click Here to Log in" and follow the appropriate directions below.

If you are logging in for the first time:

  1. In the Username field, type the number 99, followed by your seven-digit UVM employee ID number. If you don't know your number, you can find it on your "View Paycheck" page under "Self-Service" in PeopleSoft Human Resources.
  2. Leave the Password field blank. Click Login.
  3. Complete the required fields and create a password for your account to be used for future logins.

If you are a returning user:

  1. In the Username field, type your Username (the number 99 followed by your seven-digit UVM employee ID number.)
  2. Type the password you have established for this site and click "Login."
  3. If you have forgotten your password you can click on the "Password Help" icon, enter your Username, and have your password e-mailed to you.
  4. If you are an existing member having trouble logging in, e-mail fsa@ebpabenefits.com for assistance.

Last modified October 27 2011 05:00 PM