Flexible Spending Accounts (FSA)

What is an FSA? How do they work? 

Watch the video below, provided by our FSA Administrator, P&G Group. It provides a detailed overview of both FSAs that we offer: Healthcare FSA and Dependent Care Assistance FSA.  

The video also reviews what events qualify members to make changes to their existing FSA elections outside of Open Enrollment (e.g. when a daycare center re-opens) and describes what qualifying expenses are.

Enroll in an FSA 

If you would like to enroll in an FSA, go to the MyApps Dashboard. Navigate to eBenefits under the Employee Links tab.

For information about eBenefits click here.


Flexible Spending Accounts (FSAs)

With a Flexible Spending Account (FSA), City and County of San Francisco and Superior Court of San Francisco employees can save up to 40% paying pre-tax for qualified out-of-pocket health care and dependent care expenses. FSA administrator P&A Group provides tools that allow you to submit reimbursements online or with a smartphone. It is easier than ever to make the most of your FSA account. Read the FSA brochure for details.

You can sign up for an FSA during open enrollment or as a new hire. The amount you request is deducted from each paycheck before taxes, and placed in your P&A Group FSA account. You then submit receipts to P&A Group for qualifying expenses, to receive your reimbursement.

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, dental and vision co-pays,
  • massage,
  • chiropractic, and
  • acupuncture

The CARES Act and Healthcare FSAs

The CARES Act passed in March of 2020 and 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 Child Care Dependent Care FSA.

Health Service Board Approved Changes to FSA

June 10, 2021 Board Approval

On June 10, 2021, the Health Service Board approved changes to provide additional relief to Members currently enrolled in Flexible Spending Accounts (FSAs). 

Dependent Care Assistance FSAs
Employees who earned $130,000 or less with the City and County of San Francisco (CCSF) in 2020 can now newly enroll or increase their pre-tax Dependent Care Assistance contributions up to $10,500 per household for the 2021 tax year (or $5,250 each if you are married filing separate tax returns). CCSF employees earning more than $130,000 in 2020 with the City will continue to have a $5,000 pre-tax limit. 

This exception only applies to the current 2021 plan year and will expire on December 31, 2021.

Any left over funds that are not reimbursed will be forfeited per IRS Rules. You can learn more about Dependent Care Assistance FSAs in this helpful P&A Group handout.

Healthcare FSAs: 

Members who had an unclaimed balance in 2020 can now use the remaining balance for 2021 claims.  Previously, the maximum carryover from 2020 to 2021 was $550, but as of June 10, the entire unused balance will carryover. This exception only applies through the end of the year and will expire on December 31, 2021. Carryovers from 2019 to 2020 are not included in this exception.

January 14, 2021 Board Approval

On January 14, 2021, the Health Service Board approved the following three changes to Dependent Care Assistance FSAs for plan year 2021:

1. All eligible employees can make the following changes to their 2021 Dependent Care Assistance FSA once without a qualifying event: i. Revoke their existing election; ii) Make a new election; iii) Increase or decrease an existing election. Please note the decrease cannot be less than the amount of your reimbursed claims.

2. Eligible children for whom expenses can be incurred has increased to 14 years of age (as long as the child reached the maximum age of 13 during the 2020 plan year).

3) Any unused amounts from from your 2020 Dependent Care Assistance FSA will automatically be carried over into plan year 2021 and may be used to pay or reimburse eligible dependent care expenses that are incurred in 2021. 

How Much Should I Set Aside for my FSA?

Before enrolling in an FSA make sure to work out a detailed estimate of the eligible expenses you are likely to incur for the plan year ahead. Budget conservatively. 

Based on federal law, you may roll forward from $10 up to $550 in unused funds year-over-year for Healthcare FSAs. Any unreimbursed funds from Healthcare FSAs in excess of $550 are forfeited at the end of the plan year and cannot be returned to you.

For Dependent Care Assistance FSAs, you may roll forward unused amounts from the 2020 play year into 2021. The carryover option for Dependent Care Assistance FSAs will expire on December 31, 2021.


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.