Human Resources

Flexible Spending Accounts (FSA) Claim Information

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Annual reimbursement maximums for 2013

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Before making your claim
Reimbursement options
Ways to send a claim

 

Before you make your claim, consider these 3 factors

Date of the expense incurred

Expenses incurred by March 15th may be claimed as expenses for the previous plan year if you were enrolled. Expenses incurred after March 15th of a year, may only be claimed as expenses for that plan year.

Required documentation

Note: documents will not be returned. The following documentation (copies are acceptable) must accompany your claim:

Dependent Care expenses

Copies of proof that you have paid the expenses in-full for the services you are claiming.

Healthcare expenses

Copies of proof that you have received the services and what expense is your responsibility.

Insurance benefits statements may be used instead of original physician bills if the date of service and charges are shown. Receipts of payment that do not include all the above information are not acceptable. Copies of personal checks are not acceptable. Documentation or copies will not be returned.

Date of claim

Claims filed no later than April 15th, may be applied to the previous year's plan expenses. After that, your previous year account will be closed and any unclaimed balance will be forfeited by you and will be retained by the State in accordance with federal regulations.

A supply of claim forms is included with your enrollment confirmation. Extra claim forms are available through your personnel assistant or you may download the form here.

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Receiving Reimbursement (payment from ASI)

ASI will review your claim and if approved, will reimburse you for the covered expenses. ASI will pay all claims incurred between January 1 and March 15 with any remaining previous plan year dollars first. Payments are generally issued within one day of ASI’s receipt of your claim. Your bi-weekly contributions will continue for the remainder of the Plan year.

Dependent Care-if your claim exceeds your available funds (contributions already made), the difference will be recorded and paid to you as funds become available from future payroll

Healthcare- payment is not limited to the amount in your account at the time of your claim but is limited to your annual election amount

Reimbursement may be received by direct deposit into the bank account of your choice. By using direct deposit you don't need to wait for a check to arrive or get it deposited. A notice that a payment was made will be sent to you. This direct deposit notice is available by U.S. Mail or by e-mail over the Internet.

If you prefer, a check can be mailed to you instead of payment by direct deposit.

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Submit claim requests and supporting documents to ASI in one of the following ways:

• Fax to 877-879-9038
• Online (log onto your ASI account at http://asiflex.com/ and attach a pdf version of your supporting documentation to your claim request)
• Send to: ASIFlex, PO Box 6044, Columbia, MO 65205-6044

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