Flexible Spending Accounts (FSA)

FSA’s allow you to set aside pre-tax deductions to help pay for eligible healthcare and/or dependent care expenses.  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 $3,200 per plan year for FY25 (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 $610 from one plan year to the next (effective with FY25 enrollment).

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 the month following your first day of employment and you have 10 days from your first day of employment to enroll.  Please complete and return the enrollment form to the Benefit Specialist.  You will receive 2 Pro-Flex Payment Cards (debit cards) within one to two weeks of enrollment.  Both cards will be 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 1st.  You will NOT receive new cards.

FSA Forms:
Pro-Flex Enrollment Form 
Pro-Flex Plan Summary
Eligible Health Care FSA Products
Pro-Flex General 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, 2024 for expenses incurred before June 30, 2024.
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
Email: csr@proflextpa.com

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
Email: csr@proflextpa.com