Flexible Spending Accounts (FSA)

What is an FSA? How do they work? 

Watch the video given by our FSA Administrator, P&A Group. It explains about two kinds of FSAs we have: Healthcare FSA and Dependent Care Assistance FSA. The video also talks about when you can change your FSA choices outside of Open Enrollment, an example is when a daycare re-opens. It explains what kinds of expenses qualify for these FSAs.

Enroll in an FSA 

For information about enrolling in FSA and accessing your health benefit plans click here.

Flexible Spending Accounts (FSAs)

Employees of the City and County of San Francisco and the Superior Court of San Francisco can use a Flexible Spending Account (FSA) to save money on certain healthcare and dependent care expenses. With an FSA, you can save up to 40% by using pre-tax dollars. The FSA is managed by P&A Group, and they offer online tools and smartphone apps to help you easily submit expenses for reimbursement. You can learn more about how the FSA works by reading the brochure. You can sign up for an FSA during open enrollment or when you're a new employee. The money you choose to put into your FSA is taken out of your paycheck before taxes and put into your FSA account with the P&A Group. Then, you can submit receipts for qualifying expenses to get your money back.

You can choose to make contributions to a Healthcare FSA, a Dependent Care Assistance FSA, or both.

Healthcare Flexible Spending Accounts

A Healthcare FSA allows you to pay with pre-tax dollars for qualifying health care expenses for you and your eligible family members, including:

• Medical,
• Pharmacy,
• Dental and Vision co-pays,
• Chiropractic and Acupuncture care, 
• and more...

The CARES Act and Healthcare FSAs

The CARES Act expanded the list of eligible expenses you can spend your Healthcare FSA dollars on.

Eligible expenses now include over-the-counter medications that previously required a prescription as well as menstrual products. 

Click here for a list of eligible items for FSA reimbursement. Eligible items include PPE materials such as face masks, hand sanitizer, sanitizing wipes. 

These items can be purchased using you FSA debit card at most major retailers.  For an expanded list of eligible products please visit FSA Store. 

Dependent Care Assistance Flexible Spending Accounts 

A Dependent Care Assistance FSA allows you to pay for certified day care, pre-school and elder care needed by eligible children under age 13 or aging parents. Note: If you have a stay-at-home parent in your household, you are not eligible for a Dependent Care Assistance FSA.

• Beginning January 1, 2026, the maximum contribution you can set aside for your Dependent Care Flexible Spending Account (FSA) will be based on your annual salary to accommodate the higher allowable maximum and comply with the IRS Highly Compensated Employee (HCEs) requirements.
• The minimum Dependent Care FSA contribution is $250 for all employees.
• Employees who gross more than $160,000, annually, are deemed to be Highly Compensated Employees (HCEs). The maximum contribution for a Dependent Care FSA, by HCEs, will be $3,000.
• For employees who gross less than or equal to $160,000 annually, the maximum contribution for Dependent Care FSA will be $7,500.

Healthcare FSAs: 

• You may set aside up to $3,300 on a pre-tax basis for your 2026 Healthcare FSA account.
• The new carryover amount for 2026 funds will be a minimum of $10 and a maximum of $660 into the 2027 plan year.

Per IRS rules, you forfeit all funds remaining in an FSA by the end of the claim filing period unless covered by the Healthcare FSA Carryover provision. 

What Kind of Deductions are Eligible for FSA Reimbursement?
P&A Group has a list of deductions that qualify for FSA reimbursement here. 

After You Enroll
After you are enrolled, there are four ways to submit an FSA claim to P&A Group:

• Benefits debit card. This allows you to swipe a card at the point-of-service. The qualifying expense will be deducted from your Flexible Spending Account balance. Use this form to request an FSA debit card.
   
• Submit a claim from your smartphone. Take a picture of the receipt or other supporting documentation. Go to the P&A website on your smartphone. Log into your P&A Account and select upload.
   
• Submit a claim from your desktop computer. Scanning a receipt or other documentation. Log into your P&A Group account and select upload.
   
• Submit a paper claim. Download and complete the Claim Form below. Send to P&A Group, along with required documentation for your eligible expense.
   
• Toll-free fax: (877) 855-7105
   
• Mailing address: P&A Group, 17 Court Street, Suite 500 Buffalo, NY 14202

Consult with your tax advisor or the IRS about your specific situation and your potential tax savings with an FSA. View IRS Publication 502 for information about the Healthcare FSA, and IRS Publication 503 for details about the Dependent Care Assistance FSA.

In some cases, due to certain qualifying events, a member may be allowed to initiate or modify FSA contributions during the plan year. A maximum of two benefit election changes due to qualifying events may be made per year. Contact SFHSS Member Services at (628) 652-4700 if you have questions about an FSA and a qualifying event.

FSA Administrator: P&A Group

Questions?
P&A Group administers FSA's on behalf of SFHSS, including processing reimbursement forms. P&A Group's mailing address is: P&A Group, 17 Court Street, Suite 500 Buffalo, NY 14202 and their toll-free fax number is (877) 855-7105. Contact P&A Group by visiting padmin.com or calling (800) 688-2611.