Flexible spending accounts require enrollment annually. The plan year is January through December on a calendar-year cycle. Employees enrolled in Flexible Spending Account (FSA) plans (health care or dependent care) with an unspent balance, must submit claims for expenses incurred during the plan year by March 31st the following year. Federal law requires any unused funds remaining in your account to be forfeited at the end of the plan year. The plan does allow for some FSA health care dollars to rollover year to year, see the enrollment form for current plan year rollover maximum.

Claims may be submitted online through the EBPA reimbursement portal.

EBPA, a third-party provider, administers UVM's Flexible Spending Account program. If your claims processing is delayed, call EBPA at 888-678-3457. 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 visit the EBPA website.

Flex Spending Account Portal

Eligibility

To be eligible for participation, you must be employed in at least a nine-month position of at least 50% FTE. You may reduce your earnings to pay for un-reimbursed medical/dental expenses, and to pay for dependent care expenses. See the Health Care Expenses brochure and/or the Dependent Care Expenses brochure for an overview of what kinds of expenses are eligible for reimbursement.
 
*Plan limits are established by the IRS annually.

Open a Flex Spending Account

  1. Use the FSA Estimating Worksheet to determine how much money you should set aside in your account(s).
  2. Complete the FSA Enrollment Form, can be found on the Forms page.

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.

Log 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.

Access 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.

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.

File a Claim

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

EBPA
PO Box 1140
Exeter, NH 03833-1140
ph: (888) 678-3457
fax: (603) 773-4415

  1. Complete the personal information requested on the Health Care Reimbursement Request Form which can be found on our forms page (name, address, employee ID number). Your employee ID number is the 7-digit number from PeopleSoft which may be found in PeopleSoft Human Resourcesunder 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. When uploading claims do not use the “Need a Healthcare Form” or “Need a Dependent Care Form” on the EBPA portal. Use the “UVM Health Care Reimbursement Form” only. If you prefer not to submit online, you may mail or fax the completed form and documentation to EBPA.

File a Claim for Your Dependent

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

Eligible Dependent Care Expenses

Dependent care expenses eligible for reimbursement must meet the following criteria:

  • 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

EBPA
PO Box 1140
Exeter, NH 03833-1140
ph: (888) 678-3457
fax: (603) 773-4415

  1. Complete the personal information requested on the Dependent Care Reimbursement Request Form which can be found on our forms page (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. When uploading claims, do not use the “Need a Healthcare Form” or “Need a Dependent Care Form” on the EBPA portal. Use the UVM “Dependent Care Reimbursement Request Form” only. If you prefer, you may mail the completed form and documentation to EBPA.

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.

students walking on campus

EBPA Flex Spending Brochure

UVM's Flex Spending Summary Plan Description