Please note health FSA and DC FSA plans run on a plan year instead of a calendar year. You may contribute from 7/1 – 6/30. You have 30 days after the end of the plan year (June 30) to submit claims for services rendered or items purchased in the prior plan year.

A great way to plan ahead and save money over the course of a year is to participate in an FSA. An FSA lets you redirect a portion of your salary on a pretax basis into a reimbursement account, saving you money on taxes. Each year that you would like to participate in the FSAs, you must elect the amount you want to contribute.

Moosilauke Visions offers two types of FSAs that can help you save on a pretax basis for out-of-pocket expenses.

Health FSA (Gold and Silver plan members, as well as those not enrolled in a medical plan)

With the health FSA, employees can elect to contribute up to $3,200 to pay for qualified medical, dental or vision expenses. This is a use-it-or-lose-it account, meaning you need to spend your entire election during the plan year. Employees have the option to roll over up to $570 in elections from the prior plan year into 2024-25.

  • Some examples of qualified expenses:
  • Office visit copays
  • Qualified supplies from the FSA store
  • Paying dental bills
  • New glasses

Limited Purpose FSA (Bronze QHDHP plan members)

Employees in the Bronze QHDHP plan who contribute to an HSA (health savings account), or have a spouse who contributes to an HSA, and still wish to use a flexible spending account must elect the limited purpose FSA account. You can elect to contribute up to $3,200 to pay for qualified dental or vision expenses. You may not use the limited purpose to pay for medical expenses. You can rollover up to $640 from the 2024-2025 plan year to the 2025-2026 plan year. For the 2023-2024 plan year, you can rollover up to $570 to the 2024-2025 plan year.

Some examples of qualified expenses:

  • Paying dental bills
  • New glasses
  • Vision exam copays

During open enrollment, you must decide how much to set aside for this account in 2024-25 plan year. You may contribute up to the IRS maximum of $3,200. For a full list of FSA-eligible expenses, visit https://fsastore.com/fsa-eligibility-list

Two ways to access your FSA Funds

Submit an FSA claim to access funds

Claim requests can be submitted many ways for your convenience:

  1. Log into the Consumer Portal at csONE.com and enter the claim details, and upload scanned supporting documentation to us.
  2. Log into the mobile app on your smartphone, enter the claim details and snap photos of supporting documentation to submit them to us.
  3. Complete a claim form, attach copies of supporting documentation and send them by mail, fax or email to us. You can even drop them off in person!

Use your Flexible Benefits Debit Card at point-of-service to:

Claim requests can be submitted many ways for your convenience:

  • Pay for eligible services at health provider.
  • Purchase prescriptions at your pharmacy.
  • Purchase eligible over-the-counter items at major pharmacies and supermarkets.
  • Pay for over-the-counter items online at FSA Store.

(visit the csONE Flex Benefit participant page for details: csONE.com)

How to Submit Debit Card Documentation:

  • Log into the Consumer Portal, select the request and upload the scanned supporting documentation to us.
  • Log into the mobile app on your smartphone, snap photo of supporting documentation and submit to us.
  • Print the documentation request, attach copies of supporting documentation and send them by mail, fax or email to csONE.

Contact Informaiton:
csONE Benefit Solutions
888.227.9745

Keep your receipts

Keep your receipts and documentation for transactions. Some purchases will auto-adjudicate at time of purchase, but others will need proof of eligibility. csONE will send you a request for documentation if proof of eligibility is necessary. However, the IRS requires that you keep documentation for all transactions paid for with FSA funds.

Healthcare flexible spending account

The healthcare FSA can be used to pay for eligible out-of-pocket medical, dental, vision and prescription drug expenses.

csONE’ feature allows you to skip the pen and paper. csONE automatically passes medical, pharmacy, dental and vision claims to your FSA, thereby eliminating the need for you to submit a manual claim form. You pay your copay or out-of-pocket expense directly to your healthcare provider, who in turn will initiate the claim. csONE initiates a direct deposit or sends you a check from your FSA to reimburse you for your eligible out-of-pocket expense. You do not have to complete any paperwork. You will be asked if you want to enroll in the csONE feature when enrolling in the healthcare FSA program.

Funds in the healthcare FSA are available at the beginning of the plan year and can be used for your expenses and those of your spouse and dependents, even if you and your family aren’t covered by our plan.

Run out period

You have 30 days after the plan year to submit claims for services rendered or items purchased in the prior plan year. Terminated employees will have 30 days from the date of the qualifying event to submit claims. Only services rendered prior to the last coverage data will be eligible.

Roll Over

If you do not use up all of the money in you account by the end of the plan year, you can roll over up to $550 to the next year.

Dependent care flexible spending account

Dependent care FSAs allow you to set aside money pretax to pay eligible out-of-pocket day care expenses so that you or your spouse can work or attend school full-time. You must contribute money through payroll deduction to your dependent care FSA before you can spend it.

During open enrollment, you must decide how much to set aside for this account in 2023. You may contribute up to $5,000, or up to $2,500 if you are married and file separate tax returns.

  • Adult day care
  • Child day care
  • After-school care
  • Babysitting (work-related, in your home or someone else’s home)
  • Babysitting by your relative who is not a tax dependent (work-related)
  • Nanny or au pair
  • Custodial elder care
  • Transportation to and from eligible care (provided by your care provider)
  • Babysitting (not work-related, for other purpose)
  • Babysitting by your tax dependent (work-related or for other purpose)
  • Custodial elder care (not work-related, for other purpose)
  • Dance lessons, piano lessons or sports lessons
  • Educational, learning or study skills services for child(ren)
  • Household services (housekeeper, maid, cook, etc.

Termed employees will have 30 days from the date of the qualifying event to submit claims. Only services rendered prior to the last coverage date will be eligible.

Ready to enroll?

Visit bswift to elect your benefits during the annual open enrollment period or if you experience a qualifying event.