Human Resources

4 Summer St., Rm 104, Haverhill, MA 01830 | Office Hours 8:00-4:00 | Phone (978) 374-3411 | Fax (978) 374-3422

  • Flexible Spending Accounts (FSA)

    Flexible Spending Accounts (FSA)

    This page will help you find a wealth of information to help you make the most of your flexible spending accounts, which are administered by Pro-Flex.  Pro-Flex offers 2 FSA account options:

    Health Care FSA (with carryover):
    You may set aside up to a maximum of $2,700 per plan year for FY20 ($2750 per plan year for FY21) (there is no minimum election). You may use the FSA for eligible medical dental and vision expenses.  Your total election is available to you on the effective date.  You may carryover up to $500 from one plan year to the next.

    Dependent Care FSA (no carryover):
    You may set aside up to a maximum of $5,000 per plan year (there is no minimum election). You may use the money for eligible dependent care expenses such as daycare, preschool, summer day camp, before / after school programs (for children under age 13) or elder day care. You must pay into the plan and incur the expense before you can submit for reimbursement.

    FSA enrollment is effective on the first day of employment and you have 30 days from your first day of employment to enroll.  FSA’s allow you to set aside pre-tax deductions to help pay for eligible healthcare and/or dependent care expenses.  You will receive 2 Pro-Flex Payment Cards (debit cards) within one to two weeks of enrollment.  Both cards are in the employee’s name.  The plan year runs from July 1st – June 30th.   The deductions are bi-weekly and deducted from 20 paychecks.  This benefit requires that you re-enroll every year during the open enrollment period.  KEEP your Pro-Flex Payment Cards from one year to the next.  Your re-enrollment election will be loaded onto these cards as of July 1stYou will NOT receive new cards.

    FSA Forms:
    Pro-Flex Enrollment Form
    Pro-Flex Plan Summary
    Pro-Flex Claim Form
    Pro-Flex Direct Deposit FAQ’s
    Pro-Flex Direct Deposit Form
    Pro-Flex Letter of Medical Necessity

    Claims may be submitted until September 28, 2020 for expenses incurred before June 30, 2020.  You may use the FSA Claim Form to submit for reimbursement via:
    Fax: 716-929-2013 or toll free 1-855-214-8987
    Mail: Pro-Flex Administrators, LLC 8321 Main Street Williamsville, NY 14221

    Both plans offer a mobile app  and the Pro-Flex participant website to submit claims, upload receipts, review recent transactions, and check account balances and the status of claims.  Pro-Flex Website and Mobile App Access Information

    You may also contact Pro-Flex via:
    Phone: 1-855-847-9069 Monday – Friday, 8:30am to 5:00pm




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