EMPLOYEE REIMBURSEMENT ACCOUNT PROGRAM
The Employee Reimbursement Account Program (ERA) is an optional
benefit program that allows eligible employees to pay certain specific
expenses from their pre-tax income rather than their after-tax income.
The program has three components:
- A Medical Expense Reimbursement Account
- A Dependent Care Reimbursement Account
- Automatic Premium Conversion--An automatic conversion of your
share of the premiums for state group health, life (excluding
spouse and dependent life insurance costs), EPIC, Spectera and
State-sponsored dental insurance premiums.
How the ERA Program Works
- The program operates on a plan year basis. You must enroll
in the medical expense account and/or dependent care expense account
portion of the program each year before the plan year begins.
- The premiums you pay for State group health and life, EPIC,
Spectera and dental insurance are automatically deducted from
your paycheck tax free under the Automatic Premium Conversion
component, unless you have filed an ERA
Premium Conversion waiver form. You do not need to re-enroll
for premium conversion each year.
- All ERA contributions and eligible insurance premiums are deducted
from your paycheck before Federal, State, and Social Security
taxes are calculated on your remaining salary. Unlike other salary
reduction programs such as tax-sheltered annuities and deferred
compensation, the ERA program eliminates income taxes on these
amounts, rather than delaying tax liability.
- Once the plan year starts, your benefit election cannot be
cancelled or changed unless you experience a valid change in status
event.
- If you enroll during the open enrollment period, your period
of coverage begins on January 1. If you were hired or newly eligible
during the plan year, your period of coverage begins on the first
of the month that begins on or after the date that the enrollment
form is received by your employer.
- There is a grace period following the end of the Plan year during
which medical and/or dependent care expenses for services provided
through March 15 may be reimbursed using funds remaining in your
prior plan year’s account. However, any unused amounts from
the prior plan year that are not used for expenses incurred by
March 15 remain subject to the “use it or lose it”
rule and will be forfeited. The deadline (or run-out period) for
filing both medical expense and dependent care claims incurred
during the Plan year, including the grace period, is April 15.
If you terminate employment before the end of the year, coverage
will cease at the end of the month from which the last ERA deduction
was taken unless you make arrangements to continue coverage.
- Only expenses incurred during the plan year including the grace
period (or your period of coverage) will be reimbursed.
- As soon as you have incurred eligible expenses, you simply
submit your receipts, bills, or invoices, and any appropriate
supporting documentation, along with a completed Reimbursement
Request Form, to Fringe Benefit Management Company (FBMC), the
program administrator. FBMC has up to 5 business days from the
day it receives a properly completed reimbursement request form
and required documentation to process your request.
Who's Eligible to Participate
All full or part-time classified and unclassified state and UW
system employees are eligible to participate in the ERA program.
Participation of represented employees is covered by the terms of
their collective bargaining agreements. Employees who are classified
as fellows, scholars, and research assistants in the University
of Wisconsin System may not participate. Also excluded from participation
are limited term employees (LTEs), student hourlies, and other temporary
employees.
Eligible Expenses
To be eligible for reimbursement, all expenses must be incurred
during the current plan year. Reimbursement will not be made for
services performed either prior to or after the current plan year.
Costs incurred for medical services are reimbursable if the service
was performed primarily for the prevention or alleviation of a physical
or mental defect or illness.
Expenses for dependent day care that enable you and your spouse
to work, actively look for work or attend school full-time are reimbursable.
A qualified dependent can be a child under the age of 13 who resides
in your household, or an adult who is mentally or physically incapable
of self care and who regularly spends at least eight hours a day
in your household.
Eligible dependent day care expenses must be for the physical care
of the dependent, either inside or outside the home, and cannot
be provided by you, your spouse, or other dependent. If you are
married, your spouse must work, actively look for work, be a full-time
student, or be mentally or physically incapable of self care.
For more information about eligible expenses, refer to the ERA
enrollment booklet.
Change in Status
The IRS has very stringent rules regarding benefit changes during
the plan year. Should a valid Change in Status event occur and you
wish to change your annual election amount or start/terminate an
account, you must complete a Change
in Status form and submit it to FBMC within 30 days after the
qualifying event. Any proposed benefit change must be on account
of and consistent with the Change in Status event.
Your coverage or change in coverage will begin on the first of
the month that begins on or after the date that the enrollment form
is received and approved by FBMC and remain in effect until the
end of the calendar year. Only eligible expenses that are incurred
after this effective date and before the end of the plan year are
reimbursable.
Change in Status Events Chart
Who to Call
If you have questions/concerns about claims processing or the eligibility
of specific expenses for reimbursement, call or write Fringe Benefits
Management Company, the program administrator.
Fringe Benefits Management Company
P.O. Box 1878
Tallahassee, FL 32302-1878
Customer Service Department Phone: 1-800-342-8017
Customer Service Department e-mail: webscustomerservice@fbmc-benefits.com
TDD: 1-800-955-8771
You may call the Interactive Benefits Information Line 24 hours
a day at 1-800-865-FBMC to review your current benefit information
or request claim forms. You may access your personal account information
through the internet as well. Log on to www.fbmc-benefits.com,
then click on the "Account Information" link. Enter your
Social Security Number as your Employee Number and the last four
digits of your SSN as your temporary PIN. If you have already used
the internet or telephone line to enroll or check your benefits,
the PIN you chose there will be the PIN you use here.
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